Can acetylcysteine ameliorate cisplatin-induced toxicities and oxidative stress without decreasing antitumor efficacy? A randomized, double-blind, placebo-controlled trial involving patients with head and neck cancer

Autor(es):Mostrar menos -

Visacri, Marilia B. ^[1] ; Quintanilha, Julia C. F. ^[1] ; de Sousa, Vanessa M. ^[2] ; Amaral, Lais S. ^[1] ; Ambrosio, Rosiane de F. L. ^[1] ; Calonga, Luciane ^[3] ; Curi, Silvia F. B. B. ^[3] ; Leme, Mayra F. de T. ^[3] ; Chone, Carlos T. ^[3] ; Altemani, Joao M. C. ^[3] ; Mazzola, Priscila G. ^[2] ; Malaguti, Carina ^[1] ; Vercesi, Anibal E. ^[1] ; Lima, Carmen S. P. ^[1] ; Moriel, Patricia ^[2]

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Sch Med Sci, Campinas, SP - Brazil

^[2] Univ Estadual Campinas, Fac Pharmaceut Sci, Campinas, SP - Brazil

^[3] Univ Estadual Campinas, Clin Hosp, Campinas, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: CANCER MEDICINE; v. 8, n. 5, p. 2020-2030, MAY 2019.
• Citações Web of Science: 0

Resumo

The protective antioxidant activity of acetylcysteine (NAC) against toxicity due to cisplatin has been reported in experimental models; however, its efficacy in patients has not been elucidated. The aim of this study was to investigate the possible protective effect of NAC on cisplatin-induced toxicity and the effect of NAC on clinical response and oxidative stress in patients treated for head and neck cancer. This was a randomized, double-blind, placebo-controlled trial conducted in patients receiving high-dose cisplatin chemotherapy concomitant to radiotherapy. Patients were randomly assigned to groups and received: (a) 600 mg NAC syrup, orally once daily at night for 7 consecutive days or (b) placebo, administered similarly to NAC. Nephro-, oto-, hepato-, myelo-, and gastrointestinal toxicities, clinical responses, and plasma and cellular markers of oxidative stress were evaluated. Fifty-seven patients were included (n = 28, NAC arm; and n = 29, placebo arm). A high prevalence of most types of toxicities was observed after cisplatin chemotherapy; however, the parameters were similar between the two groups. There was a predominance of partial response to treatment. In the cellular and plasmatic oxidative stress analyses, minor differences were observed. Overall, there was no statistically significant difference between the groups for all outcomes. These findings show that low-dose oral NAC does not protect patients with head and neck cancer from cisplatin-induced toxicities and oxidative stress. The antitumor efficacy of cisplatin was apparently not impaired by NAC. (AU)

• Processo FAPESP: 17/17728-8 - Função e disfunção mitocondrial: implicações para o envelhecimento e doenças associadas
• Beneficiário: Aníbal Eugênio Vercesi
• Modalidade de apoio: Auxílio à Pesquisa - Temático
• Processo FAPESP: 14/04744-7 - Avaliação do uso da N-acetilcisteína na atenuação de toxicidades causadas por estresse oxidativo em pacientes com câncer de cabeça e pescoço em tratamento com cisplatina
• Beneficiário: Marília Berlofa Visacri
• Modalidade de apoio: Bolsas no Brasil - Doutorado
• Processo FAPESP: 14/18294-3 - Avaliação do uso da N-acetilcisteína na atenuação de toxicidades causadas por estresse oxidativo em pacientes com câncer de cabeça e pescoço em tratamento com cisplatina
• Beneficiário: Patricia Moriel
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 15/01793-0 - Estudo das reações adversas, qualidade de vida e estresse oxidativo celular em pacientes com câncer de cabeça e pescoço em tratamento com cisplatina e radioterapia
• Beneficiário: Júlia Coelho França Quintanilha
• Modalidade de apoio: Bolsas no Brasil - Mestrado