Omega-3 fatty acids are protective against paclitaxel-induced peripheral neuropathy: A randomized double-blind placebo controlled trial

Zohreh Ghoreishi,Mohammad Asghari Jafarabadi,Ali Esfahani,Masoud Darabi,Mahmoud Djalali,Hormoz Ayromlou,Shahriar Hashemzade,Vahid Montazeri,Abolghasem Djazayeri,Banafsheh Golestan,Seyed Ali Keshavarz

doi:10.1186/1471-2407-12-355

Zohreh Ghoreishi, Mohammad Asghari Jafarabadi + Show 9 more

Open Access

https://doi.org/10.1186/1471-2407-12-355

Copy DOI

Abstract

BackgroundAxonal sensory peripheral neuropathy is the major dose-limiting side effect of paclitaxel.Omega-3 fatty acids have beneficial effects on neurological disorders from their effects on neurons cells and inhibition of the formation of proinflammatory cytokines involved in peripheral neuropathy.MethodsThis study was a randomized double blind placebo controlled trial to investigate the efficacy of omega-3 fatty acids in reducing incidence and severity of paclitaxel-induced peripheral neuropathy (PIPN). Eligible patients with breast cancer randomly assigned to take omega-3 fatty acid pearls, 640 mg t.i.d during chemotherapy with paclitaxel and one month after the end of the treatment or placebo. Clinical and electrophysiological studies were performed before the onset of chemotherapy and one month after cessation of therapy to evaluate PIPN based on "reduced Total Neuropathy Score".ResultsTwenty one patients (70%) of the group taking omega-3 fatty acid supplement (n = 30) did not develop PN while it was 40.7%( 11 patients) in the placebo group(n = 27). A significant difference was seen in PN incidence (OR = 0.3, .95% CI = (0.10-0.88), p = 0.029). There was a non-significant trend for differences of PIPN severity between the two study groups but the frequencies of PN in all scoring categories were higher in the placebo group (0.95% CI = (−2.06 -0.02), p = 0.054).ConclusionsOmega-3 fatty acids may be an efficient neuroprotective agent for prophylaxis against PIPN. Patients with breast cancer have a longer disease free survival rate with the aid of therapeutical agents. Finding a way to solve the disabling effects of PIPN would significantly improve the patients’ quality of life.Trial registrationThis trial was registered at ClinicalTrials.gov (NCT01049295)

Highlights

Axonal sensory peripheral neuropathy is the major dose-limiting side effect of paclitaxel.Omega-3 fatty acids have beneficial effects on neurological disorders from their effects on neurons cells and inhibition of the formation of proinflammatory cytokines involved in peripheral neuropathy
Our results showed that omega-3 fatty acids prevented the significant decrease of sural nerve amplitude measurement of sensory action potentials (a-SAP) in group I that it may be related to their ability of peripheral neuropathy (PIPN) reduction in this group
Conclusions the survival rate of breast cancer patients improved by significant advances in treatment strategies, disabling and dose-limiting peripheral neuropathy due to chemotherapy with paclitaxel decreases the patients’ quality of life and sometimes forces the oncologist to change or even end the treatment [18]

Summary

Introduction

Axonal sensory peripheral neuropathy is the major dose-limiting side effect of paclitaxel.Omega-3 fatty acids have beneficial effects on neurological disorders from their effects on neurons cells and inhibition of the formation of proinflammatory cytokines involved in peripheral neuropathy. Paclitaxel is one of the taxane-derived chemotherapeutic agents used for treatment of solid tumors including those of the breast, ovary, lung, and Kaposi’s sarcoma. It was originated from the Pacific yew Taxus brevifolia. Paclitaxel-induced peripheral neuropathy (PIPN) is the major dose-limiting side effect of paclitaxel [2]. Paclitaxel induces an axonal sensory peripheral neuropathy (PN) as a result of aggregation of microtubules in axons and Schwann cells. It may cause fiber demyelination in some severs cases [1]

Methods

Results

Discussion

Conclusion