Topical Cannabidiol for the Treatment of Chemotherapy-Induced Peripheral Neuropathy
Topical Cannabidiol (CBD) for the Treatment of Chemotherapy-Induced Peripheral Neuropathy: A Randomized Placebo-Controlled Pilot Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To evaluate whether topical cannabidiol (CBD) improves CIPN, compared to placebo.
II. To evaluate side effects from topical CBD cream use, compared to placebo.
SECONDARY OBJECTIVES:
I. Other measures of neuropathy as measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) CIPN20 motor subscale, the EORTC QLQ CIPN20 autonomic scale, and the total Common Terminology Criteria for Adverse Events (CTCAE) neuropathy scale.
II. Adverse event profiles will also be assessed using symptom questionnaires and CTCAE version (v)5.0.
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients apply cannabidiol cream topically to affected areas twice daily (BID) for 14 days. Patients then apply placebo cream topically to affected areas BID for 14 days.
ARM II: Patients apply placebo cream topically to affected areas BID for 14 days. Patients then apply cannabidiol cream topically to affected areas BID for 14 days.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Minnesota
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Albert Lea, Minnesota, United States, 56007
- Mayo Clinic Health System Albert Lea
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Grand Rapids, Minnesota, United States, 55744
- Fairview Grand Itasca Clinic and Hospital
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Hibbing, Minnesota, United States, 55746
- Fairview Range Medical Center
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Mankato, Minnesota, United States, 56001
- Mayo Clinic Health System Mankato
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Monticello, Minnesota, United States, 55362
- Monticello Cancer Center
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Princeton, Minnesota, United States, 55371
- Fairview Northland Medical Center
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Rochester, Minnesota, United States, 55905
- Mayo Clinic in Rochester
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Thief River Falls, Minnesota, United States, 56701
- Sanford Thief River Falls
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Worthington, Minnesota, United States, 56187
- Sanford Worthington
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age >= 18 years
- English speaking
- Cancer diagnosis of any tumor type with chemotherapy-induced neuropathy
- At least 4 out of 10 severity of neuropathy pain and/or tingling
- Stable for at least 7 days prior to registration on medications for neuropathy, if any are being used
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0, 1 or 2
Negative pregnancy test done =< 7 days prior to registration, for persons of childbearing potential only
- NOTE: If a urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required
- Able to provide written informed consent
- Ability to complete questionnaire(s) by themselves or with assistance
- No evidence of residual cancer
- Platelet count > 100,000/mm^3 (following completion of chemotherapy)
- Absolute neutrophil count (ANC) >= 1,000/mm^3 (following completion of chemotherapy)
- Hemoglobin > 11 g/dL (following completion of chemotherapy)
- Serum transaminase (alanine aminotransferase [ALT] or aspartate aminotransferase [AST]) =< 1.2 x upper limit of normal (ULN) (following completion of chemotherapy)
- Alkaline phosphatase =< 1.2 x ULN (following completion of chemotherapy)
- Serum creatinine =< 1.2 x ULN (following completion of chemotherapy)
Exclusion Criteria:
Any of the following because this study involves an investigational agent whose genotoxic, mutagenic and teratogenic effects on the developing fetus and newborn are unknown:
- Pregnant persons
- Nursing persons
- Persons of childbearing potential who are unwilling to employ adequate contraception
- Any medical condition that would prohibit use of a topical cream (skin infection or open wound in the area of the neuropathy)
- Co-morbid systemic illnesses or other severe concurrent disease which, in the judgment of the investigator, would make the patient inappropriate for entry into this study or interfere significantly with the proper assessment of safety and toxicity of the prescribed regimens
- Pre-existing neuropathy prior to chemotherapy that would confuse the issue of CIPN
- Currently on chemotherapy or received chemotherapy treatment within the prior 3 months
- Use of other cannabis products within 30 days prior to registration
- History of allergy to cannabis products
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm I (cannabidiol, placebo)
Patients apply cannabidiol cream topically to affected areas BID for 14 days.
Patients then apply placebo cream topically to affected areas BID for 14 days.
|
Ancillary studies
Other Names:
Ancillary studies
Applied topically
Other Names:
Applied topically
|
|
Experimental: Arm II (placebo, cannabidiol)
Patients apply placebo cream topically to affected areas BID for 14 days.
Patients then apply cannabidiol cream topically to affected areas BID for 14 days.
|
Ancillary studies
Other Names:
Ancillary studies
Applied topically
Other Names:
Applied topically
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Chemotherapy-induced Peripheral Neuropathy (CIPN) From Baseline
Time Frame: Week 1, week 2, week 3, and week 4
|
CIPN will be measured by the sensory subscale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-CIPN20 which is composed of 9 individual items.
Each item is scored on a 1-to-4 scale, where 1 means "not at all" and 4 means "very much."
Higher scores indicate greater severity of symptoms.
|
Week 1, week 2, week 3, and week 4
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in EORTC QLQ CIPN20 Motor Subscale From Baseline
Time Frame: Week 1, week 2, week 3, and week 4
|
Motor symptoms of CIPN will be measured by the motor subscale of the EEORTC QLQ-CIPN20 which is composed of 8 individual items.
Each item is scored on a 1-to-4 scale, where 1 means "not at all" and 4 means "very much."
Higher scores indicate greater severity of symptoms.
Will be compared between arms using two-sample, two-sided t-tests.
The cannabidiol arm will be compared to the placebo arm.
Will construct 95% confidence intervals for the mean difference in sensory neuropathy score between arms.
Repeated measures mixed models will be applied to the sensory scores over all time points to determine longitudinal effects and to adjust for confounding factors.
Graphical results will include profile plots over time, stream plots of individual changes over time, and forest plots of the 95% confidence intervals by arm.
|
Week 1, week 2, week 3, and week 4
|
|
Change in EORTC QLQ CIPN20 Autonomic Scale From Baseline
Time Frame: Week 1, week 2, week 3, and week 4
|
Autonomic nervous system symptoms related to CIPN will be measured by the autonomic subscale of the EEORTC QLQ-CIPN20 which is composed of 3 individual items answered on a 4-point scale ranging from "not at all' to "very much." .
Higher scores indicate more severe symptoms.
Will be compared between arms using two-sample, two-sided t-tests.
The cannabidiol arm will be compared to the placebo arm.
Will construct 95% confidence intervals for the mean difference in sensory neuropathy score between arms.
Repeated measures mixed models will be applied to the sensory scores over all time points to determine longitudinal effects and to adjust for confounding factors.
Graphical results will include profile plots over time, stream plots of individual changes over time, and forest plots of the 95% confidence intervals by arm.
|
Week 1, week 2, week 3, and week 4
|
|
Incidence of Adverse Events (AEs)
Time Frame: Up to 14 days for each part of a sequence
|
Incidence of AEs will be reported per arm, assessed using Common Terminology Criteria (CTCAE) version 5.0.
|
Up to 14 days for each part of a sequence
|
|
Incidence of Grade 3 or Higher Adverse Events
Time Frame: Up to 28 days
|
Will be assessed using symptom questionnaires and CTCAE version 5.0.
Will compare the maximum (worst) values between arms.
Fisher's exact tests will be used to compare incidence rates and Wilcoxon rank-sum tests will be used to compare maximum values between arms.
|
Up to 28 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Stacy D. D'Andre, M.D., Mayo Clinic in Rochester
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- MC211003 (Mayo Clinic in Rochester)
- NCI-2022-02479 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- 21-011969 (Other Identifier: Mayo Clinic Institutional Review Board)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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