N-acetylcysteine offers no protection against chemo-induced neuropathy

Treatment with oral N-acetylcysteine (NAC) 1,200 mg/day does not result in a significant reduction in the incidence or severity of chemotherapy-induced peripheral neuropathy (CIPN) in patients with breast cancer, a recent study has shown.

No significant difference was found in the incidence and severity of CIPN between patients who received 1,200 mg of oral NAC and those who received placebo at 1 (p=0.328) and 12 weeks (p=0.569) after chemotherapy.

Baseline characteristics, such as age, disease stage, and number of treatment cycles, did not differ substantially between the two treatment groups, suggesting a homogenous population.

“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 investigators said. “The need for further research to optimize NAC’s chemoprotective role in CIPN remains evident.”

This randomized, triple-blind, placebo-controlled trial recruited 80 patients with breast cancer who were undergoing taxane-based chemotherapy. The investigators divided the participants into two groups: intervention (oral NAC 1,200 mg in divided doses per day) and placebo. They assessed the patients for neuropathy grade and functional status at 1 and 12 weeks postintervention.

“CIPN is a significant clinical issue that affects patients’ quality of life and can limit the dosing of chemotherapeutic agents,” the investigators said. "NAC has been proposed as a potential chemoprotective agent against CIPN due to its antioxidant properties.”