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CompletedNCT03290976Updated Aug 22, 2024

Integrative Medicine for Chemotherapy-Induced Peripheral Neuropathy

An interventional study of Acupuncture and Multi-modality (Acupuncture "plus") in Chemotherapy-induced Peripheral Neuropathy, sponsored by The Chaim Sheba Medical Center. Completed at 1 site in Israel. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-08-22.

Sponsored by The Chaim Sheba Medical Center · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
168
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and often debilitating complication of cancer treatments. There is presently no known treatment which can prevent the onset of CIPN, with treatment of existing symptoms limited to reducing the dose intensity of the offending agent. Clinical research has shown that complementary/integrative medicine (CIM) modalities such as acupuncture and reflexology may be effective in relieving CIPN-related symptoms. The present study will included 120 patients suffering from CIPN-related symptoms, and will take place at 3 medical centers in Israel which provide CIM treatments to oncology and hemato-oncology patients. Participants will be allocated to either the control arm (standard conventional supportive care; n=40) or to the intervention arm of the study (standard care with CIM treatments; n=80), based on their preference. Patients in the treatment arm of the study will be randomly allocated to either twice-weekly, single modality acupuncture treatments (n=40), or to a multi-modality treatment program (n=40), which will include acupuncture and additional CIM modalities (i.e., manual-movement and mind-body therapies), for a 6-week period.

The effect of CIM treatments in reducing the severity of CIPN-related symptoms will be assessed at baseline and at 6- and 9-week follow-up visits, using the Functional Assessment of Cancer Therapy -Taxane (FACT-Tax) tool; the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - C30 (EORTC QLQ-C30); and the Measure Yourself Concerns and Well-being (MYCAW) questionnaire. Interim assessment of symptom severity will be conducted by the study nurse throughout the study period, through either telephone or e-mail. Additional study outcomes will include the safety of the CIM treatments; QOL-related concerns which may affect CIPN-related symptoms (e.g., anxiety, depression, sleep disturbances, etc.), as well as issues related to body image and coping with CIPN; physiological assessment of CIPN using a von Frey test (with hairs of varying diameters to assess the threshold for touch evoked sensations); and adherence to the planned oncology treatment regimen, as measured by the Relative Dose Intensity (RDI) calculation.

02

Conditions studied

  • Chemotherapy-induced Peripheral Neuropathy
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Female patients with breast or gynecological cancers who are undergoing a treatment regimen which includes taxane-based chemotherapy (e.g., Paclitaxel, Docetaxel); or
  • Patients of either gender with hematological malignancies who are undergoing a treatment regimen which includes neuropathy-inducing agents (e.g., bortezumab for multiple myeloma, etc.).
  • Eligible patients will report altered sensations and/or pain in the areas of the feet and or hands, with a score of ≥ 2 (moderate-to-severe) for chemotherapy-induced peripheral neuropathy on the National Cancer Institute (NCI) Common Toxicity Criteria for Adverse Events - version 4.0 (CTC-AE.v-4.0)
  • The onset of CIPN-related symptoms must be recent, following a recently-administered course of chemotherapy and with symptoms appearing no more than a month prior to study recruitment.

Patients must be able to comply with the study protocol, which includes weekly follow-up visits, either in person or by phone; completion of the study questionnaires, in accordance with the study protocol; and, for patients in the treatment arm of the study, attending twice-weekly CIM treatment sessions.

Exclusion criteria

Exclusion Criteria:

  • Patients not fulfilling the inclusion criteria, or those with a history of chronic medical conditions which predispose to the development of CIPN (e.g., diabetes mellitus, alcohol abuse), will be ineligible for participation in the study.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
168 participants (actual)

Study arms

  • No intervention
    Control Group

    The control group will consist of patients who choose not to undergo CIM treatments for their CIPN-related symptoms. Participants in this arm of the study will receive standard conventional supportive care, as provided by their oncology health care professionals (HCPs), and closely monitored for any changes in the severity of their CIPN-related symptoms.

  • Active comparator
    Intervention Group A: Single Modality (acupuncture)

    Patients choosing to undergo CIM treatments, in addition to standard conventional care: Acupuncture x2/week, for 6 weeks.

    Other: Acupuncture

  • Active comparator
    Intervention Group B: Multi-modality (acupuncture "plus")

    Patients choosing to undergo CIM treatments, in addition to standard conventional care: Acupuncture with additional CIM treatment modalities, x2/week, for 6 weeks.

    Other: Acupuncture · Other: Multi-modality (Acupuncture "plus")

Interventions

  • OtherAcupuncture

    Acupuncture treatments will be patient-tailored, with the acupuncture points (acu-points) to be selected by the acupuncturist at each treatment session, in accordance with the dynamic of the patient's symptoms, concerns and expectations. At the same time, acupuncturists will be required to choose at least 5 of the following 11 acupoints, which are to be incorporated into their treatment regimen: Lower limb points: Liver (LIV) 3, Spleen (SP) 4, SP6, Stomach (ST) 36, Gallbladder (GB) 34, Kidney (KID) 3, LIV8, Web (Bafeng) points Upper limb points: Large Intestine (LI) 4, LI 11, LI10, Pericardium (PC) 6, Triple Warmer (TW) 3/4/5

  • OtherMulti-modality (Acupuncture "plus")

    A number of additional CIM treatment modalities will be added to the acupuncture treatment in this arm of the study, in accordance with the practitioners available at each of the participating study centers. These will include one of more of the following: * Manual-movement therapies - e.g. acupressure/reflexology, self- and caregiver-practiced acupressure * Mind-body therapies - e.g. relaxation/imagery method, Anthroposophic music therapy The multimodal CIM treatment regimen will be re-evaluated at each session, and adapted according to the concerns and expectations of the patients, as well as the recommendation of the treating CIM practitioner.

05

What researchers measure

Primary outcomes

  1. Symptom Severity(neuropathy): Functional Assessment of Cancer Therapy -Taxane (FACT-Tax) tool

    CIPN-related symptoms

    Time frame: Up to 9 weeks

  2. Symptom Severity(neuropathy): European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)

    CIPN-related symptoms

    Time frame: Up to 9 weeks

  3. Symptom Severity(neuropathy): Measure Yourself Concerns and Well-being (MYCAW) questionnaire:

    CIPN-related symptoms

    Time frame: Up to 9 weeks

Secondary outcomes

  1. Symptom Severity(additional concerns): Functional Assessment of Cancer Therapy -Taxane (FACT-Tax) tool

    Additional QOL-related concerns

    Time frame: Up to 9 weeks

  2. Symptom Severity(additional concerns): European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)

    Additional QOL-related concerns

    Time frame: Up to 9 weeks

  3. Symptom Severity(additional concerns): Measure Yourself Concerns and Well-being (MYCAW) questionnaire:

    Additional QOL-related concerns

    Time frame: Up to 9 weeks

  4. Symptom Severity(neuropathy): Physiological Assessment of CIPN Severity

    The von Frey test (Semmes Weinstein Monofilament Set, Bioseb In Vivo Research Instruments, France/USA).

    Time frame: Up to 9 weeks

  5. Adherence to Chemotherapy Regimen: Relative Dose Intensity (RDI)

    RDI = Dose Administered (mg) / Interval between treatments (days) ÷ Planned Dose (mg) / Planned Interval between treatments (days)

    Time frame: After 9 weeks

  6. Adverse Effects Associated with CIM treatments

    Registering of any adverse events believed to be related to the study intervention treatments

    Time frame: After 9 weeks

06

Study locations

1 site
  • Chaim Sheba Medical Center
    Ramat Gan, 52621, Israel
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03290976
Lead sponsor
The Chaim Sheba Medical Center
Collaborators
Bnai Zion Medical Center, Lin Medical Center, Haifa, Carmel Medical Center
Responsible party
Noah Samuels (Medical Director, Tal Center for Integrative Oncology, Institute of Oncology, The Chaim Sheba Medical Center) — Principal investigator
First posted
Sep 25, 2017
Start date
Mar 1, 2018
Primary completion
May 31, 2021
Completion
May 31, 2021
Last update
Aug 22, 2024

Study contacts

Elad Schiff, MD
principal investigator · Bnai Zion Medical Center, Haifa
Eran Ben-Arye, MD
principal investigator · Lin Medical Center, Haifa

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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