- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT07593365
Clinical Application of Vagus Nerve Stimulation Combined With Immunoregulatory T Cells in Alleviating Aromatase Inhibitor-Induced Pain
The goal of this clinical trial is to learn whether transcutaneous auricular vagus nerve stimulation, also called taVNS, can help relieve aromatase inhibitor-related joint and muscle pain in adult women with hormone receptor-positive breast cancer.
The main questions this study aims to answer are:
- Does taVNS reduce pain caused by aromatase inhibitor treatment?
- Does taVNS improve quality of life, mood symptoms, and the need for pain medicine?
- What side effects or medical problems occur during treatment?
Researchers will compare active taVNS with sham stimulation. Participants in both groups will receive mild electrical stimulation around the ear, but the sham stimulation will be applied to an area not expected to activate the vagus nerve.
Participants will:
- Be randomly assigned to active taVNS or sham stimulation
- Receive one 30-minute treatment session every day for 28 days
- Complete pain, mood, and quality-of-life questionnaires before treatment, after treatment, and during follow-up
- Report pain medicine use and any side effects
- Provide small blood samples to measure inflammatory markers, T-cell profiles, and tumor markers
Participants will be followed for up to 6 months after treatment. For some participants who do not have enough pain relief after taVNS, an optional second-stage study may be offered. In this stage, participants may receive low-dose interleukin-2, also called IL-2, by injection every other day for 2 weeks.
Tutkimuksen yleiskatsaus
Tila
Ehdot
Interventio / Hoito
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskeluyhteys
- Nimi: Yi Feng, M.D
- Puhelinnumero: +86-010-88325590
- Sähköposti: fengyi@pkuph.edu.cn
Tutki yhteystietojen varmuuskopiointi
- Nimi: Pei Li, M.D
- Puhelinnumero: +86-13126762029
- Sähköposti: pli@stu.pku.edu.cn
Opiskelupaikat
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Beijing Municipality
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Beijing, Beijing Municipality, Kiina, 100044
- Peking University People's Hospital
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Ottaa yhteyttä:
- Pei Li, M.D
- Puhelinnumero: +86-13126762029
- Sähköposti: pli@stu.pku.edu.cn
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Kuvaus
Inclusion Criteria:
- Female participants aged over 18 years;
- Patients with pathologically confirmed stage I-III primary breast cancer;
- Patients who have recovered from systemic symptoms related to surgery, radiotherapy, or chemotherapy;
- Patients with estrogen receptor- and/or progesterone receptor-positive breast cancer who are receiving aromatase inhibitor therapy and have aromatase inhibitor-related musculoskeletal pain, with a score greater than 3 on the Worst Pain item of the Brief Pain Inventory (BPI-WP);
- Patients who have received aromatase inhibitor therapy for more than 30 days and are expected to continue treatment for more than 1 year;
Patients who voluntarily agree to participate in this study and sign the informed consent form.
For participants receiving combined IL-2 treatment, the following additional criterion applies:
- Pain relief rate of less than 50% after taVNS treatment and a lower peripheral blood Treg count than before treatment.
Exclusion Criteria:
- Patients with advanced breast cancer;
- Patients with other significant organ dysfunction, such as major cardiovascular disease, diabetes mellitus, or hyperthyroidism;
- Patients with other cancers;
- Patients with a history of fracture or surgery around the painful joint area within the past 6 months;
- Patients currently receiving corticosteroids or opioid therapy;
- Patients with contraindications to vagus nerve stimulation;
- Patients who are unable to communicate normally, such as those with cognitive impairment or hearing impairment;
Patients who have participated in another clinical trial within the past 1 month.
For participants receiving combined IL-2 treatment, the following additional exclusion criteria apply:
- Severe cardiac or renal disease, or hematologic disease;
- Previous IL-2-related toxic reaction or allergy;
- Use of other biologic agents or immunosuppressive drugs within the past 1 month;
- Any other condition that the investigator considers unsuitable for study participation.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Kaksinkertainen
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
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Active Comparator: transcutaneous auricular vagus nerve stimulation group
Electrodes will be placed on specific areas of the participant's left external ear that are mainly innervated by the auricular branch of the vagus nerve.
The electrodes will be connected to an electrical stimulation device, and stimulation will be delivered at tolerable intensity using preset study parameters.
Treatment will be given once daily for 28 consecutive days.
|
Electrodes will be placed on specific areas of the participant's left external ear that are mainly innervated by the auricular branch of the vagus nerve.
The electrodes will be connected to an electrical stimulation device, and stimulation will be delivered at tolerable intensity using preset study parameters.
Treatment will be given once daily for 28 consecutive days.
Muut nimet:
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Huijausvertailija: sham stimulation group
Compared with transcutaneous auricular vagus nerve stimulation group, electrodes will be placed on different areas of the participant's left external ear that are not innervated by the auricular branch of the vagus nerve.
The electrodes will be connected to an electrical stimulation device, and stimulation will be delivered at tolerable intensity using preset study parameters.
Treatment will be given once daily for 28 consecutive days.
|
Compared with transcutaneous auricular vagus nerve stimulation group, electrodes will be placed on different areas of the participant's left external ear that are not innervated by the auricular branch of the vagus nerve.
The electrodes will be connected to an electrical stimulation device, and stimulation will be delivered at tolerable intensity using preset study parameters.
Treatment will be given once daily for 28 consecutive days.
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
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The pain relief rate of patients at the end of the 4-week treatment period
Aikaikkuna: From enrollment to the end of treatment at 4 weeks.
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From enrollment to the end of treatment at 4 weeks.
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Pain relief rate at follow-up
Aikaikkuna: At 1, 2, 3, and 6 months after completion of treatment.
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At 1, 2, 3, and 6 months after completion of treatment.
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Dosage of analgesic drugs
Aikaikkuna: At 1, 2, 3, and 6 months after completion of treatment.
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At 1, 2, 3, and 6 months after completion of treatment.
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Depression scores
Aikaikkuna: At 1, 2, 3, and 6 months after completion of treatment.
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PHQ-9 is used to measure depression.
PHQ-9 ( unabbreviated scale title: Patient Health Questionnaire-9) Minimum Value: 0 Maximum Value: 27 Score Interpretation: Higher scores mean a WORSE outcome.
Details:The PHQ-9 is a screening tool for depression.
A higher score indicates more severe depressive symptoms.
Generally, scores are interpreted as follows: 0-4 (Minimal), 5-9 (Mild), 10-14 (Moderate), 15-19 (Moderately Severe), and 20-27 (Severe) depression.
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At 1, 2, 3, and 6 months after completion of treatment.
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Anxiety scores
Aikaikkuna: At 1, 2, 3, and 6 months after completion of treatment.
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GAD-7 is used to measure anxiety.
GAD-7 (unabbreviated scale title: Generalized Anxiety Disorder-7) Minimum Value: 0 Maximum Value: 21 Score Interpretation: Higher scores mean a WORSE outcome.
Details:The GAD-7 measures the severity of generalized anxiety disorder.
A higher score reflects more frequent and severe anxiety symptoms.
Typical interpretations are: 0-4 (Minimal), 5-9 (Mild), 10-14 (Moderate), and 15-21 (Severe) anxiety.
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At 1, 2, 3, and 6 months after completion of treatment.
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Quality of life score
Aikaikkuna: At 1, 2, 3, and 6 months after completion of treatment.
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Quality of life assessed by the EuroQol 5-Dimension 5-Level questionnaire and EuroQol Visual Analogue Scale Description: Quality of life will be assessed using the EuroQol 5-Dimension 5-Level questionnaire (EQ-5D-5L) and the EuroQol Visual Analogue Scale (EQ VAS). For the EQ-5D-5L descriptive system, scores range from 5 to 25, with higher scores indicating worse health status. For the EQ VAS, scores range from 0 to 100, with higher scores indicating better self-rated health status. |
At 1, 2, 3, and 6 months after completion of treatment.
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Plasma inflammatory marker levels
Aikaikkuna: Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
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Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
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The proportion of T cells in the blood
Aikaikkuna: Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
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Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
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The count of T cells in the blood
Aikaikkuna: Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
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Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
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Muut tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
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Tumor marker levels
Aikaikkuna: Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
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Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
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Adverse events and serious adverse events
Aikaikkuna: Adverse events and serious adverse events will be recorded throughout the study.
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Adverse events and serious adverse events will be recorded throughout the study.
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Yhteistyökumppanit ja tutkijat
Sponsori
Yhteistyökumppanit
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Redgrave J, Day D, Leung H, Laud PJ, Ali A, Lindert R, Majid A. Safety and tolerability of Transcutaneous Vagus Nerve stimulation in humans; a systematic review. Brain Stimul. 2018 Nov-Dec;11(6):1225-1238. doi: 10.1016/j.brs.2018.08.010. Epub 2018 Aug 23.
- Zhang S, Zhao Y, Qin Z, Han Y, He J, Zhao B, Wang L, Duan Y, Huo J, Wang T, Wang Y, Rong P. Transcutaneous Auricular Vagus Nerve Stimulation for Chronic Insomnia Disorder: A Randomized Clinical Trial. JAMA Netw Open. 2024 Dec 2;7(12):e2451217. doi: 10.1001/jamanetworkopen.2024.51217.
- Zhang Q, Hresko ME, Picton LK, Su L, Hollander MJ, Nunez-Cruz S, Zhang Z, Assenmacher CA, Sockolosky JT, Garcia KC, Milone MC. A human orthogonal IL-2 and IL-2Rbeta system enhances CAR T cell expansion and antitumor activity in a murine model of leukemia. Sci Transl Med. 2021 Dec 22;13(625):eabg6986. doi: 10.1126/scitranslmed.abg6986. Epub 2021 Dec 22.
- Ren Z, Zhang A, Sun Z, Liang Y, Ye J, Qiao J, Li B, Fu YX. Selective delivery of low-affinity IL-2 to PD-1+ T cells rejuvenates antitumor immunity with reduced toxicity. J Clin Invest. 2022 Feb 1;132(3):e153604. doi: 10.1172/JCI153604.
- Miao M, Li Y, Huang B, Chen J, Jin Y, Shao M, Zhang X, Sun X, He J, Li Z. Treatment of Active Idiopathic Inflammatory Myopathies by Low-Dose Interleukin-2: A Prospective Cohort Pilot Study. Rheumatol Ther. 2021 Jun;8(2):835-847. doi: 10.1007/s40744-021-00301-3. Epub 2021 Apr 14.
- Zhang X, Miao M, Zhang R, Liu X, Zhao X, Shao M, Liu T, Jin Y, Chen J, Liu H, Zhang X, Li Y, Zhou Y, Yang Y, Li R, Yao H, Liu Y, Li C, Li Y, Ren L, Su Y, Sun X, He J, Li Z. Efficacy and safety of low-dose interleukin-2 in combination with methotrexate in patients with active rheumatoid arthritis: a randomized, double-blind, placebo-controlled phase 2 trial. Signal Transduct Target Ther. 2022 Mar 7;7(1):67. doi: 10.1038/s41392-022-00887-2.
- He J, Chen J, Miao M, Zhang R, Cheng G, Wang Y, Feng R, Huang B, Luan H, Jia Y, Jin Y, Zhang X, Shao M, Wang Y, Zhang X, Li J, Zhao X, Wang H, Liu T, Xiao X, Zhang X, Su Y, Mu R, Ye H, Li R, Liu X, Liu Y, Li C, Liu H, Hu F, Guo J, Liu W, Zhang WB, Jacob A, Ambrus JL Jr, Ding C, Yu D, Sun X, Li Z. Efficacy and Safety of Low-Dose Interleukin 2 for Primary Sjogren Syndrome: A Randomized Clinical Trial. JAMA Netw Open. 2022 Nov 1;5(11):e2241451. doi: 10.1001/jamanetworkopen.2022.41451.
- He J, Zhang X, Wei Y, Sun X, Chen Y, Deng J, Jin Y, Gan Y, Hu X, Jia R, Xu C, Hou Z, Leong YA, Zhu L, Feng J, An Y, Jia Y, Li C, Liu X, Ye H, Ren L, Li R, Yao H, Li Y, Chen S, Zhang X, Su Y, Guo J, Shen N, Morand EF, Yu D, Li Z. Low-dose interleukin-2 treatment selectively modulates CD4(+) T cell subsets in patients with systemic lupus erythematosus. Nat Med. 2016 Sep;22(9):991-3. doi: 10.1038/nm.4148. Epub 2016 Aug 8.
- Yang Y, Zhang R, Zhong Z, Li J, Feng Y. Efficacy of transauricular vagus nerve stimulation for the treatment of chemotherapy-induced painful peripheral neuropathy: a randomized controlled exploratory study. Neurol Sci. 2024 May;45(5):2289-2300. doi: 10.1007/s10072-023-07229-2. Epub 2023 Dec 8.
- Abdullahi A, Wong TWL, Ng SSM. Putative role of non-invasive vagus nerve stimulation in cancer pathology and immunotherapy: Can this be a hidden treasure, especially for the elderly? Cancer Med. 2023 Sep;12(18):19081-19090. doi: 10.1002/cam4.6466. Epub 2023 Aug 17.
- Shi X, Hu Y, Zhang B, Li W, Chen JD, Liu F. Ameliorating effects and mechanisms of transcutaneous auricular vagal nerve stimulation on abdominal pain and constipation. JCI Insight. 2021 Jul 22;6(14):e150052. doi: 10.1172/jci.insight.150052.
- Barbanti P, Grazzi L, Egeo G, Padovan AM, Liebler E, Bussone G. Non-invasive vagus nerve stimulation for acute treatment of high-frequency and chronic migraine: an open-label study. J Headache Pain. 2015;16:61. doi: 10.1186/s10194-015-0542-4. Epub 2015 Jun 30.
- Arem H, Sorkin M, Cartmel B, Fiellin M, Capozza S, Harrigan M, Ercolano E, Zhou Y, Sanft T, Gross C, Schmitz K, Neogi T, Hershman D, Ligibel J, Irwin ML. Exercise adherence in a randomized trial of exercise on aromatase inhibitor arthralgias in breast cancer survivors: the Hormones and Physical Exercise (HOPE) study. J Cancer Surviv. 2016 Aug;10(4):654-62. doi: 10.1007/s11764-015-0511-6. Epub 2016 Jan 19.
- van Hellemond IEG, Geurts SME, Tjan-Heijnen VCG. Current Status of Extended Adjuvant Endocrine Therapy in Early Stage Breast Cancer. Curr Treat Options Oncol. 2018 Apr 27;19(5):26. doi: 10.1007/s11864-018-0541-1.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Arvioitu)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
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Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- 2026PHB256-001
- 82571385 (Muu apuraha/rahoitusnumero: National Natural Science Foundation of China)
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