The use of vitamin E in preventing taxane-induced peripheral neuropathy

Cancer Chemother Pharmacol. 2021 Dec;88(6):931-939. doi: 10.1007/s00280-021-04347-6. Epub 2021 Sep 1.

Abstract

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) is a dose-limiting side effect of chemotherapy. Several trials have evaluated the protective effect of vitamin E in preventing CIPN with controversial results. This study aims to outline the role of vitamin E in preventing CIPN.

Methods: A prospective phase II, open-label randomized controlled study was conducted in patients receiving taxane-based chemotherapy in Ain Shams University Hospitals, using vitamin E at a dose of 400 mg twice daily. The primary endpoint was the incidence of grade ≥ 2 sensory neuropathy according to CTCAE v 5.0 in each treatment arm. Secondary endpoints include time to onset and the duration of grade ≥ 2 sensory neuropathy.

Results: A total of 140 patients were randomized between the control and vitamin E arms. There was no difference in the incidence of grade ≥ 2 sensory neuropathy between the two arms (25.7% in each arm; P = 1.0), as well as the time to onset of neuropathy (P = 0.24). However, there was a statistically significant difference between the 2 arms as regards the duration of neuropathy. The median duration was 12.5 vs. 5 weeks in the control and vitamin E arms respectively (P = 0.01).

Conclusion: Our study did not demonstrate a protective role of vitamin E in decreasing the incidence of CIPN in patients receiving taxane-based chemotherapy. However, the recovery from CIPN was much better as compared to the control arm, which may indicate a role for vitamin E in decreasing the duration and severity of CIPN.

Keywords: Chemotherapy-induced peripheral neuropathy; Sensory neuropathy toxicity; Taxane; Vitamin E.

Publication types

  • Clinical Trial, Phase II
  • Randomized Controlled Trial

MeSH terms

  • Antineoplastic Agents / adverse effects*
  • Antioxidants / therapeutic use*
  • Bridged-Ring Compounds / adverse effects*
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy*
  • Neoplasms / pathology
  • Peripheral Nervous System Diseases / chemically induced
  • Peripheral Nervous System Diseases / pathology
  • Peripheral Nervous System Diseases / prevention & control*
  • Prognosis
  • Prospective Studies
  • Taxoids / adverse effects*
  • Vitamin E / therapeutic use*

Substances

  • Antineoplastic Agents
  • Antioxidants
  • Bridged-Ring Compounds
  • Taxoids
  • Vitamin E
  • taxane