Pharmacotherapy

Losartan dramatically cuts risk of paclitaxel neuropathy

March 24, 2026

A single-center randomized controlled trial (NCT06135493) of 89 women with early-stage breast cancer found that adding losartan 100 mg daily to weekly paclitaxel significantly reduced the incidence of clinically meaningful neuropathy. Grade ≥2 neuropathy occurred in 33.3% of losartan recipients vs. 86.4% with standard care alone (p<0.001). Losartan also delayed onset of neuropathy by roughly a month (73 vs. 44 days; hazard ratio, 0.20; 95% confidence interval, 0.11–0.35). At 12 weeks, patients on losartan reported better quality of life (Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity 31.9 vs. 15.5; p<0.001) and lower pain scores (median visual-analogue scale 3 vs. 8; p<0.001). Nerve growth factor levels and adverse events were similar between groups.

Clinical takeaway: Consider losartan as a potential future prophylactic strategy for paclitaxel-induced neuropathy, but await confirmatory multicenter data before routine adoption.

Source:

Mahmoud AMAS, et al. (2206, March 9). Pharmacotherapy. The Effect of Losartan in Preventing Paclitaxel-Induced Peripheral Neuropathy in Breast Cancer: A Randomized, Controlled Study. https://pubmed.ncbi.nlm.nih.gov/41800821/