Pyridoxine reduced neurotoxicity associated with altretamine, but also reduced its effectiveness.
Clinical evidence,mechanism, importance and management
In a large randomised study in women with advanced ovarian cancer neurotoxicity associated with altretamine and cisplatin chemotherapy was reduced by pyridoxine, but response duration was also reduced (See reference number 1). In this study,cisplatin was given on day 1 (37.5 or 75 mg/m(See reference number 2)) and altretamine 200 mg/m(See reference number 2) daily was given on days 8 to 21, and half patients also received pyridoxine 100mg three times daily on days 1 to 21. It is unclear how pyridoxine reduced activity of this regimen, but use of pyridoxine (vitamin B6) should probably be avoided in patients receiving altretamine.
1. Wiernik PH,Yeap B, Vogel SE, Kaplan BH, Comis RL, Falkson G, Davis TE, Fazzini E,Cheuvart B, Horton J. Hexamethylmelamine and low or moderate dose cisplatin with or without pyridoxine for treatment of advanced ovarian carcinoma: a study of the Eastern Cooperative Oncology Group. Cancer Invest (1992) 10, 1–9.