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Ultrasound in Detecting Taxane-Induced Neuropathy in Patients With Breast Cancer

Primary Purpose

Peripheral Neuropathy, Stage 0 Breast Cancer, Stage I Breast Cancer

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Biopsy
Questionnaire Administration
Ultrasound Tomography
Sponsored by
Wake Forest University Health Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Peripheral Neuropathy

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Breast cancer (any stage)
  • Previously or currently receiving taxane-based chemotherapy
  • Clinical symptoms of peripheral neuropathy noted in medical record and suspected to be secondary to taxane-based therapy
  • Ability and willingness to understand and sign an informed consent

Exclusion Criteria:

  • Self-reported or documented history of pre-existing peripheral neuropathy prior to initiation of taxane chemotherapy
  • Unable to provide history

Sites / Locations

  • Comprehensive Cancer Center of Wake Forest University

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Diagnostic (ultrasound)

Arm Description

Patients undergo peripheral nerve ultrasound. Patients also undergo skin biopsy.

Outcomes

Primary Outcome Measures

Tibial nerve cross-sectional area
Will be determined by ultrasound in the tibial nerve. Will be compared to the historical data from healthy patients using two-sample t-test (two-sample t-test selected as primary data from the historical control patients is available and will be used for analysis). Will also compare the nerve cross-sectional area in our study sample to that in the historical diabetic neuropathy patients and historical oxaliplatin neuropathy patients using one-sample t-test. The general linear model will be used to evaluate any factors (e.g., age) that may be associated with the nerve cross-sectional area. Due

Secondary Outcome Measures

Amplitude of nerve response
Spearman's rank correlation coefficient will be used to examine the associations between nerve cross-sectional area and nerve conduction studies.
Conduction velocity of nerve response
Spearman's rank correlation coefficient will be used to examine the associations between nerve cross-sectional area and nerve conduction studies.
Distal latency of nerve response
Spearman's rank correlation coefficient will be used to examine the associations between nerve cross-sectional area and nerve conduction studies.
Nerve fiber density in the skin
Spearman's rank correlation coefficient will be used to examine the association between nerve cross-sectional area and intraepidermal nerve fiber density.
Self-reported neuropathy score
Will be assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-Induced Peripheral Neuropathy 20. Spearman's rank correlation coefficient will be used to examine the associations between the cross-sectional area and the self-reported neuropathy scale.
Sural nerve cross-sectional area
Will be determined by ultrasound of the sural nerve. Spearman's rank correlation coefficient will be used to examine the associations between nerve cross-sectional area and nerve conduction studies. The general linear model will be also used to evaluate the association after adjusting for one or two risk factors (e.g., age). Nerve cross-sectional area will be treated as the dependent variable.

Full Information

First Posted
May 1, 2017
Last Updated
May 8, 2020
Sponsor
Wake Forest University Health Sciences
Collaborators
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT03139435
Brief Title
Ultrasound in Detecting Taxane-Induced Neuropathy in Patients With Breast Cancer
Official Title
A Pilot Study Using Ultrasound for the Detection of Taxane-Induced Peripheral Neuropathy
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
May 11, 2017 (Actual)
Primary Completion Date
December 12, 2018 (Actual)
Study Completion Date
January 11, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wake Forest University Health Sciences
Collaborators
National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This pilot clinical trial studies how well ultrasound works in detecting taxane-induced neuropathy in patients with breast cancer. Ultrasound may work better in diagnosing and detecting neuropathy in breast cancer patients treated with the chemotherapy drug called a taxane.
Detailed Description
PRIMARY OBJECTIVES: I. To compare tibial motor nerve ultrasound cross-sectional area (CSA) between taxane-induced peripheral neuropathy (TIPN) patients and historical data among healthy adults. SECONDARY OBJECTIVES: I. To compare sural sensory nerve ultrasound CSA between TIPN patients and historical data among healthy adults. II. To determine if the above changes in nerve CSA correlate with NCS changes in the same TIPN patients. III. To determine if the above changes in nerve CSA correlate with changes on a self-reported neuropathy scale (Quality of Life Questionnaire - Chemotherapy-Induced Peripheral Neuropathy 20 [QLQ-CIPN20]) in the same TIPN patients. IV. To determine if the above changes in nerve CSA correlate with intraepidermal nerve fiber (IENF) density changes on skin biopsy in the same TIPN patients. TERTIARY OBJECTIVES: I. To assess activated mast cells in skin biopsies in TIPN patients in relation to severity of symptoms and above findings. II. To assess serum inflammatory markers in TIPN patients in relation to severity of symptoms and above findings. OUTLINE: Patients undergo peripheral nerve ultrasound. Patients also undergo skin biopsy. After completion of study, patients are followed up for 30 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peripheral Neuropathy, Stage 0 Breast Cancer, Stage I Breast Cancer, Stage IA Breast Cancer, Stage IB Breast Cancer, Stage II Breast Cancer, Stage IIA Breast Cancer, Stage IIB Breast Cancer, Stage III Breast Cancer, Stage IIIA Breast Cancer, Stage IIIB Breast Cancer, Stage IIIC Breast Cancer, Stage IV Breast Cancer

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Diagnostic (ultrasound)
Arm Type
Experimental
Arm Description
Patients undergo peripheral nerve ultrasound. Patients also undergo skin biopsy.
Intervention Type
Procedure
Intervention Name(s)
Biopsy
Other Intervention Name(s)
Bx
Intervention Description
Undergo skin biopsy
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Intervention Type
Diagnostic Test
Intervention Name(s)
Ultrasound Tomography
Intervention Description
Undergo peripheral nerve ultrasound
Primary Outcome Measure Information:
Title
Tibial nerve cross-sectional area
Description
Will be determined by ultrasound in the tibial nerve. Will be compared to the historical data from healthy patients using two-sample t-test (two-sample t-test selected as primary data from the historical control patients is available and will be used for analysis). Will also compare the nerve cross-sectional area in our study sample to that in the historical diabetic neuropathy patients and historical oxaliplatin neuropathy patients using one-sample t-test. The general linear model will be used to evaluate any factors (e.g., age) that may be associated with the nerve cross-sectional area. Due
Time Frame
Up to 30 days
Secondary Outcome Measure Information:
Title
Amplitude of nerve response
Description
Spearman's rank correlation coefficient will be used to examine the associations between nerve cross-sectional area and nerve conduction studies.
Time Frame
Up to 30 days
Title
Conduction velocity of nerve response
Description
Spearman's rank correlation coefficient will be used to examine the associations between nerve cross-sectional area and nerve conduction studies.
Time Frame
Up to 30 days
Title
Distal latency of nerve response
Description
Spearman's rank correlation coefficient will be used to examine the associations between nerve cross-sectional area and nerve conduction studies.
Time Frame
Up to 30 days
Title
Nerve fiber density in the skin
Description
Spearman's rank correlation coefficient will be used to examine the association between nerve cross-sectional area and intraepidermal nerve fiber density.
Time Frame
Up to 30 days
Title
Self-reported neuropathy score
Description
Will be assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Chemotherapy-Induced Peripheral Neuropathy 20. Spearman's rank correlation coefficient will be used to examine the associations between the cross-sectional area and the self-reported neuropathy scale.
Time Frame
Up to 30 days
Title
Sural nerve cross-sectional area
Description
Will be determined by ultrasound of the sural nerve. Spearman's rank correlation coefficient will be used to examine the associations between nerve cross-sectional area and nerve conduction studies. The general linear model will be also used to evaluate the association after adjusting for one or two risk factors (e.g., age). Nerve cross-sectional area will be treated as the dependent variable.
Time Frame
Up to 30 days
Other Pre-specified Outcome Measures:
Title
Serum levels of inflammatory molecules
Description
Spearman's rank correlation coefficient will be used to assess the associations between activated mast cells in skin biopsies, serum inflammatory markers, severity of symptoms, and primary outcome and secondary outcomes in taxane-induced peripheral neuropathy patients.
Time Frame
Up to 30 days
Title
The number of activated mast cells
Description
Spearman's rank correlation coefficient will be used to assess the associations between activated mast cells in skin biopsies, serum inflammatory markers, severity of symptoms, and primary outcome and secondary outcomes in taxane-induced peripheral neuropathy patients.
Time Frame
Up to 30 days

10. Eligibility

Sex
Female
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Breast cancer (any stage) Previously or currently receiving taxane-based chemotherapy Clinical symptoms of peripheral neuropathy noted in medical record and suspected to be secondary to taxane-based therapy Ability and willingness to understand and sign an informed consent Exclusion Criteria: Self-reported or documented history of pre-existing peripheral neuropathy prior to initiation of taxane chemotherapy Unable to provide history
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roy Strowd
Organizational Affiliation
Wake Forest University Health Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Comprehensive Cancer Center of Wake Forest University
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States

12. IPD Sharing Statement

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Ultrasound in Detecting Taxane-Induced Neuropathy in Patients With Breast Cancer

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