title: Long-term glutamate supplementation failed to protect against peripheral neurotoxicity of paclitaxel.
abstract: Toxic peripheral neuropathy is still a significant limiting factor for chemotherapy with paclitaxel (PAC), although glutamate and its closely related amino acid glutamine were claimed to ameliorate PAC neurotoxicity. This pilot trial aimed to evaluate the role of glutamate supplementation for preventing PAC-induced peripheral neuropathy in a randomized, placebo-controlled, double-blinded clinical and electro-diagnostic study. Forty-three ovarian cancer patients were available for analysis following six cycles of the same PAC-containing regimen: 23 had been supplemented by glutamate all along the treatment period, at a daily dose of three times 500 mg (group G), and 20 had received a placebo (group P). Patients were evaluated by neurological examinations, questionnaires and sensory-motor nerve conduction studies. There was no significant difference in the frequency of signs or symptoms between the two groups although neurotoxicity symptoms presented mostly with lower scores of severity in group G. However, this difference reached statistical significance only with regard to reported pain sensation (P = 0.011). Also the frequency of abnormal electro-diagnostic findings showed similarity between the two groups (G: 7/23 = 30.4%; P: 6/20 = 30%). This pilot study leads to the conclusion that glutamate supplementation at the chosen regimen fails to protect against peripheral neurotoxicity of PAC.
authors.affiliation: Department of Oncology, Rappaport School of Medicine, Ha'Emek Medical Center, Afula, Israel. loven_da@clalit.org.il
authors.forename: D
authors.initials: D
authors.lastname: Loven
authors.forename: H
authors.initials: H
authors.lastname: Levavi
authors.forename: G
authors.initials: G
authors.lastname: Sabach
authors.forename: R
authors.initials: R
authors.lastname: Zart
authors.forename: M
authors.initials: M
authors.lastname: Andras
authors.forename: A
authors.initials: A
authors.lastname: Fishman
authors.forename: Y
authors.initials: Y
authors.lastname: Karmon
authors.forename: T
authors.initials: T
authors.lastname: Levi
authors.forename: R
authors.initials: R
authors.lastname: Dabby
authors.forename: N
authors.initials: N
authors.lastname: Gadoth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D018698:Glutamic Acid / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000517:prevention & control*; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000009:adverse effects* / Q000627:therapeutic use; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D018698:Glutamic Acid; D017239:Paclitaxel