Chemotherapy saves lives, but for many patients it also delivers a lasting cost.
Nerve endings in the hands and feet can be scorched by the same drugs that kill tumor cells, leaving burning, tingling and numbness that can persist for years.
A new study in mice suggests the psychedelic compound psilocybin may be able to prevent that damage before it takes hold.
The research, published in the journal Science by scientists at The University of Texas MD Anderson Cancer Center, showed that as few as two doses of psilocybin given before chemotherapy protected mice from nerve injury across as many as six treatment cycles.
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A Phase 2 clinical trial in humans, called NeuroGuard, is planned as the next step.
A common and lasting side effect
The condition is called chemotherapy-induced peripheral neuropathy, or CIPN.
It happens when nerve fibers in the arms, legs, hands and feet are damaged by common cancer drugs, producing pain, numbness, cold sensitivity and loss of touch.
A review in the journal Neurotherapeutics reports that roughly 30 to 40 percent of patients treated with neurotoxic chemotherapy will develop the condition.
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The rate is higher for some drugs.
Platinum-based agents such as cisplatin can push prevalence far above that range, and symptoms often last months or years after treatment ends. There is no approved therapy that reliably prevents it.
What the mouse study found
The MD Anderson team tested psilocybin ahead of chemotherapy in mice given cisplatin, paclitaxel or docetaxel, three drugs commonly used against solid tumors.
Animals that received the compound before treatment kept their sensitivity to touch, avoided cold hypersensitivity and retained healthy sensory nerve endings, according to Scientific American's coverage of the results.
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The tumor-killing effect of the chemotherapy was preserved.
The researchers traced the protection to a specific pathway.
Psilocybin activates the serotonin 5-HT2A receptor, which in turn helps preserve the movement of mitochondria, the cell's energy factories, along the length of nerve fibers.
Chemotherapy typically disrupts that transport, starving the nerve endings of energy.
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Moving from mice to people
Findings in mice do not automatically translate to patients, and the authors are careful to describe the work as preclinical.
To probe whether the mechanism holds in humans, the team also examined donor sensory neurons and skin biopsies from patients, as Genetic Engineering and Biotechnology News described, and found that the same serotonin receptor and mitochondrial pathway was present.
The next step is the Phase 2 NeuroGuard trial (NCT07227909), which will test psilocybin in cancer patients starting chemotherapy.
Scientific American reported the trial is planned to open in about a month and will enroll patients with colorectal, breast, and head and neck cancers.
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Whether the protective effect seen in mice appears in people, and at what dose, remains an open question.
Patients concerned about neuropathy during cancer treatment should talk with their oncology team about monitoring and current supportive care, not seek psilocybin on their own.
The MD Anderson work was funded in part by the National Institutes of Health and the National Cancer Institute.
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.