Influence of different photobiomodulation protocols on the prevention of chemotherapy induced dysgeusia in breast cancer patients treated with Doxorubicin Cyclophosphamide a phase III randomized triple blinded non inferiority clinical trial summary

Welcome back to PACULit, your daily literature update for clinical pharmacists and physicians. Today we review a Phase III, triple-blind, placebo-controlled randomized trial evaluating photobiomodulation (PBM) to prevent chemotherapy-induced dysgeusia in breast cancer patients receiving doxorubicin–cyclophosphamide. The study directly compares a combined red plus infrared PBM protocol against single-wavelength PBM (red only or infrared only) to isolate each wavelength’s contribution. Primary endpoint was objective taste function; secondary endpoints included subjective taste measures, quality of life, salivary flow, ECOG status, BMI/weight, and safety. Enrolling 180 patients across three arms, the results showed that the combination of red and infrared PBM best preserved objective taste and yielded the most favorable ECOG improvements and weight trends, with salivary flow maintained and no increase in adverse events. By contrast, red-light alone led to objective taste decline, while infrared alone produced worse subjective taste outcomes, suggesting a synergistic effect when both wavelengths are used together. Contextualized with prior Phase II findings and WALT recommendations, these results strengthen PBM as a non-pharmacologic supportive care option to mitigate chemo-induced dysgeusia, though limitations include single-center design and short-term follow-up, with no dose–response exploration. The authors call for multicenter trials across other regimens and cancers, and potential integration with nutrition and oral health interventions. Clinicians should consider proactive taste assessment in patients on anthracyclines and discuss combined PBM as a preventive strategy where feasible. DOI: 10.1007/s00520-025-09756-4.