Reducing hot flashes is often a critical component of breast cancer care, Charles L. Loprinzi, MD, explains.

Loprinzi, a consultant in the Division of Medical Oncology in the Department of Oncology at Mayo Clinic in Rochester, Minnesota, has been involved in approximately 30 clinical trials related to non-estrogenic management of chemotherapy-induced hot flashes in patients with breast cancer. Currently, Loprinzi is serving as the principal investigator of an ongoing phase 3 trial seeking to assess whether a lower dose of oxybutynin will yield fewer adverse events (AEs) in patients with breast cancer who either are not candidates for or are not interested in hormone replacement therapy.

 Miami Breast Cancer Conference®, Loprinzi spoke with 

® about how he typically helps patients manage chemotherapy-induced hot flashes.

“There are a number of non-estrogenic things that can be used [as a] treatment. Newer antidepressants, [like] selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs) have been around for some time. Decades ago, the very first placebo-controlled trial looked at venlafaxine, which markedly decreased hot flashes [by] about 60% vs about 20% with a placebo,” Loprinzi. “A lot of doctors, when they think of antidepressants, they think [of venlafaxine] first. I don't ever use that drug myself [to treat] hot flashes; citalopram works as well as venlafaxine and has less toxicities: with nausea upfront, and with [less] withdrawal symptoms than some people have with venlafaxine.”

Clinical trials: oxybutynin chloride in managing hot flashes. Mayo Clinic. Accessed March 7, 2022. https://mayocl.in/3ISrDFw

Videos

Ahead of his presentation at the 39th Annual Miami Breast Cancer Conference, Charles L. Loprinzi, MD, highlights some non-estrogenic approaches to hot flash management for patients with breast cancer.

Hot Flash Treatment Strategies for Patients With Breast Cancer

Charles Loprinzi, MD, Giant of Cancer Care: Supportive/Palliative Care, Mayo Clinic, discusses potential treatments for chemotherapy-induced peripheral neuropathy (CIPN).

Duloxetine has demonstrated benefits in managing CIPN in clinical trials, but Loprinzi adds that the benefits are not great and the drug is associated with some toxicities.Â 

Loprinzi says minocycline, which is commonly used to treat acne, has promising preclinical data in preventing neuropathy. Pilot studies for the drug are ongoing.Â 

Another method being tested for the treatment of CIPN is Scrambler therapy, in which electrodes are placed on the skin in areas around sites of pain. Electrical signals send non-pain messages to areas that are interpreting chronic pain, such as that caused by neuropathy. This therapy has not been proven effective in treating CIPN, but Loprinzi says that he is convinced it can help a number of patients in this population.Â 

Articles

Charles Loprinzi, MD, Giant of Cancer Care: Supportive/Palliative Care, Mayo Clinic, discusses potential treatments for chemotherapy-induced peripheral neuropathy (CIPN).


Charles Loprinzi on Potential Treatments for Chemotherapy-Induced Peripheral Neuropathy

Charles Loprinzi, MD, Mayo Clinic, discusses managing chemotherapy-induced peripheral neuropathy in adult patients with cancer. 

When patients present with symptoms of chemotherapy-induced neuropathy, healthcare professionals need to weigh the benefits of continuing therapy. 

Loprinzi says that he tends to stop treatment early in patients with neuropathy in order to prevent the condition from becoming chronic. 

Charles Loprinzi, MD

Articles

Hot Flash Treatment Strategies for Patients With Breast Cancer

Charles Loprinzi on Potential Treatments for Chemotherapy-Induced Peripheral Neuropathy

Charles Loprinzi on Chemotherapy-Induced Peripheral Neuropathy