Methylphenidate in the management of asthenia in breast cancer patients treated with docetaxel: results of a pilot study.
BACKGROUND
The objectives of this pilot study were to evaluate the safety and efficacy of the central nervous system stimulant methylphenidate in the management of asthenia in breast cancer patients treated with docetaxel.


METHODS
Patients with early breast cancer who presented asthenia >3 on the Visual Analogue Scale (VAS) after the first cycle of docetaxel-based chemotherapy were included. Patients received two additional cycles of chemotherapy, one with methylphenidate (10 mg bid) and the other without methylphenidate. Asthenia was evaluated using VAS and the Functional Assessment of Cancer Therapy-Fatigue (FACT-F) scale. Distress was assessed using the Hospital Anxiety and Depression Scale (HADS), and quality of life using FACT-F.


RESULTS
Ten patients were included and evaluated for efficacy and safety. Overall, cycles with methylphenidate were better tolerated than those without methylphenidate in terms of asthenia (VAS, p = 0.004; FACT-F, p = 0.027) and quality of life (FACT-F, p = 0.047). No significant differences were observed in terms of distress (HADS, p = 0.297). Six (60%) patients continued with methylphenidate after study end. Main adverse events during study were palpitations and insomnia (30% of patients each).


CONCLUSIONS
This pilot study suggests that methylphenidate may reduce asthenia and improve quality of life in breast cancer patients treated with docetaxel.
Cueva
Juan F
JF
Medical Oncology Service, Complejo Hospitalario Universitario Santiago de Compostela, 15706 Santiago de Compostela, Spain. juancueva@telefonica.net
Calvo
Marcos
M
Anido
Urbano
U
León
Luis
L
Gallardo
Elena
E
Areses
Carmen
C
Bernárdez
Beatriz
B
Gayoso
Lucía
L
García
Jorge
J
Jesús Lamas
María
M
Curiel
Teresa
T
Vázquez
Francisca
F
Candamio
Sonia
S
Vidal
Yolanda
Y
Javier Barón
Francisco
F
López
Rafael
R
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001247:Asthenia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D018592:Cross-Over Studies; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008774:Methylphenidate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013030:Spain; D011795:Surveys and Questionnaires; D043823:Taxoids / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D043823:Taxoids; D000077143:Docetaxel; D008774:Methylphenidate