ATAS Acupuncture Reduces Chemotherapy Induced Fatigue in Breast Cancer Through Regulating ADROA1 Expression: A Randomized Sham-Controlled Pilot Trial

Yun-Fen Li; De-Quan Liu; Jian-Yun Nie; De-Dian Chen; Mei Yan; Zhen Zuo; Liang-Xian Liu; Wei-Yu Wang; Mian-Sheng Zhu; Wen-Hui Li

doi:10.2147/OTT.S272747

ATAS Acupuncture Reduces Chemotherapy Induced Fatigue in Breast Cancer Through Regulating ADROA1 Expression: A Randomized Sham-Controlled Pilot Trial

Onco Targets Ther. 2020 Nov 17:13:11743-11754. doi: 10.2147/OTT.S272747. eCollection 2020.

Authors

Yun-Fen Li^#¹, De-Quan Liu^#¹, Jian-Yun Nie^#¹, De-Dian Chen^#¹, Mei Yan¹, Zhen Zuo², Liang-Xian Liu³, Wei-Yu Wang⁴, Mian-Sheng Zhu^{2

5}, Wen-Hui Li¹

Affiliations

¹ The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Hospital, Breast Cancer Surgery Department, Kunming, People's Republic of China.
² Yunnan University of Traditional Chinese Medicine, College of Acupuncture, Kunming, People's Republic of China.
³ Kunming Hospital of Traditional Chinese Medicine/The Third Affiliated Hospital of Yunnan University Traditional Chinese Medicine, Acupuncture Department, Kunming, People's Republic of China.
⁴ Servbus Technology (Beijing) Co., Ltd., Technical Service Department, Beijing, People's Republic of China.
⁵ ARIATAS, Association Pour la Recherche et l'Information de l'Acupuncture Time-Acupoints-Space, College of Acupuncture, Paris, France.

^# Contributed equally.

Abstract

Objective: To investigate the feasibility and effectiveness of ATAS acupuncture (Acupoints-Time-Space Acupuncture) as a non-pharmacological intervention to prevent or relieve chemotherapy-induced fatigue in breast cancer patients undergoing taxane chemotherapy.

Methods: A pilot study in Kunming center with the aim of evaluating 40 patients randomized to 3 groups: ATAS, sham and non-acupuncture with an unequal randomization of 2:1:1. Participants with stage I-III breast cancer were scheduled to receive adjuvant EC4P4 chemotherapy. Participants in the ATAS and sham acupuncture arms received 20 sessions of acupuncture over 20 weeks, non-acupuncture arm received usual care. Evaluation scales, including VAS-F, MFI-20, HDAS, ISI, and blood samples were collected at four timepoints (T1-T4). mRNA sequencing was performed to detect the mechanism of acupuncture.

Results: A total of 581 sessions of acupuncture were performed on patients in the acupuncture group. There was no difference between the three groups in terms of clinical characteristics. Patients randomized to ATAS acupuncture had improved symptoms including fatigue, anxiety and insomnia during the whole process of chemotherapy compared with the other two groups. The VAS-F score of ATAS acupuncture group was decreased compared with non-acupuncture group (P=0.004). The score of MFI-20 in ATAS acupuncture group was kept at low level, while the other two groups' scores kept climbing during chemotherapy (P=0.016; P=0.028, respectively). The mechanism of ATAS acupuncture which reduced fatigue and depression may be related to ADROA1, by regulating cGMP/PKG pathway.

Conclusion: This pilot study has demonstrated that ATAS acupuncture can significantly reduce fatigue induced by chemotherapy.

Trial registration: Chinese Clinical Trials Registry, ChiCTR-IPR-17,013,652, registered Dec 3, 2017. http://www.chictr.org.cn/.

Protocol version: Version 3.2 dated from 2018/04/20.

Keywords: ATAS; adjuvant chemotherapy; chemotherapy induced fatigue; early stage breast cancer.

Grants and funding

This trial (ChiCTR-IPR-17013652) is granted by the Key research and development project of Yunnan provincial science and technology department (2018IA059) (for further details see Supplementary material D), governmental funding. The funding agencies were not involved in the design and conduct of the study, nor in the collection, management, analysis, and interpretation of the data. They were not involved in the writing of the manuscript.