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Evaluating N-Acetylcysteine As a Protective Agent Against Chemotherapy-Induced Neuropathy in Breast Cancer: A Triple-Blind, Randomized Clinical Trial Publisher Pubmed



Hassanzadeh E1, 2 ; Sedighi Pashaki A1, 2 ; Akbari Hamed E1 ; Mehrpooya M3 ; Mohammadian K1 ; Bayani R4 ; Sheikhi K5 ; Ranjbar H6 ; Abbasi M7
Authors
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Authors Affiliations
  1. 1. Department of Radiation Oncology, Hamedan University of Medical Science, Hamedan, Iran
  2. 2. Cancer Research Center, Hamedan University of Medical Science, Hamedan, Iran
  3. 3. Department of Clinical Pharmacy, School of Pharmacy, Hamedan University of Medical Science, Hamedan, Iran
  4. 4. Department of Radiation, Oncology Research Center
  5. 5. Department of Kurdistan, University of Medical Science, Iran
  6. 6. Department of Hematology and Medical Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Science, Tehran, Iran
  7. 7. Department of Hematology and Oncology, Hamedan University of Medical Science, Hamedan, Iran

Source: American Journal of Clinical Oncology: Cancer Clinical Trials Published:2025


Abstract

Objectives: Chemotherapy-induced peripheral neuropathy (CIPN) is a significant clinical issue that affects patients' quality of life and can limit the dosing of chemotherapeutic agents. N-acetylcysteine (NAC) has been proposed as a potential chemoprotective agent against CIPN due to its antioxidant properties. This study aimed to investigate the efficacy of oral NAC in preventing and controlling taxane-induced neuropathy in patients with breast cancer. Methods: This randomized, triple-blind, placebo-controlled trial included 80 breast cancer patients undergoing taxane-based chemotherapy. Participants were divided into 2 groups: an intervention group receiving 1200 mg of oral NAC in divided doses per day and a placebo group. Patients were evaluated for neuropathy grade and functional status at 1 and 12 weeks postintervention. Results: Our analysis revealed no significant difference in the incidence and severity of neuropathy between the intervention and placebo groups at 1 (P=0.328) and 12 weeks (P=0.569) postchemotherapy. Baseline characteristics such as age, number of treatment cycles, and disease stage were similar between groups, indicating a homogeneous population. Conclusions: Oral NAC at a dose of 1200 mg per day did not significantly reduce the incidence or severity of taxane-induced neuropathy. These findings suggest that the oral bioavailability of NAC may be insufficient to exert a protective effect and that future studies should consider alternative dosing strategies or routes of administration. The need for further research to optimize NAC's chemoprotective role in CIPN remains evident. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.