Symptomatic and neurophysiological responses of paclitaxel- or cisplatin-induced neuropathy to oral acetyl-L-carnitine.
Acetyl-L-carnitine (ALC) improves non-oncological neuropathies. We tested oral ALC (1 g tid) for 8 weeks in 25 patients with neuropathy grade 3 (common toxicity criteria--CTC) during paclitaxel or cisplatin therapy, or grade 2 persisting for at least three months after discontinuing the drugs. An independent neurologist assessed patients before and after ALC. All patients except one reported symptomatic relief, and only two described grade 1 nausea. The sensory neuropathy grade improved in 15 of 25 (60%), and motor neuropathy in 11 of 14 patients (79%). Total neuropathy score (TNS) that included neurophysiological measures improved in 23 (92%). Amelioration of sensory amplitude and conduction velocity (sural and peroneal nerves) was measured in 22 and 21 patients, respectively. Symptomatic improvement persisted in 12 of 13 evaluable patients at median 13 months after ALC. In view of its effect in improving established paclitaxel- and cisplatin-neuropathy, we recommend ALC testing in preventing progression or revert symptoms during neurotoxic chemotherapy.
Bianchi
Giulia
G
Medical Oncology A, Istituto Nazionale per lo Studio e la Cura dei Tumori, Via Venezian 1, 20133 Milan, Italy.
Vitali
Giordano
G
Caraceni
Augusto
A
Ravaglia
Sabrina
S
Capri
Giuseppe
G
Cundari
Sante
S
Zanna
Claudio
C
Gianni
Luca
L
D000108:Acetylcarnitine / Q000008:administration & dosage*; D000200:Action Potentials / Q000187:drug effects; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000187:drug effects; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000517:prevention & control; D009475:Neurons, Afferent / Q000187:drug effects; D017239:Paclitaxel / Q000009:adverse effects*; D011930:Reaction Time / Q000187:drug effects
D000970:Antineoplastic Agents; D000108:Acetylcarnitine; D017239:Paclitaxel; D002945:Cisplatin