Will the drug Amifostine (Ethyol) help prevent or
limit the development of peripheral neuropathy???
A phase III randomized trial found treatment with Amifostine (Ethyol) at doses 740-910 mg/m2 just before administration of Cytoxan and Cisplatin was protective for a wide variety of normal tissue (liver, kidney, nerves) from serious cumulative toxicity. The action of the chemotherapy drug on cancerous cells was not effected (J.Clin.Oncol. July 1996; 14(7):(2101-2112).
A phase I trial found Ethyol protective against neurotoxicities of Taxol (Paclitaxel), even at doses of 310 mg/m2 (CanTherap 1998, DiPaola).
Preliminary findings of a phase II trial of Ethyol to reverse the neuropathy caused by Cisplatin found a modest vibratory test improvement, but a clinically significant improvement in functional ability (ProcAnnMeeting ASCO 1999, abstract #2326 [http://www.asco.org]).
Use of Ethyol with increasing dose levels of Carboplatin in a high dose Cytoxan/Carboplatin phase I/II clinical trial found that Ethyol was protective against neuropathy and ear damage (ototoxicity), without altering the anti-tumor effects of chemo (ASCO 1999, abstract #230).
Ethyol was found to be a cost effective resource to control neuropathy. (This is a good reference for insurance companies that won't pay for Ethyol treatments--Semin Oncol 26(2 suppl 7):102-7, 1999. Found on NCI's CancerLit web site.)
Ethyol may cause low blood pressure, which is relieved if the patient lies flat during, and for about 30 minutes after, Ethyol is given. Other side effects are nausea, vomiting, low calcium levels, sneezing, a warm flushed feeling, and somnolence (trance-like sleepiness). All side effects are reversible when treatment ends. Sneezing ends 30-60 minutes after the infusion is stopped. If calcium blood levels fall, high calcium foods or calcium supplements may be helpful (ONF, 3/98, 25(3):515-523). One woman said that her doctor told her it can cause increased nausea and vomiting, which he controlled with medication. She admits the nausea is no fun, but is certainly more temporary than neuropathy.
Experiences of some women with Ethyol: