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This study investigated whether Coenzyme Q10 (CoQ10) could mitigate paclitaxel-induced adverse events and improve treatment tolerability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>In this open label randomized controlled trial, 60 patients with breast cancer were randomized (1:1) receive weekly paclitaxel (80 mg\/m\u00b2) for 12 weeks either alone (control group, n\u2009=\u200930) or in combination with oral CoQ10. The primary outcome was the cumulative incidence of grade\u2009\u2265\u20092 peripheral neuropathy. Secondary endpoints included time-to-onset of grade\u2009\u2265\u20092 neuropathy; fatigue, headache, insomnia, musculoskeletal, gastrointestinal, and hematological adverse events; and left ventricular ejection fraction. Adverse events were graded using the Common Terminology Criteria for Adverse Events (CTCAE), version 5.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CoQ10 supplementation was associated with a lower incidence of clinically relevant neuropathy, with grade\u2009\u2265\u20092 events occurring in 68% of the CoQ10 group versus 96% of controls (p\u2009=\u20090.01) with delayed onset of neuropathy (30.0 vs. 20.0 days; log-rank p\u2009=\u20090.005). Significant reductions in severity were also observed for fatigue and insomnia from week 9, and for mucositis, diarrhea, arthralgia, and myalgia from week 11 (p\u2009&lt;\u20090.05). Hemoglobin levels were higher at week 12 (p\u2009=\u20090.009). CoQ10 was associated with preservation of left ventricular ejection fraction (p\u2009=\u20090.005).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CoQ10 supplementation during paclitaxel therapy was associated with reduced treatment-related toxicities, preservation of hematologic parameters, and favorable changes in left ventricular ejection fraction, with favorable tolerability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov (NCT06570811) on August 26, 2024. Available at:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/clinicaltrials.gov\/study\/NCT06570811\" ext-link-type=\"uri\">https:\/\/clinicaltrials.gov\/study\/NCT06570811<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40360-026-01163-7","type":"journal-article","created":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T03:36:18Z","timestamp":1783136178000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Coenzyme Q10 as an adjunctive strategy to reduce paclitaxel-induced toxicities in breast cancer: a randomized controlled trial"],"prefix":"10.1186","volume":"27","author":[{"given":"Gehad","family":"Hassoub","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noha A.","family":"El\u2011Bassiouny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Abdelkader","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Ashour","family":"Badawy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amira B.","family":"Kassem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,4]]},"reference":[{"key":"1163_CR1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","volume":"74","author":"F Bray","year":"2024","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. 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