L-glutamine Supplementation to Alleviate Symptoms of Taxane-Induced Neuropathy in Patients With Breast Cancer

- Biopsy proven adenocarcinoma of the breast

- Received at least one prior taxane-containing chemotherapy regimen which resulted in persistent taxane-induced peripheral neuropathy

- Anticipated survival of at least 6 months

- Eastern Cooperative Oncology Group (ECOG) performance status (PS) = 0, 1, or 2

- The patient must have screening laboratory: Transaminases<2.5 x upper limit of normal; total bilirubin <2.0; creatinine <1.5

- Neuropathy onset from taxane administration no more than 18 months from date enrolled in trial

- Willingness to adhere to supplemental regimen of l-glutamine 10,000mg taken orally twice daily, with one potential dose escalation to 10,000mg taken orally three times daily.

- Grade I-III sensory peripheral neuropathy related to prior taxane use as assessed by their treating oncologist at Eastern Regional Medical Center

- Able to give informed consent for protocol participation

- Participants are not able to understand or provide written informed consent.

- The research team deems that the participant may not be able to follow the study protocol.

- Current diagnosis of bipolar disorder or other manic state

- Prior use of l-glutamine for prevention or empirical treatment of taxane-induced sensory peripheral neuropathy

- Prior treatment with a platinum chemotherapy

- Concurrent use of physical therapy interventions such as the 'Rebuilder', chiropractic care, acupuncture, or other modalities specifically targeting peripheral neuropathy

- Concomitant use of nutraceutical supplements which may mitigate symptoms of taxane-induced peripheral neuropathy including B-Complex vitamins, alpha-lipoic acid, vitamin E, acetyl-l-carnitine, intramuscular B12 injections, fish oil, etc… during study

- Renal insufficiency : serum creatinine of >1.5 mg /dl

- Hepatic insufficiency: transaminases > 2.5 x upper limit of normal due to isolated reports of possible hepatic encephalopathy

- New prescription or dose adjustment of current medication for the treatment of peripheral neuropathy such as gabapentin or Lyrica within the past 30 days.

- Pre-existing sensory peripheral neuropathy from other comorbid conditions such as diabetes or alcoholism

- Current serious infection or other serious medical condition

- Currently active second malignancy other than nonmelanatous skin cancer or carcinoma in situ of the cervix

- Pregnant or lactating female (pre-menopausal females will undergo pregnancy test prior to administration of protocol drugs throughout treatment cycles during this study)

- Acetaminophen use exceeding 2 g per day-includes use of acetaminophen-containing pain medications such as Percocet.