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Drug shown effective for treating 'chemo brain'
Source: (cancerfacts.com)
Friday, June 03, 2005
ORLANDO – June 3, 2005 – Breast cancer patients who underwent a combination chemotherapy regimen experienced less fatigue and reported clearer thinking following treatment with a drug used to treat attention deficit disorders, researchers say.
Among the more persistent side effects of chemotherapy reported by cancer patients is fatigue, sometimes so severe it makes carrying out normal daily activities difficult. More subtle, but possibly related are complaints about difficulty thinking, making decisions or following directions. The symptoms are so common some clinicians have dubbed the cluster of loosely related side effects as "chemobrain."
In an eight-week study led by Dr. Elyse Lower, of the University of Cincinnati Medical Center, cancer patients diagnosed with chemotherapy-related fatigue and cognitive impairment were treated with the central nervous system stimulant dexmethylphenidate (Focalin®) or an inactive look-a-like placebo. The researchers reported their findings last week at the American Society of Clinical Oncology annual meeting.
"(The drug) significantly reduced chemotherapy-related fatigue in this adult population," Lower said in a prepared statement. "And doses up to 50 mg/day are safe and well-tolerated." She and her colleagues suggest the drug should be recommended to treat both the fatigue and the memory impairment associated with chemobrain.
In this early stage trial testing the safety and effectiveness of dexmethylphenidate (d-MPH), 154 cancer patients were enrolled at 21 centers over 14 months. All patients had completed at least four cycles of chemotherapy at least two months before the study began. The patients' median age was about 53 years old; 94 percent of them were female (76 percent of them with breast cancer and 14 percent with ovarian cancer), 79 percent were white, and nine percent were African-American.
All of the patients were diagnosed with chemotherapy-related fatigue and cognitive impairment as measured by a variety of tests. For one week, they took a 5 milligram (mg) pill twice a day, which doctors, but not the patients themselves, knew was a placebo. Those patients whose symptoms persisted or worsened were then randomly assigned to receive either a placebo or d-MPH for eight weeks.
At the end of eight weeks, patients on d-MPH were significantly less fatigued than those in the placebo group. The drug also helped patients do significantly better on the memory portion of a standardized cognitive test, though none of the other cognitive functions appeared to improve. Despite this testing, the researchers caution that, the trial was not designed to reach definitive conclusions about cognitive functions.
Cancer-related fatigue may affect as many as seven in 10 cancer patients, and is normally not relieved by rest. Some 99 percent of breast and lung cancer patients report fatigue, and 61 percent of patients receiving chemotherapy or radiotherapy report that their fatigue persists after treatment has stopped.
While this study was conducted among breast and ovarian cancer patients, the researchers think the findings may be relevant to other cancers too.
"The drugs we use for breast cancer are routine for treating other common cancers. It's fair to assume this drug will probably work in any setting where patients report fatigue and cognitive deficits after chemotherapy," the researchers wrote.
Source: American Society of Clinical Oncology annual meeting, Orlando, Florida, May 17, 2005
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