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Electroacupuncture for Cognitive Toxicity in Cancer Survivors: Assessing Implementation, Cost, and Effectiveness for Integration (EAST-ALIGN)

6. maj 2026 opdateret af: National Cancer Centre, Singapore

ElectroAcupuncture to Manage Symptoms of Cognitive Toxicity in Cancer Survivors: Assessing impLementation, Cost, and effectIveness for inteGratioN (EAST-ALIGN)

The goal of this clinical trial is to evaluate the clinical effectiveness and understand the biological mechanisms of electroacupuncture (EA) in reducing cognitive toxicity among cancer survivors. The study aims are:

  • To evaluate the clinical effectiveness of a 10-week EA regimen targeting neuropsychiatric-related acupoints in reducing cognitive toxicity among cancer survivors in Singapore.
  • To explore the biological mechanisms underlying EA's effects on cognitive function.
  • To assess the early implementation of EA for managing cognitive toxicity in cancer survivors.

Researchers will compare results from the true EA arm, sham EA arm and waitlist control arm, to see if electroacupuncture can help improve cognitive issues related to cancer and its treatment, how it may work, and what factors may affect how it is delivered in cancer care.

Participants will:

  • Be assigned to either of the 3 arms (true EA, sham EA, waitlist control)
  • Received 10 EA sessions (if assigned to true or sham EA arm)
  • Complete 3 study assessment visits at baseline, Week 13, and Week 17
  • Be invited to a one-time interview to share their study experience (optional, if selected)

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Electroacupuncture (EA) is a promising, emerging intervention to manage cognitive toxicity among patients with cancer. The primary goal of the EAST-ALIGN study is to evaluate the clinical effectiveness and understand the biological mechanisms of EA in reducing cognitive toxicity among cancer survivors through a randomized, blinded sham and waitlist controlled, clinical trial. Simultaneously, the investigators will collect implementation data on engaging community Traditional Chinese Medicine (TCM) practitioners to deliver EA. This approach facilitates the early identification and resolution of implementation barriers, accelerating EA adoption into clinical practice if proven effective.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

168

Fase

  • Fase 3

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Singapore
      • Singapore, Singapore, 168583
        • National Cancer Center Singapore
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

Survivor participants

  • Aged 21-85 years
  • Documented cancer diagnosis in electronic health records
  • Perceived by the survivor or oncology care provider that cognitive function has worsened since cancer diagnosis and/or beginning of cancer treatment
  • Able to understand English or Mandarin
  • Able to provide informed consent

Stakeholder participants

  • Aged ≥21 years
  • Identified as having a relevant role, experience, or perspective relating to the delivery, referral, coordination, or implementation of EA or supportive cancer care in the study context
  • Able to provide informed consent

Exclusion Criteria:

Survivor participants

  • Presence of brain metastases
  • Severe needle phobia
  • Known bleeding disorder (e.g. hemophilia, von Willebrand disease, thrombocytopenia).
  • Current use of antiplatelet or anticoagulant therapy (e.g. aspirin, clopidogrel, warfarin, enoxaparin, rivaroxaban, dabigatran)
  • Known blood-borne communicable disease (e.g. hepatitis B, hepatitis C, human immunodeficiency virus)
  • Presence of a pacemaker or other electronic implant, or a history of epilepsy
  • Current acupuncture treatment or acupuncture received within the past 3 months
  • Current pregnancy, planned pregnancy over the next 5 months, or breastfeeding.
  • Incapable of providing informed consent
  • Unable to complete study procedures

Stakeholder participants

  • Incapable of providing informed consent
  • Unable to complete study procedures

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Støttende pleje
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Dobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: True electroacupuncture arm
Each participant will receive 10 electroacupuncture treatment sessions over the course of 10-12 weeks.
Enhed: True electroacupuncture
Electroacupuncture is administered at 13 predefined acupoints: Shenting (GV24), Baihui (DU20), Sishencong (EX-HN1), Zhongwan (CV12), Guanyuan (CV4), Neiguan (PC6, bilateral), Shenmen (HT7, bilateral), Zusanli (ST36, bilateral), Sanyinjiao (SP6, bilateral), Taixi (KI3, bilateral), Zhaohai (KI6, bilateral), Hegu (LI4, bilateral), and Taichong (LIV3, bilateral.
Sham-komparator: Sham electroacupuncture arm
Each participant will receive 10 sham electroacupuncture sessions designed to mimic treatment without therapeutic stimulation over the course of 10-12 weeks.
Enhed: Sham electroacupuncture
Electroacupuncture is administered at predefined non-disease related acupoints: Pianli (LI6) bilateral, Wenliu (LI7) bilateral, Futu (ST32) bilateral, Xiajuxu (ST39) bilateral, Daheng (SP15) bilateral, and Jiaosun (TE20) bilateral.
Ingen indgriben: Waitlist control arm
Each participant will continue to receive usual care, but will not receive electroacupuncture or other acupuncture treatments.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Objective cognitive function - multitasking
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) Multitasking Test, a computerized cognitive testing software. Score ranges from 0-160, with a lower score reflecting better performance. Clinically significant improvement is defined as a Reliable Change Index (RCI) exceeding 1.96 from baseline in at least one out of five tests (including this Multitasking Test).
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Objective cognitive function - learning and memory
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) Paired Associates Learning Test, a computerized cognitive testing software. Score ranges from 0-70, with a lower score reflecting better performance. Clinically significant improvement is defined as a Reliable Change Index (RCI) exceeding 1.96 from baseline in at least one out of five tests (including this Paired Associates Learning Test).
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Objective cognitive function - sustained attention
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) Rapid Visual Information Processing Test, a computerized cognitive testing software. Score ranges from 0-1, with a higher score reflecting better performance. Clinically significant improvement is defined as a Reliable Change Index (RCI) exceeding 1.96 from baseline in at least one out of five tests (including this Rapid Visual Information Processing Test).
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Objective cognitive function - response speed
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) Reaction Time Test, a computerized cognitive testing software. Score ranges from 100-5100 ms, with a lower score reflecting faster reaction time. Clinically significant improvement is defined as a Reliable Change Index (RCI) exceeding 1.96 from baseline in at least one out of five tests (including this Reaction Time Test).
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Objective cognitive function - working memory
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) Spatial Working Memory Test, a computerized cognitive testing software. Score ranges from 0-153, with a lower score reflecting better performance. Clinically significant improvement is defined as a Reliable Change Index (RCI) exceeding 1.96 from baseline in at least one out of five tests (including this Spatial Working Memory Test).
Baseline, 13 weeks after baseline, and 17 weeks after baseline.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Subjective cognitive function
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
The Functional Assessment of Cancer Therapy-Cognition (FACT-Cog) version 3 is a validated 37-item questionnaire assessing self-perceived subjective cognitive function. The total FACT-Cog score is summed from all items (range: 0-148), with higher scores indicating better subjective cognitive functioning.
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Fatigue
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
The Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF) is a validated questionnaire that comprises 30 items and contains 5 subscales, each with 6 items: general fatigue, physical fatigue, emotional fatigue, mental fatigue, and vigor. The total MFSI-SF score is obtained by subtracting the vigor subscale from the sum of all items (range: 24-96), with a higher score indicating higher fatigue level.
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Symptom burden
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
The Rotterdam Symptom Checklist (RSCL) is a validated self-report measure of quality of life in patients with cancer. It includes 30 symptom items, 8 activity items, and 1 overall quality-of-life item. The symptom distress score combines the physical symptom distress scale (23 items, range 23-92) and, psychological distress scale (7 items, range 7-28), for a total range of 30-120. Higher scores indicate greater symptom burden, distress, or quality of life.
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Work productivity
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
The Work Productivity and Activity Impairment (WPAI) questionnaire is a patient-reported outcome measure that assesses the impact of health problems on work productivity and regular activities, including absenteeism, presenteeism, overall work impairment, and activity impairment. Scores in each of these four areas are expressed as a percentage from 0% to 100%, with higher scores indicating greater impairment and worse productivity.
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Health utility
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
EuroQOL Group 5-Dimension (EQ-5D-5L) contains a 5-item descriptive system measuring 5 dimensions: mobility, self-care, usual activities, pain/ discomfort, anxiety/ depression; a visual analogue scale (VAS) measuring overall health status. EQ-5D Index Value (Utility Score) ranges from 0 to 1.0 with higher value indicating better health-related quality of life. The VAS ranges from 0 to 100, with higher scores reflecting better self-rated health.
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Biomarkers - plasma BDNF
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Plasma brain-derived neurotropic factor levels at each time point will be analyzed from blood samples collected.
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Biomarkers - plasma cytokines (IL-1β, IL-4, IL-6, IL-8, IL-10, TNF-alpha)
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Plasma concentrations of interleukin-1 beta (IL-1β), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-alpha) will be measured from blood samples. Each cytokine will be reported in picograms per milliliter (pg/mL). Higher values indicate higher plasma cytokine concentrations.
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Biomarkers - epigenetic ageing
Tidsramme: Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Epigenetic ageing will be assessed using DNA methylation-based biological age metrics derived from blood samples.
Baseline, 13 weeks after baseline, and 17 weeks after baseline.
Safety assessment
Tidsramme: 13 weeks after baseline and 17 weeks after baseline.
Participants will be monitored for adverse events and the severity will be graded according to the Common Terminology Criteria for Adverse Events (CTCAE).
13 weeks after baseline and 17 weeks after baseline.
Implementation - acceptability of electroacupuncture treatment
Tidsramme: 13 weeks after baseline.
Participants in the true and sham EA arms will complete a questionnaire evaluating their perceptions towards the true/sham EA treatment. Participants will be asked if they are satisfied and benefited from the treatment, and whether they would consider undergoing treatment again outside of a trial setting.
13 weeks after baseline.
Implementation - adoption of EA
Tidsramme: From commencement of study recruitment till the end of recruitment, assessed up to 3 years.
Adoption will be evaluated by tracking study enrollment logs, including the number of eligible individuals approached, the number recruited, and documented reasons for non-participation when available.
From commencement of study recruitment till the end of recruitment, assessed up to 3 years.
Implementation - treatment fidelity
Tidsramme: 13 weeks after baseline.
Treatment fidelity will be assessed from standardized treatment logs for each true/sham EA session by the TCM practitioners. For blinding assessment, participants in the true and sham EA arms will be asked to guess their treatment arm allocation (True EA/ Sham EA/ Don't know).
13 weeks after baseline.
Implementation - feasibility
Tidsramme: 17 weeks after baseline, through study completion, estimated as up to 3 years.
Semi-structured interviews conducted using an interview guide developed based on the Consolidated Framework for Implementation Research (CFIR). Semi-structured interviews with key stakeholders (TCM practitioners, tertiary healthcare providers, clinical operations staff) to identify barriers and facilitators to integrating EA into routine oncology care.
17 weeks after baseline, through study completion, estimated as up to 3 years.
Implementation - implementation cost
Tidsramme: From commencement of study recruitment, through study completion, estimated as up to 3 years.
Implementation cost will be assessed using a time-driven activity-based costing approach. A structured activity log will be maintained by study personnel to document the time and resources required for each implementation activity, including personnel effort and fixed consumable resources.
From commencement of study recruitment, through study completion, estimated as up to 3 years.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

National Cancer Centre, Singapore

Samarbejdspartnere

Singapore Thong Chai Medical Institution

Efterforskere

  • Studiestol: Yu KE, PhD, National Cancer Centre, Singapore

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. juli 2026

Primær færdiggørelse (Anslået)

31. oktober 2028

Studieafslutning (Anslået)

13. januar 2029

Datoer for studieregistrering

Først indsendt

24. april 2026

Først indsendt, der opfyldte QC-kriterier

6. maj 2026

Først opslået (Faktiske)

13. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

6. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2026-0516

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