Memantine prophylaxis in docetaxel-induced neuropathy: randomised clinical trial in breast cancer.
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OBJECTIVES: Peripheral neuropathy is considered a common complication of taxanes, which in severe cases can limit the optimal treatment. Our study aimed to evaluate the efficacy of memantine in the prevention of docetaxel-induced neuropathy in patients with breast cancer. METHODS: In this randomised clinical trial, 40 women between the ages of 18 and 64 years with non-metastatic breast cancer were included. All patients were treated with the AC-T regimen (with docetaxel). Patients in the intervention group received memantine 20 mg for 8 weeks from the beginning of the first cycle of docetaxel. Patients in the control group did not receive any medication for the prevention of neuropathy. To assess the neuropathy, Douleur Neuropathies 4 (DN4) and Common Terminology Criteria for Adverse Events (CTCAE) questionnaires were used at baseline, 1 month (follow-up 1), 3 months (follow-up 3) and 6 months (follow-up 6) after the study initiation. RESULTS: The DN4 score was remarkably less in the memantine group in follow-up one (p=0.033) and three (p<00.1). The CTCAE follow-up score did not change during the study. Neuropathy duration and onset were significantly different between the intervention and control groups (p=0.050 and p=0.001, respectively). Out of 40 patients, 8 (40%) in the memantine group and 2 (10%) in the control group did not experience neuropathy. CONCLUSIONS: Based on the results, memantine 20 mg/day may be effective in reducing the risk of docetaxel-induced neuropathy in patients with breast cancer, but further studies are needed to confirm these findings.Based on the findings, memantine at a dosage of 20 mg/day may exhibit a potential preventive effect in patients with breast cancer undergoing treatment with docetaxel as part of their chemotherapy regimen. TRIAL REGISTRY NUMBER: IRCT20160310026998N9.