Lack of neuroprotection by an ACTH (4-9) analogue. A randomized trial in patients treated with vincristine for Hodgkin's or non-Hodgkin's lymphoma

J Cancer Res Clin Oncol. 2004 Mar;130(3):153-60. doi: 10.1007/s00432-003-0524-9. Epub 2004 Jan 16.

Abstract

Purpose: This randomized, double-blind, placebo-controlled study evaluates the effect of the corticotropin (4-9) analogue Org 2766 on the neuropathy-free interval in patients receiving vincristine (VCR) containing chemotherapy for Hodgkin's or non-Hodgkin's lymphoma.

Patients and methods: In a longitudinal design, 150 patients were evaluated by interview, neurological examination, and neurophysiological techniques. Patients with an expected cumulative VCR dose of at least 8 mg received a single dose of Org 2766 or placebo before and after each intravenous VCR injection and 3-4 weeks after cessation of VCR. The final patient assessment was performed 1 month after discontinuation of study medication. The neuropathy-free interval as the major end point of this study was defined as the first occurrence of bilateral paresthesias and expressed as the administered cumulative VCR dose. This bi-center study represents the largest cohort of patients monitored for the effect of an ACTH-analogue on VCR neurotoxicity.

Results: A total of 147 patients were included in the final analysis. No significant differences were observed between the placebo and actively treated group for the major and secondary endpoints.

Conclusion: Contrary to a single previous pilot study in patients receiving VCR-based chemotherapy, in our study the ACTH (4-9) analogue Org 2766 did not provide protection from VCR-induced neuropathy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenocorticotropic Hormone / analogs & derivatives*
  • Adrenocorticotropic Hormone / pharmacology*
  • Adult
  • Aged
  • Anticonvulsants / pharmacology*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Cohort Studies
  • Double-Blind Method
  • Female
  • Hodgkin Disease / drug therapy*
  • Humans
  • Interviews as Topic
  • Longitudinal Studies
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Male
  • Middle Aged
  • Nervous System Diseases / chemically induced*
  • Peptide Fragments / pharmacology*
  • Placebos
  • Vincristine / administration & dosage

Substances

  • Anticonvulsants
  • Peptide Fragments
  • Placebos
  • Org 2766
  • Vincristine
  • Adrenocorticotropic Hormone