Multiple Sclerosis Drug Could Ease Chemo Patient Pain

Researchers in Saint Louis are examing the ways in which a drug already approved for multiple sclerosis (MS) could ease some of the pain associated with chemotherapy for cancer patients.

The study, which was published in a recent edition of the Journal of Biological Chemistry, was spearheaded by Daniela Salvemini, PhD, Professor of Pharmacological and Psychological Science at Saint Louis University. In the study, Salvemini discussed a particular pathway that can cause chemotherapy-induced peripheral neuropathy (CIPN), as well as the steps her research team has taken to ease the pain for patients.

“The chemotherapy drug paclitaxel (Taxol) is widely used to treat many forms of cancer, including breast, ovarian and lung cancers,” she said, adding that it is one of several drugs that can have CIPN as a “debilitating” side effect.

Symptoms for patients can include tingling or numbness in the hands and feet, shooting or burning pain in the limbs, or a feeling of temperature extremes, according to Salvemini. The symptoms can last weeks or months after stopping chemotherapy, but there have also been cases where it has lasted for years.

It has been estimated that 30-90% of all patients treated with taxanes, which include paclitaxel, and combination chemotherapies are affected by CIPN. While studying the drug, Salvemini and her team discovered that the activation of sphingosine 1-phosphate receptor subtype 1 (S1PR1) plays a key role in the series of molecular interactions in the pain pathway. They said it occurs by engaging a series of damaging neuro-inflammatory processes, which causes the patients' pain as part of their treatment.

The researchers then realized they could stop the pain by inhibiting the molecule without stopping the drug from its cancer-fighting purpose. Their study was also aided by the fact that the US Food and Drug Administration (FDA) has already approved a drug called FTY720, or Gilenya, which modulates S1PR1 and is used to treat MS.

The use of the drug proved effective with not only paclitaxel, but also other drugs used during chemotherapy. Although more studies will need to be conducted, Salvemini said she is encouraged by the early results.

“We have identified a critical pathway by which CIPN develops and continues that can be targeted with a drug that is already FDA approved. This does not happen often," she noted. “We need to capitalize on these finding and explore use of these agents in cancer patients to improve quality of life and potentially maximize anticancer efficacy as soon as possible.”

Salvemini’s study was funded by the Leukemia and Lymphoma Society Transitional Research Program and the Mayday Fund, with additional funding provided by the Saint Louis University Cancer Center.