Purpose: Secondary
lymphedema is a common complication of
cancer treatment for which no effective
drug treatments yet exist. Level I clinical data suggests that
doxycycline is effective for treating
filariasis-induced
lymphedema, in which it decreases tissue
edema and
skin abnormalities; however, this treatment has not been tested for
cancer-related
lymphedema. Over the past year, we used
doxycycline in an off-label manner in patients with
breast cancer-related secondary
lymphedema. The purpose of this report was to retrospectively analyze the efficacy of this treatment. Methods: Patients who presented to our
lymphedema clinic between January 2021 and January 2022 were evaluated, and barring
allergies or
contraindications to
doxycycline treatment, were counseled on the
off-label use of this treatment. Patients who wished to proceed were treated with
doxycycline (200 mg given orally once daily) for 6 weeks. After IRB approval of this study,
lymphedema outcomes were retrospectively reviewed. Results: Seventeen patients with a mean follow-up of 17.0 ± 13.2 weeks were identified in our retrospective review. Although
doxycycline treatment had no significant effect on relative limb volume change or L-Dex scores, we found a significant improvement in patient-reported quality of life. Analysis of patient responses to the
Lymphedema Life Impact Scale showed a significant improvement in the total impairment score due to improvements in the physical and psychological well-being subscales (p = 0.03, p = 0.03, p = 0.04, respectively). Conclusion: This small, retrospective study did not show significant improvements in limb volume or L-Dex scores in patients with
breast cancer-related lymphedema treated with
doxycycline. However, our patients reported improvements in quality-of-life measures using a validated
lymphedema patient-reported outcome instrument. Our results suggest that
doxycycline may be of use in patients with
breast cancer-related lymphedema; however, larger and more rigorous studies are needed.