Oral alpha-lipoic acid to prevent chemotherapy-induced peripheral neuropathy: a randomized, double-blind, placebo-controlled trial

Abstract

Objectives Chemotherapy-induced peripheral neuropathy is frequently a dose-limiting factor in cancer treatment and may cause pain and irreversible function loss in cancer survivors. We tested whether alpha-lipoic acid (ALA) could decrease the severity of peripheral neuropathy symptoms in patients undergoing platinum-based chemotherapy. Methods Cancer patients 18 years or older were randomly selected to receive either 600 mg ALA or a placebo three times a day orally for 24 weeks while receiving chemotherapy regimens including cisplatin or oxaliplatin. Neuropathy was measured by the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-Ntx) scale and the NCI Common Toxicity Criteria for Adverse Events neurotoxicity grades. Results from timed functional tests and the Brief Pain Inventory (BPI) were secondary endpoints. Results 70 of 243 (29%) patients completed the study (24 weeks). Both the ALA and the placebo arms had a comparable drop-out rate. No statistically significant differences were found between the ALA and the placebo groups for FACT/GOG-Ntx scores, BPI scores, and patients’ functional outcomes.. Conclusion This strategy of oral ALA administration was ineffective at preventing neurotoxicity caused by oxaliplatin or cisplatin. High attrition rates due to poor patient compliance and manner of dosage administration in this trial demonstrated a lack of feasibility for this intervention. Future studies to explore ALA as a neuroprotective agent should take heed of the barriers confronted in this study.

Chemotherapy-induced peripheral neuropathy in the adult

“…Neuropathy was measured by the Functional Assessment of Cancer Therapy/ Gynecologic Oncology Group-Neurotoxicity scale and the NCI-CTC for adverse events neurotoxicity grades. No statistically significant differences were found between the ALA and the placebo groups [49].…”

Effects and mechanism of lipoic acid on beta-amyloid-intoxicated C6 glioma cells

“…LA, a powerful antioxidant, can inhibit the generation of oxygen free radicals and thus can regulate GSH. This suggested that LA might have certain protective effects against diseases induced by oxygen free radicals (Bhadri et al, 2013;Guo et al, 2014;Patel et al, 2014). Our study demonstrated that Aβ peptides could significantly inhibit the proliferation of C6 cells, while LA could reverse the inhibition effect of Aβ and promote the recovery of cell viability.…”

Efficacy and Interaction of Antioxidant Supplements as Adjuvant Therapy in Cancer Treatment

“…71 Similarly, the effect of α-lipoic acid on chemotherapy-induced peripheral neuropathy has been investigated. 72 The neuroprotective mechanism of α-lipoic acid is related to the reduction of oxidative stress from free-radical formation. It also has a protective effect during chemotherapy via the regulation of proinflammatory cytokines.…”

“…It also has a protective effect during chemotherapy via the regulation of proinflammatory cytokines. 73 Guo et al 72 conducted a double-blind, placebo-controlled trial for patients undergoing platinum-based chemotherapy. Although only 28% of patients in the supplementation group and 30% in the placebo group completed this trial, they reported no significant effects in regard to the tumor reduction rate, activities of daily living, or chemotherapy-induced toxicity such as neurotoxicity and pain.…”