In a phase II trial (NRG-CC004) reported in the Journal of Clinical Oncology, Barton et al found that bupropion, a dopaminergic agent, did not improve sexual desire vs placebo as measured by the Female Sexual Function Index (FSFI) desire subscale among postmenopausal women with low desire scores who had completed definitive therapy for breast or gynecologic cancers.
In the double-blind trial, 230 women with low baseline FSFI desire scores (defined as < 3.3) from multiple sites in the NRG Oncology NCI Community Oncology Research Program network were randomly assigned 1:1:1 between May 2017 and 2020 to receive once-daily extended-release bupropion at 150 mg (n = 79) or 300 mg (n = 74) or placebo (n = 77). The FSFI desire subscale consists of two items (frequency and intensity), with scores ranging from 1.2 to 6 (higher scores = more desire). The FSFI total score is the sum of scores on a total of six subscales.
The primary endpoint was change at 9 weeks from baseline in the desire subscale score.
Bupropion was not more effective than placebo in improving the desire subscale of the FSFI. Subscale and total scores of the FSFI demonstrated dysfunction throughout the 9 weeks of the study. More research is needed to support sexual function in female cancer survivors.— Barton et al
Tweet this quote
There were no significant differences in mean desire subscale scores (1.56–1.67) among groups at baseline.
At 9 weeks, improvements in scores were observed in all groups, with no significant differences between the bupropion groups vs placebo. Mean changes (standard deviation) were 0.64 (0.95) in the 150-mg bupropion group (mean change vs placebo = 0.02, 95% confidence interval [CI] = –0.36 to 0.39, P = .93), 0.60 (0.89) in the 300-mg bupropion group (mean change vs placebo = –0.02, 95% CI = –0.40 to 0.36, P = .92), and 0.62 (1.18) in the placebo group. At 9 weeks, mean scores were 2.17, 2.27, and 2.30 in the 150-mg, 300-mg, and placebo groups, respectively.
Increases in mean FSFI arousal (0.33–0.75), lubrication (0.45–1.06), orgasm (0.47–0.88), satisfaction (0.66–0.84), and pain (0.33–0.55) subscales and FSFI total score (3.29–4.70) were observed in all groups at week 9, with no significant differences in change from baseline between the bupropion groups vs placebo. Mean FSFI subscale and total scores remained low throughout the study in all groups.
The investigators concluded, “Bupropion was not more effective than placebo in improving the desire subscale of the FSFI. Subscale and total scores of the FSFI demonstrated dysfunction throughout the 9 weeks of the study. More research is needed to support sexual function in female cancer survivors.”
Debra L. Barton, RN, PhD, of the University of Michigan School of Nursing, Ann Arbor, is the corresponding author for the Journal of Clinical Oncology article.
Disclosure: The study was supported by grants from the National Cancer Institute and Breast Cancer Research Foundation. For full disclosures of the study authors, visit ascopubs.org.The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.