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01-11-2017 | Original Article

A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I

Authors: Deirdre R. Pachman, Travis Dockter, Patricia J. Zekan, Briant Fruth, Kathryn J. Ruddy, Lauren E. Ta, Jacqueline M. Lafky, Todor Dentchev, Nguyet Anh Le-Lindqwister, William M. Sikov, Nathan Staff, Andreas S. Beutler, Charles L. Loprinzi

Published in: Supportive Care in Cancer | Issue 11/2017

Abstract

Purpose

Paclitaxel is associated with both an acute pain syndrome (P-APS) and chronic chemotherapy-induced peripheral neuropathy (CIPN). Given that extensive animal data suggest that minocycline may prevent chemotherapy-induced neurotoxicity, the purpose of this pilot study was to investigate the efficacy of minocycline for the prevention of CIPN and the P-APS.

Methods

Patients with breast cancer were enrolled prior to initiating neoadjuvant or adjuvant weekly paclitaxel for 12 weeks and were randomized to receive minocycline 200 mg on day 1 followed by 100 mg twice daily or a matching placebo. Patients completed (1) an acute pain syndrome questionnaire daily during chemotherapy to measure P-APS and (2) the EORTC QLQ-CIPN20 questionnaire at baseline, prior to each dose of paclitaxel, and monthly for 6 months post treatment, to measure CIPN.

Results

Forty-seven patients were randomized. There were no remarkable differences noted between the minocycline and placebo groups for the overall sensory neuropathy score of the EORTC QLQ-CIPN20 or its individual components, which evaluate tingling, numbness and shooting/burning pain in hands and feet. However, patients taking minocycline had a significant reduction in the daily average pain score attributed to P-APS (p = 0.02). Not only were no increased toxicities reported with minocycline, but there was a significant reduction in fatigue (p = 0.02).

Conclusions

Results of this pilot study do not support the use of minocycline to prevent CIPN, but suggest that it may reduce P-APS and decrease fatigue; further study of the impact of this agent on those endpoints may be warranted.

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Title: A pilot study of minocycline for the prevention of paclitaxel-associated neuropathy: ACCRU study RU221408I
Authors: Deirdre R. Pachman
Travis Dockter
Patricia J. Zekan
Briant Fruth
Kathryn J. Ruddy
Lauren E. Ta
Jacqueline M. Lafky
Todor Dentchev
Nguyet Anh Le-Lindqwister
William M. Sikov
Nathan Staff
Andreas S. Beutler
Charles L. Loprinzi
Publication date: 01-11-2017
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 11/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3760-2

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Abstract

Purpose

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Conclusions

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