Evaluation of the effect of N-acetylcysteine on the prevention and amelioration of paclitaxel-induced peripheral neuropathy in breast cancer patients: a randomized controlled study

Khalefa, Hadeer G.; Shawki, May Ahmed; Aboelhassan, Rasha; Wakeel, Lamia Mohamed El

doi:10.1007/s10549-020-05762-8

Cited by 33 publications

(25 citation statements)

References 31 publications

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“…Administration of several antioxidants decreased or prevented these effects and helped pinpoint the potential role of antioxidants as drugs that may be able to reduce both oxidative stress and cognitive dysfunction caused by chemotherapy. Some recent trials performed in cancer patients suggested that N-acetylcysteine at doses of 1200 mg or 2400 mg/daily counteracted oxidative stress (expressed as an increase in serum malondialdehyde levels) and improved the incidence of peripheral neuropathy induced by paclitaxel [106]. Because N-acetylcysteine can also cross the blood-brain barrier [107,108], it may be a useful means of protection from the cognitive impairment induced by paclitaxel or taxanes, and perhaps by other chemotherapy drugs as well.…”

Section: Discussionmentioning

confidence: 99%

Oxidative Stress and Cognitive Alterations Induced by Cancer Chemotherapy Drugs: A Scoping Review

Cauli

2021

Antioxidants

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Cognitive impairment is one of the most deleterious effects of chemotherapy treatment in cancer patients, and this problem sometimes remains even after chemotherapy ends. Common classes of chemotherapy-based regimens such as anthracyclines, taxanes, and platinum derivatives can induce both oxidative stress in the blood and in the brain, and these effects can be reproduced in neuronal and glia cell cultures. In rodent models, both the acute and repeated administration of doxorubicin or adriamycin (anthracyclines) or cisplatin impairs cognitive functions, as shown by their diminished performance in different learning and memory behavioural tasks. Administration of compounds with strong antioxidant effects such as N-acetylcysteine, gamma-glutamyl cysteine ethyl ester, polydatin, caffeic acid phenethyl ester, and 2-mercaptoethane sulfonate sodium (MESNA) counteract both oxidative stress and cognitive alterations induced by chemotherapeutic drugs. These antioxidant molecules provide the scientific basis to design clinical trials in patients with the aim of reducing the oxidative stress and cognitive alterations, among other probable central nervous system changes, elicited by chemotherapy in cancer patients. In particular, N-acetylcysteine and MESNA are currently used in clinical settings and are therefore attracting scientific attention.

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Section: Discussionmentioning

confidence: 99%

Oxidative Stress and Cognitive Alterations Induced by Cancer Chemotherapy Drugs: A Scoping Review

Cauli

2021

Antioxidants

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“…As seen above, there is benefit with NAC in diabetic neuropathy, and there is evidence that NAC at 1200 or 2400 mg daily may reduce the incidence and severity of paclitaxel-induced peripheral neuropathy in chemotherapy treatment [ 116 ].…”

Section: Neurodegenerative Disordersmentioning

confidence: 99%

N-Acetylcysteine: A Review of Clinical Usefulness (an Old Drug with New Tricks)

Schwalfenberg

2021

Journal of Nutrition and Metabolism

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Objective. To review the clinical usefulness of N-acetylcysteine (NAC) as treatment or adjunctive therapy in a number of medical conditions. Use in Tylenol overdose, cystic fibrosis, and chronic obstructive lung disease has been well documented, but there is emerging evidence many other conditions would benefit from this safe, simple, and inexpensive intervention. Quality of Evidence. PubMed, several books, and conference proceedings were searched for articles on NAC and health conditions listed above reviewing supportive evidence. This study uses a traditional integrated review format, and clinically relevant information is assessed using the American Family Physician Evidence-Based Medicine Toolkit. A table summarizing the potential mechanisms of action for N-acetylcysteine in these conditions is presented. Main Message. N-acetylcysteine may be useful as an adjuvant in treating various medical conditions, especially chronic diseases. These conditions include polycystic ovary disease, male infertility, sleep apnea, acquired immune deficiency syndrome, influenza, parkinsonism, multiple sclerosis, peripheral neuropathy, stroke outcomes, diabetic neuropathy, Crohn’s disease, ulcerative colitis, schizophrenia, bipolar illness, and obsessive compulsive disorder; it can also be useful as a chelator for heavy metals and nanoparticles. There are also a number of other conditions that may show benefit; however, the evidence is not as robust. Conclusion. The use of N-acetylcysteine should be considered in a number of conditions as our population ages and levels of glutathione drop. Supplementation may contribute to reducing morbidity and mortality in some chronic conditions as outlined in the article.

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“…To evaluate the presence of neuropathy, 11 studies used validated questionnaires based on self-reported symptoms (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18). Seven studies used objective measures such as nerve conduction studies, electrophysiological studies, sensory testing, or balance scores (19)(20)(21)(22)(23)(24)(25).…”

Section: Search Strategy Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy

et al. 2022

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BackgroundPaclitaxel-induced peripheral neuropathy (PIPN) is a disabling side effect of paclitaxel with few effective preventive strategies. We aim to determine the efficacy of pharmacological and non-pharmacological neuroprotective interventions in preventing PIPN incidence.MethodsBiomedical literature databases were searched from years 2000 to 2021 for trials comparing neuroprotective interventions and control. Meta-analysis was performed using the random-effects model. The primary outcome was the incidence of PIPN.ResultsOf 24 relevant controlled trials, 14 were eligible for meta-analysis. Pooled results from seven non-pharmacological trials were associated with a statistically significant 48% relative reduction of PIPN risk with low heterogeneity. Conversely, pooled results from six pharmacological trials were associated with a significant 20% relative reduction of PIPN risk with moderate heterogeneity. Both pharmacological and non-pharmacological approaches appear effective in reducing PIPN incidence in the treatment arm compared to control (pooled RR < 1).ConclusionCurrent evidence suggests that both interventions may reduce PIPN risk. Non-pharmacological interventions appear more effective than pharmacological interventions.

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Evaluation of the effect of N-acetylcysteine on the prevention and amelioration of paclitaxel-induced peripheral neuropathy in breast cancer patients: a randomized controlled study

Cited by 33 publications

References 31 publications

Oxidative Stress and Cognitive Alterations Induced by Cancer Chemotherapy Drugs: A Scoping Review

Oxidative Stress and Cognitive Alterations Induced by Cancer Chemotherapy Drugs: A Scoping Review

N-Acetylcysteine: A Review of Clinical Usefulness (an Old Drug with New Tricks)

A Systematic Review and Meta-Analysis of the Effectiveness of Neuroprotectants for Paclitaxel-Induced Peripheral Neuropathy

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