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Effectiveness of Cryotherapy Combined With Compression Therapy for Preventing Chemotherapy-induced Peripheral Neuropathy

Primary Purpose

Breast Cancer

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Frozen glove and sock
ddEC-ddT
Sponsored by
Peking University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Breast Cancer focused on measuring Chemotherapy-induced Peripheral Neuropathy, Albumin-paclitaxel, Cryotherapy, Compression Therapy, dose-dense chemotherapy

Eligibility Criteria

20 Years - 70 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Female patients aged from 20 to 70 years old;
  2. Histologically confirmed as invasive breast cancer;
  3. HER-2 negative (defined by IHC 0 or 1+ ,or FISH negative);
  4. Participants who meet any of the following conditions: 1) T > 2 cm, ER<1% and PR<1%; 2) T > 2 cm, ER≥1% and biopsy pathology (FNAB or CNB) diagnosed regional lymph node metastasis;
  5. Without any previous treatment;
  6. ddEC-ddT neoadjuvant chemotherapy is planned;
  7. Participants must have at least one measurable disease according to RECIST 1.1;
  8. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
  9. LVEF ≥ 50%;
  10. The ECG results are judged to be almost normal or normal, or the investigator judges that the abnormalities are not clinically significant;
  11. Bone marrow function: absolute neutrophil counts (ANC) ≥ 1.5x10^9/L, platelets ≥ 100x10^9/L, hemoglobin ≥ 90g/L;
  12. Liver and kidney function: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are both ≤2.5 ULN; serum total bilirubin and serum creatinine are both ≤ 1.5 ULN;
  13. Participants had good compliance with the planned treatment and follow-up, understood the study procedures of this study, and signed informed consent form.

Exclusion Criteria:

  1. Breast cancer with distant metastasis;
  2. A history of other malignancies;
  3. In the past or present, participants with sensory or motor neurological diseases;
  4. Participants who are known to be allergic to the active or other components of the study treatment;
  5. Cerebral thrombosis is present;
  6. In the past and present, participants with severe cardiac disease or discomfort , including but not limited: 1) High-risk uncontrolled arrhythmia, atrial tachycardia (heart rate > 100/min in resting state), significant ventricular arrhythmia (ventricular arrhythmia) or higher atrioventricular block (second-degree type 2 [Mobitz 2] atrioventricular block or third-degree atrioventricular block); 2) Angina pectoris requiring anti-angina medication; 3) Clinically significant valvular heart disease; 4) ECG showing transmural myocardial infarction; 5) ncontrolled hypertension (eg systolic blood pressure > 180mm Hg or diastolic blood pressure > 100mmHg); 6) Myocardial infarction; 7) Congestive heart failure;
  7. Participants have the following serious illnesses or medical conditions, including but not limited: 1) History of serious neurological or psychiatric disorders, including psychosis, dementia, or epilepsy, that prevent understanding and informed consent; 2) Active uncontrolled infection; 3) Active pepticulcer, unstable diabetes;
  8. Participants who are pregnant, breastfeeding, or refuse to use adequate contraception prior to study entry and for the duration of study participation;
  9. Participants who were judged by the investigator to be unsuitable for this study.

Sites / Locations

  • Peking University Cancer HospitalRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Other

Arm Label

ddEC-ddT and cryotherapy combined with compression

ddEC-ddT

Arm Description

Cryotherapy will be applied using a frozen glove and sock for 15 minutes before, during and 15 minutes after each albumin-paclitaxel infusion. Compression therapy will be applied using a surgical glove for 30 minutes before, during and 30 minutes after each albumin-paclitaxel infusion.

ddEC-ddT will be administered without cryotherapy combined with compression.

Outcomes

Primary Outcome Measures

Incidence of grade 3 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0
Incidence of grade 3 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0

Secondary Outcome Measures

Incidence of grade 2 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0
Incidence of grade 2 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0
Proportion of patients reporting level D and above based on the Patient Neurotoxicity Questionnaire (PNQ)
PNQ scale ranges from scores A to E; with scoring of A being not affected neuropathy, and E with the worst neuropathy.
EORTC QLQ-CIPN20
The EORTC QLQ-CIPN20 is a fairly new 20-item questionnaire evaluating various aspects of CIPN. It has three subscales assessing sensory (nine items), motor (eight items), and autonomic (three items) symptoms and functioning with each item measured on an ordinal 1-4 scale (1, not at all; 4, very much).
Incidence and severity of other adverse events as assessed by NCI-CTCAE V5.0
Incidence and severity of other adverse events as assessed by NCI-CTCAE V5.0
Total pathological complete response (tpCR) rate
Total pathological complete response (tpCR) was defined as the absence of invasive lesions in the breast and axillary lymph nodes (ypT0/is ypN0). The tpCR rate is the percentage of participants with tpCR.
Breast pathological complete response (bpCR) rate
Breast pathological complete response (bpCR) was defined as no invasive carcinoma in the breast (ypT0/is). The bpCR rate is the percentage of participants with bpCR.
Objective response rate (ORR)
The number of participants who achieved complete response and partial response at the end of neoadjuvant chemotherapy as a percentage of the overall evaluable participants.
Invasive disease-free survival (IDFS)
Invasive disease free survival was defined as the time from enrollment until the date of first occurrence of one of the following events: invasive ipsilateral breast tumor recurrence, local/regional invasive recurrence, distant recurrence (including first metastasis), invasive contralateral breast cancer, second primary invasive cancer (nonbreast, not including squamous or basal cell skin cancers, or new in situ carcinomas of any site), or death from any cause.

Full Information

First Posted
April 17, 2022
Last Updated
June 10, 2022
Sponsor
Peking University
Collaborators
CSPC Ouyi Pharmaceutical Co., Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05341141
Brief Title
Effectiveness of Cryotherapy Combined With Compression Therapy for Preventing Chemotherapy-induced Peripheral Neuropathy
Official Title
Effectiveness of Cryotherapy Combined With Compression Therapy in Preventing Albumin-paclitaxel Induced Peripheral Neuropathy in Breast Cancer Patients
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Recruiting
Study Start Date
June 10, 2022 (Actual)
Primary Completion Date
August 2026 (Anticipated)
Study Completion Date
November 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking University
Collaborators
CSPC Ouyi Pharmaceutical Co., Ltd.

4. Oversight

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

5. Study Description

Brief Summary
This is a prospective, multi-center, randomized study designed to evaluate the clinical efficacy of cryotherapy combined with compression therapy in preventing albumin-paclitaxel induced peripheral neuropathy.
Detailed Description
All HER-2 negative breast cancer patients received neoadjuvant chemotherapy with four cycles of dose-dense epirubicin and cyclophosphamide (ddEC) followed by four cycles of dose-dense albumin-paclitaxel (ddT). The patients were randomly assigned in a 1:1 ratio to receive cryotherapy combined with compression or no intervention. The primary endpoint was incidence of grade 3 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer
Keywords
Chemotherapy-induced Peripheral Neuropathy, Albumin-paclitaxel, Cryotherapy, Compression Therapy, dose-dense chemotherapy

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
102 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ddEC-ddT and cryotherapy combined with compression
Arm Type
Experimental
Arm Description
Cryotherapy will be applied using a frozen glove and sock for 15 minutes before, during and 15 minutes after each albumin-paclitaxel infusion. Compression therapy will be applied using a surgical glove for 30 minutes before, during and 30 minutes after each albumin-paclitaxel infusion.
Arm Title
ddEC-ddT
Arm Type
Other
Arm Description
ddEC-ddT will be administered without cryotherapy combined with compression.
Intervention Type
Device
Intervention Name(s)
Frozen glove and sock
Intervention Description
Preparation of frozen glove and sock: 4℃ for 3 hours.
Intervention Type
Drug
Intervention Name(s)
ddEC-ddT
Other Intervention Name(s)
Chemotherapy
Intervention Description
Epirubicin (E) 90~100mg/m^2, i.v., d1 + cyclophosphamide (C) 600 mg/m^2, i.v., d1, q2w, for 4 cycles followed by albumin-paclitaxel (T) 260 mg/m^2, i.v., d1, q2w, for 4 cycles.
Primary Outcome Measure Information:
Title
Incidence of grade 3 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0
Description
Incidence of grade 3 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0
Time Frame
4 years
Secondary Outcome Measure Information:
Title
Incidence of grade 2 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0
Description
Incidence of grade 2 and higher peripheral neuropathy as assessed by NCI-CTCAE V5.0
Time Frame
4 years
Title
Proportion of patients reporting level D and above based on the Patient Neurotoxicity Questionnaire (PNQ)
Description
PNQ scale ranges from scores A to E; with scoring of A being not affected neuropathy, and E with the worst neuropathy.
Time Frame
4 years
Title
EORTC QLQ-CIPN20
Description
The EORTC QLQ-CIPN20 is a fairly new 20-item questionnaire evaluating various aspects of CIPN. It has three subscales assessing sensory (nine items), motor (eight items), and autonomic (three items) symptoms and functioning with each item measured on an ordinal 1-4 scale (1, not at all; 4, very much).
Time Frame
4 years
Title
Incidence and severity of other adverse events as assessed by NCI-CTCAE V5.0
Description
Incidence and severity of other adverse events as assessed by NCI-CTCAE V5.0
Time Frame
4 years
Title
Total pathological complete response (tpCR) rate
Description
Total pathological complete response (tpCR) was defined as the absence of invasive lesions in the breast and axillary lymph nodes (ypT0/is ypN0). The tpCR rate is the percentage of participants with tpCR.
Time Frame
Within 2 to 4 weeks after completion of neoadjuvant therapy
Title
Breast pathological complete response (bpCR) rate
Description
Breast pathological complete response (bpCR) was defined as no invasive carcinoma in the breast (ypT0/is). The bpCR rate is the percentage of participants with bpCR.
Time Frame
Within 2 to 4 weeks after completion of neoadjuvant therapy
Title
Objective response rate (ORR)
Description
The number of participants who achieved complete response and partial response at the end of neoadjuvant chemotherapy as a percentage of the overall evaluable participants.
Time Frame
After the last dose to before surgery or within 28 days
Title
Invasive disease-free survival (IDFS)
Description
Invasive disease free survival was defined as the time from enrollment until the date of first occurrence of one of the following events: invasive ipsilateral breast tumor recurrence, local/regional invasive recurrence, distant recurrence (including first metastasis), invasive contralateral breast cancer, second primary invasive cancer (nonbreast, not including squamous or basal cell skin cancers, or new in situ carcinomas of any site), or death from any cause.
Time Frame
3 years

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female patients aged from 20 to 70 years old; Histologically confirmed as invasive breast cancer; HER-2 negative (defined by IHC 0 or 1+ ,or FISH negative); Participants who meet any of the following conditions: 1) T > 2 cm, ER<1% and PR<1%; 2) T > 2 cm, ER≥1% and biopsy pathology (FNAB or CNB) diagnosed regional lymph node metastasis; Without any previous treatment; ddEC-ddT neoadjuvant chemotherapy is planned; Participants must have at least one measurable disease according to RECIST 1.1; Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1; LVEF ≥ 50%; The ECG results are judged to be almost normal or normal, or the investigator judges that the abnormalities are not clinically significant; Bone marrow function: absolute neutrophil counts (ANC) ≥ 1.5x10^9/L, platelets ≥ 100x10^9/L, hemoglobin ≥ 90g/L; Liver and kidney function: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are both ≤2.5 ULN; serum total bilirubin and serum creatinine are both ≤ 1.5 ULN; Participants had good compliance with the planned treatment and follow-up, understood the study procedures of this study, and signed informed consent form. Exclusion Criteria: Breast cancer with distant metastasis; A history of other malignancies; In the past or present, participants with sensory or motor neurological diseases; Participants who are known to be allergic to the active or other components of the study treatment; Cerebral thrombosis is present; In the past and present, participants with severe cardiac disease or discomfort , including but not limited: 1) High-risk uncontrolled arrhythmia, atrial tachycardia (heart rate > 100/min in resting state), significant ventricular arrhythmia (ventricular arrhythmia) or higher atrioventricular block (second-degree type 2 [Mobitz 2] atrioventricular block or third-degree atrioventricular block); 2) Angina pectoris requiring anti-angina medication; 3) Clinically significant valvular heart disease; 4) ECG showing transmural myocardial infarction; 5) ncontrolled hypertension (eg systolic blood pressure > 180mm Hg or diastolic blood pressure > 100mmHg); 6) Myocardial infarction; 7) Congestive heart failure; Participants have the following serious illnesses or medical conditions, including but not limited: 1) History of serious neurological or psychiatric disorders, including psychosis, dementia, or epilepsy, that prevent understanding and informed consent; 2) Active uncontrolled infection; 3) Active pepticulcer, unstable diabetes; Participants who are pregnant, breastfeeding, or refuse to use adequate contraception prior to study entry and for the duration of study participation; Participants who were judged by the investigator to be unsuitable for this study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Zhaoqing Fan, MD
Phone
+86-10-88197838
Email
zhqfan@sina.com
First Name & Middle Initial & Last Name or Official Title & Degree
Lize Wang, MD
Phone
+86-10-88197828
Email
lize2010@163.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhaoqing Fan, MD
Organizational Affiliation
Breast center at Peking University Cancer Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peking University Cancer Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100142
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Zhaoqing Fan
Phone
+86-10-88197838
Email
zhqfan@sina.com
First Name & Middle Initial & Last Name & Degree
Zhaoqing Fan, MD
First Name & Middle Initial & Last Name & Degree
Lize Wang, MD

12. IPD Sharing Statement

Learn more about this trial

Effectiveness of Cryotherapy Combined With Compression Therapy for Preventing Chemotherapy-induced Peripheral Neuropathy

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