The antidepressant drug duloxetine, known commercially as Cymbalta, helped relieve painful tingling feelings caused by chemotherapy in 59 percent of patients, a new study finds. This is the first clinical trial to find an effective treatment for this pain.
Chemotherapy-induced peripheral neuropathy is a common side effect of certain chemotherapy drugs. The tingling feeling -- usually felt in the toes, feet, fingers and hands -- can be uncomfortable for many patients, but for about 30 percent of patients, it's a painful sensation. Previous studies have found no reliable way to treat this type of pain.
In the current study, which will be presented Tuesday at the American Society of Clinical Oncology Annual Meeting, researchers looked at 231 patients who reported painful neuropathy after receiving the chemotherapy drugs oxaliplatin or paclitaxel. Patients were randomly assigned to receive duloxetine or a placebo for five weeks. They were asked to report on their pain levels weekly throughout the study.
The researchers found that 59 percent of patients who received duloxetine reported reduced pain, while only 39 percent of those taking placebo did.
"These drugs don't work in everyone. The good news is it worked in the majority of patients. We need to figure out who are the responders. If we can predict who they are, we can target the treatment to the people it's going to work for," said lead study author Ellen M. Lavoie Smith, Ph.D., APRN, AOCN, assistant professor at the University of Michigan School of Nursing and a researcher at the U-M Comprehensive Cancer Center.
Duloxetine has previously been shown to help relieve painful diabetic neuropathy. This type of antidepressant is believed to work on pain by increasing neurotransmitters that interrupt pain signals to the brain.
In this study, participants received a half dose of duloxetine – 30 milligrams a day - the first week before ramping up to a full dose of 60 mg daily for four more weeks. Few severe side effects were reported with this approach. The most common side effect was fatigue.
Treating painful peripheral neuropathy is critical because the condition can lead doctors to limit the patient's chemotherapy dose if the pain becomes too severe.
"In addition to improving symptoms and quality of life, treating peripheral neuropathy pain potentially improves quantity of life if it helps patients avoid decreasing their chemotherapy medications," Smith says.
Often, Smith adds, patients avoid telling their doctors about pain because they do not want their chemotherapy dose decreased.
"Patients make this trade-off sometimes: They don't want to give up the chemotherapy and decide they'd rather have this pain. That's a terrible trade off to make," Smith says.
The researchers' next steps are to determine which patients are most likely to benefit from duloxetine.
Additional authors: Herbert Pang, Ph.D.; Constance Cirrincione, M.S.; Stewart Fleishman, M.D.; Electra D. Paskett, Ph.D.; Tim Ahles, Ph.D.; Camilo Fadul, M.D.; Chetaye Knox; Charles L. Shapiro, M.D.
Funding: National Institutes of Health's National Cancer Institute; drugs and placebo provided by Lilly Pharmaceuticals
Reference: "CRA9013: CALGB 170601: A phase III double blind trial of duloxetine to treat painful chemotherapy-induced peripheral neuropathy (CIPN)," Smith et al. American Society of Clinical Oncology Annual Meeting, June 1-5, 2012Resources:
Nicole Fawcett | EurekAlert!
Smart Data Transformation – Surfing the Big Wave
02.12.2016 | Fraunhofer-Institut für Angewandte Informationstechnik FIT
Climate change could outpace EPA Lake Champlain protections
18.11.2016 | University of Vermont
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
Broadband rotational spectroscopy unravels structural reshaping of isolated molecules in the gas phase to accommodate water
In two recent publications in the Journal of Chemical Physics and in the Journal of Physical Chemistry Letters, researchers around Melanie Schnell from the Max...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
05.12.2016 | Power and Electrical Engineering
05.12.2016 | Materials Sciences
05.12.2016 | Power and Electrical Engineering