Gabapentin for the Reduction of Radiation Therapy Induced Pain During the Treatment of Oropharyngeal Cancer

January 19, 2022 updated by: Andrew Cook, Henry Ford Health System

Randomized Phase III, Double-Blind, Placebo Controlled Study of Prophylactic Gabapentin for the Reduction of Radiation Therapy Induced Pain During the Treatment of Oropharyngeal Squamous Cell Carcinoma

Strategies to minimize and mitigate external beam radiation therapy related mucositis and pain during the treatment of head and neck cancer remain limited. The investigators hypothesize that gabapentin could be used to delay or reduce treatment-related pain, reliance on opioid medication, and improve the quality of life for these patients.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The specific aims of this proposed study include the following:

  • Evaluate the reduction or delay of mucositis related pain and morbidity with the use of gabapentin in patients with stage III or IV oropharyngeal squamous cell carcinoma undergoing definitive radiation with concurrent chemotherapy as part of their cancer management, compared to standard supportive side effect mitigation - using patient reported quality of life endpoints such as the Patient-Reported Oral Mucositis Symptoms (PROMS) scale.
  • Assess morphine-equivalent opioid use in both treatment arms by collecting the patient's narcotic use in the previous 24-hour period at each weekly evaluation during radiation treatment.
  • Report on change in Speech and swallow performance, as measured by the Performance Status Scale (PSS) for Head and Neck Cancer Patients
  • Evaluate changes in weight from baseline throughout treatment between the two arms.
  • Assess feeding tube requirements during treatment.
  • Evaluate the adverse events associated with gabapentin.
  • Evaluate the severity of radiation mucositis (grade 3-4, CTCAE, v. 4)

Study Type

Interventional

Enrollment (Actual)

65

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Michigan
      • Detroit, Michigan, United States, 48202
        • Henry Ford Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients being treated with combination chemotherapy and radiation therapy daily for locally advanced (stage III-IV) squamous cell carcinoma of the oropharynx.
  • Age ≥ 18.
  • ECOG performance status ≤ 1.
  • Patients must provide study specific informed consent prior to study entry and be able to fill out toxicity and quality of life related questionnaires.

Exclusion Criteria:

  • Patients may not be receiving gabapentin, any other investigational agents, or other anticonvulsants.
  • Patients with metastatic disease are excluded from this clinical trial.
  • Patient with allergies or hypersensitivity to gabapentin.
  • Patients receiving surgery as part of their definitive management.
  • Patients who have received prior chemotherapy or radiation therapy.
  • Patients unable to complete the required forms; however, verbal completion is adequate if recorded on the form daily.
  • Uncontrolled serious illness including, but not limited to, ongoing or serious active infection requiring IV antibiotics for over 30 days, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia other than chronic, stable atrial fibrillation, or psychiatric illness/social situations that would limit compliance with study requirements.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Control Arm
Standard supportive care during definitive treatment plus placebo
Placebo
Experimental: Experimental Arm
Gabapentin plus standard supportive care
Gabapentin is an anticonvulsant and has been used to manage neuropathic pain and is FDA-approved for the treatment of post-herpetic neuralgia and partial onset seizures

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Quality of Life From Mucositis-related Pain Measured by the Patient-Reported Oral Mucositis Symptoms (PROMS) Scale From Baseline to Follow-up
Time Frame: Evaluated change in scores from baseline to 6 weeks post-treatment, approximately 13 weeks
Scale tile: Patient Reported Oral Mucositis Symptoms scale, range 0-1000, higher scores indicate worse outcomes
Evaluated change in scores from baseline to 6 weeks post-treatment, approximately 13 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Total FACT-HN Scores From Baseline to Follow-up
Time Frame: Administered at baseline and at 6-week follow-up endpoint, approximately 13 weeks
Scale: Functional Assessment of Cancer Therapy-Trial Outcome (FACT-HN), range 0-148, higher scores indicate better outcomes
Administered at baseline and at 6-week follow-up endpoint, approximately 13 weeks
Average Opioid Use, Measured in Morphine Equivalents Per Day.
Time Frame: Over the entire study period from baseline to follow-up, approximately 13 weeks
Over the entire study period from baseline to follow-up, approximately 13 weeks
Change in PRO-CTCAE Scores From Baseline to Follow-up
Time Frame: Evaluated change in scores from baseline to 6 weeks post-treatment, approximately 13 weeks
Scale: Patient-reported outcomes of Common Terminology Criteria for Adverse Events (PRO-CTCAE), 5-point Likert scale, higher scores indicate worse outcomes. Range of scores 0-40 (min-max).
Evaluated change in scores from baseline to 6 weeks post-treatment, approximately 13 weeks
Percent Weight Lost
Time Frame: Percent change from baseline to week 7 of treatment
Percent weight lost from baseline to week 7 of treatment (end of treatment)
Percent change from baseline to week 7 of treatment
Feeding Tube Placement
Time Frame: Evaluated placement of feeding tube from baseline (start of radiation) to 6 weeks post-treatment, approximately 13 weeks
Measure of number of patients who required feeding tube placement at any time during the study period
Evaluated placement of feeding tube from baseline (start of radiation) to 6 weeks post-treatment, approximately 13 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Chair: Farzan Siddiqui, MD PhD, Henry Ford Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 5, 2017

Primary Completion (Actual)

December 9, 2020

Study Completion (Actual)

December 9, 2020

Study Registration Dates

First Submitted

June 5, 2017

First Submitted That Met QC Criteria

August 30, 2017

First Posted (Actual)

August 31, 2017

Study Record Updates

Last Update Posted (Actual)

January 26, 2022

Last Update Submitted That Met QC Criteria

January 19, 2022

Last Verified

January 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • HFHS-Gabapentin/RT Study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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