THE ASSESSMENT OF THE EFFICIENCY OF ALPHA-LIPOIC ACID AND IPIDACRINE HYDROCHLORIDE TREATMENT IN THE PREVENTION OF PACLITAXEL-INDUCED PERIPHERAL NEUROPATHY BASED ON THE PATIENT NEUROTOXICITY QUESTIONNAIRE
DOI:
https://doi.org/10.32471/oncology.2663-7928.t-24-2-2022-g.10522Keywords:
acetylcholinesterase inhibitors, alpha-lipoic acid, chemotherapy, neuropathy, Paclitaxel, patient neurotoxicity questionnaireAbstract
Aim: to evaluate the efficiency of the combination of alpha-lipoic acid and acetylcholinesterase inhibitor ipidacrine hydrochloride in the prevention of the development of paclitaxel-induced peripheral neuropathy and improvment of its course in breast cancer patients using the data of the Patient Neurotoxicity Questionnaire. Object and Methods: 70 patients with breast cancer (T1–4N0–3M0–1) who underwent chemotherapy with the AT regimen (paclitaxel, doxorubicin) or ET regimen (paclitaxel, epirubicin) in neoadjuvant, adjuvant or palliative mode were randomized into two groups. The first group (n = 35) received the chemotherapy alone while the second group (n = 35) received the chemotherapy plus the treatment for prevention of neuropathy (alpha-lipoic acid in combination with ipidacrine hydrochloride). The patients completed the Patient Neurotoxicity Questionnaire before the chemotherapy and after the 3rd and the 6th cycles of paclitaxel polychemotherapy. Results: the paclitaxel-based polychemotherapy braught about sensory and motor peripheral neuropathy of the upper and/or lower extremities in the patients which progressed with increasing cumulative dose. Sensory peripheral neuropathy at higher severity levels affected the normal daily activities of the patients. First of all, those daily activities that require fine motor skills were disrupted in the patients with paclitaxel-induced peripheral neuropathy. Comparing the study groups, statistically significant improvements, according to the responses, were found in patients’ group II (who recived studied scheme of prevention of paclitaxel-induced peripheral neuropathy) as to the symptoms of sensory peripheral neuropathy, both after 3 and after 6 cycles of paclitaxel chemotherapy. In particular, in group II, in contrast to group I, neurosensory symptoms significantly improved by 18.95% (p<0.05) and 31.42% (p<0.01) respectively after 3 and 6 cycles of the chemotherapy with paclitaxel. However, there was not observed a statistically significant improvement in motor peripheral neuropathy symptoms in group II patients both after 3 and after 6 cycles of chemotherapy. Conclusion: the use of alpha-lipoic acid in combination with acetylcholinesterase inhibitor ipidacrine hydrochloride improves the course of paclitaxel-induced sensory peripheral neuropathy.
References
Kudlowitz D, Muggia F. Defining risks of taxane neuropathy: insights from randomized clinical trials. Clin Cancer Res 2013; 19 (17): 4570–7. doi: 10.1158/1078-0432.CCR-13-0572.
Klein I, Lehmann HC. Pathomechanisms of paclitaxel-induced peripheral neuropathy. Toxics 2021; 9 (10): 229. doi: 10.3390/toxics9100229.
Park SB, Kwok JB, Loy CT, et al. Paclitaxel-induced neuropathy: potential association of MAPT and GSK3B genotypes. BMC Cancer 2014; 14: 993. doi: 10.1186/1471-2407-14-993.
Hershman DL, Unger JM, Crew KD, et al. Two-year trends of taxane-induced neuropathy in women enrolled in a randomized trial of acetyl-L-carnitine (SWOG S0715). J Natl Cancer Inst 2018; 110 (6): 669–76. doi: 10.1093/jnci/djx259.
Colvin LA. Chemotherapy-induced peripheral neuropathy: where are we now? Pain 2019; 160: 1–10. doi: 10.1097/j.pain.0000000000001540.
Zhang H, Dougherty PM. Enhanced excitability of primary sensory neurons and altered gene expression of neuronal ion channels in dorsal root ganglion in paclitaxel-induced peripheral neuropathy. Anesthesiology 2014; 120 (6): 1463–75. doi: 10.1097/ALN.0000000000000176.
Freilich RJ, Balmaceda C, Seidman AD, et al. Motor neuropathy due to docetaxel and paclitaxel. Neurology 1996; 47 (1): 115–8. doi: 10.1212/wnl.47.1.115.
Hershman DL, Unger JM, Crew KD, et al. Randomized double-blind placebo-controlled trial of acetyl-L-carnitine for the prevention of taxane-induced neuropathy in women undergoing adjuvant breast cancer therapy. J Clin Oncol 2013; 31 (20): 2627–33. doi: 10.1200/JCO.2012.44.8738.
Hershman DL, Lacchetti C, Dworkin RH, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 2014; 32 (18): 1941–67. doi: 10.1200/JCO.2013.54.0914.
Bachegowda LS, Makower DF, Sparano JA. Taxanes: impact on breast cancer therapy. Anticancer Drugs 2014; 25 (5): 512–21. doi: 10.1097/CAD.0000000000000090.
Hausheer FH, Schilsky RL, Bain S, et al. Diagnosis, management, and evaluation of chemotherapy-induced peripheral neuropathy. Semin Oncol 2006; 33 (1): 15–49. doi: 10.1053/j.seminoncol.2005.12.010.
Shimozuma K, Ohashi Y, Takeuchi A, et al. Taxane-induced peripheral neuropathy and health-related quality of life in postoperative breast cancer patients undergoing adjuvant chemotherapy: N-SAS BC 02, a randomized clinical trial. Support Care Cancer 2012; 20: 3356–64. doi: 10.1007/s00520-012-1492-x.
Hong JS, Tian J, Wu LH. The influence of chemotherapy-induced neurotoxicity on psychological distress and sleep disturbance in cancer patients. Curr Oncol 2014; 21 (4): 174–80. doi: 10.3747/co.21.1984.
Cavaletti G, Frigeni B, Lanzani F, et al. Chemotherapy-induced peripheral neurotoxicity assessment: a critical revision of the currently available tools. Eur J Cancer 2010; 46 (3): 479–94. doi: 10.1016/j.ejca.2009.12.008.
Griffith KA, Merkies ISJ, Hill EE, et al. Measures of chemotherapy-induced peripheral neuropathy: a systematic review of psychometric properties. J Peripher Nerv Syst 2010; 15 (4): 314–25. doi: 10.1111/j.1529-8027.2010.00292.x.
Cirillo M, Venturini M, Ciccarelli L, et al. Clinician versus nurse symptom reporting using the National Cancer Institute-Common Terminology Criteria for Adverse Events during chemotherapy: results of a comparison based on patient’s self-reported questionnaire. Ann Oncol 2009; 20 (12): 1929–35. doi: 10.1093/annonc/mdp287.
Morton RF, Sloan JA, Grothey A, et al. A comparison of simple single-item measures and the common toxicity criteria in detecting the onset of oxaliplatin-induced peripheral neuropathy in patients with colorectal cancer. J Сlin Oncol 2005; 23 (16): 8087.
Sasane M, Tencer T, French A, et al. Patient-reported outcomes in chemotherapy-induced peripheral neuropathy: a review. J Support Oncol 2010; 8: 15–21.
Gedlicka C, Kornek GV, Schmid K, et al. Amelioration of docetaxel/cisplatin induced polyneuropathy by alpha-lipoic acid. Ann Oncol 2003; 14 (2): 339–40. doi: 10.1093/annonc/mdg051.
Melli G, Taiana M, Camozzi F, et al. Alpha-lipoic acid prevents mitochondrial damage and neurotoxicity in experimental chemotherapy neuropathy. Exp Neurol 2008; 214 (2): 276–84. doi: 10.1016/j.expneurol.2008.08.013.
Schloss J, Colosimo M, Vitetta L. New insights into potential prevention and management options for chemotherapy-induced peripheral neuropathy. Asia Pac J Oncol Nurs 2016; 3 (1): 73–85. doi: 10.4103/2347-5625.170977.
Kyte SL, Toma W, Bagdas D, et al. Nicotine prevents and reverses paclitaxel-induced mechanical allodynia in a mouse model of CIPN. J Pharmacol Exp Ther 2018; 364(1): 110–9. doi: 10.1124/jpet.117.243972.
Toma W, Kyte SL, Bagdas D, et al. The α7 nicotinic receptor silent agonist R-47 prevents and reverses paclitaxel-induced peripheral neuropathy in mice without tolerance or altering nicotine reward and withdrawal. Exp Neurol 2019; 320: 113010. doi: 10.1016/j.expneurol.2019.113010.
Ishii N, Tsubouchi H, Miura A, et al. Ghrelin alleviates paclitaxel-induced peripheral neuropathy by reducing oxidative stress and enhancing mitochondrial anti-oxidant functions in mice. Eur J Pharmacol 2018; 819: 35–42. doi: 10.1016/j.ejphar.2017.11.024.
Holotiuk IS, Kryzhanivska AY, Holotiuk SI, et al. Evaluation of the efficiency of alpha-lipoic acid and ipidacrine hydrochloride for the prevention of paclitaxel-induced peripheral neuropathy according to the Total Neuropathy Score. Exp Oncol 2022; 44 (1): 75–82. doi: 10.32471/exp-oncology.2312-8852.vol-44-no-1.17257.
