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Lamotrigine in Treating Peripheral Neuropathy Caused by Chemotherapy in Patients With Cancer
The Efficacy of Lamotrigine in the Management of Chemotherapy-Induced Peripheral Neuropathy: A Phase III Randomized, Double Blind, Placebo-Controlled Trial
RATIONALE: Lamotrigine may be effective in reducing pain, numbness, tingling, and other symptoms of peripheral neuropathy. It is not yet known whether lamotrigine is effective in treating peripheral neuropathy caused by chemotherapy.
PURPOSE: This randomized phase III trial is studying how well lamotrigine works in reducing pain, numbness, tingling, and other symptoms of peripheral neuropathy caused by chemotherapy in patients with cancer.
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
OBJECTIVES:
- Compare the efficacy of lamotrigine vs placebo in reducing pain and symptoms of chemotherapy-induced peripheral neuropathy in patients with cancer.
- Compare symptom distress, mood states, functional abilities, and overall quality of life of patients treated with these agents.
- Determine the toxic effects of lamotrigine in these patients.
OUTLINE: This is a randomized, placebo-controlled, double-blind study. Patients are stratified according to neurotoxic chemotherapy received (taxanes vs platinum-based compounds vs vinca alkaloids vs combination vs other), status of neurotoxic chemotherapy (actively receiving therapy vs discontinued or completed), and duration of pain or neuropathy symptoms (1-3 months vs 3-6 months vs more than 6 months). Patients are randomized to 1 of 2 treatment arms.
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 3
Contacten en locaties
Studie Locaties
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Arizona
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Scottsdale, Arizona, Verenigde Staten, 85259
- Mayo Clinic Scottsdale
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Florida
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Jacksonville, Florida, Verenigde Staten, 32224
- Mayo Clinic - Jacksonville
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Georgia
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Atlanta, Georgia, Verenigde Staten, 30342-1701
- CCOP - Atlanta Regional
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Hawaii
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Honolulu, Hawaii, Verenigde Staten, 96813
- MBCCOP - Hawaii
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Illinois
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Peoria, Illinois, Verenigde Staten, 61615-7828
- CCOP - Illinois Oncology Research Association
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Urbana, Illinois, Verenigde Staten, 61801
- CCOP - Carle Cancer Center
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Iowa
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Cedar Rapids, Iowa, Verenigde Staten, 52403-1206
- CCOP - Cedar Rapids Oncology Project
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Des Moines, Iowa, Verenigde Staten, 50309-1854
- CCOP - Iowa Oncology Research Association
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Sioux City, Iowa, Verenigde Staten, 51101-1733
- Siouxland Hematology-Oncology Associates at June E. Nylen Cancer Center
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Kansas
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Wichita, Kansas, Verenigde Staten, 67214-3882
- CCOP - Wichita
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Michigan
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Ann Arbor, Michigan, Verenigde Staten, 48106
- CCOP - Michigan Cancer Research Consortium
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Minnesota
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Duluth, Minnesota, Verenigde Staten, 55805
- CCOP - Duluth
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Rochester, Minnesota, Verenigde Staten, 55905
- Mayo Clinic Cancer Center
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Saint Cloud, Minnesota, Verenigde Staten, 56303
- Coborn Cancer Center
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Saint Louis Park, Minnesota, Verenigde Staten, 55416
- CCOP - Metro-Minnesota
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Nebraska
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Omaha, Nebraska, Verenigde Staten, 68106
- CCOP - Missouri Valley Cancer Consortium
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North Dakota
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Bismarck, North Dakota, Verenigde Staten, 58501-5505
- Cancer Care Center at Medcenter One Hospital
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Ohio
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Dayton, Ohio, Verenigde Staten, 45429
- CCOP - Dayton
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Toledo, Ohio, Verenigde Staten, 43623-3456
- CCOP - Toledo Community Hospital
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South Carolina
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Spartanburg, South Carolina, Verenigde Staten, 29303
- CCOP - Upstate Carolina
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South Dakota
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Rapid City, South Dakota, Verenigde Staten, 57709
- Rapid City Regional Hospital
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Sioux Falls, South Dakota, Verenigde Staten, 57104
- CCOP - Sioux Community Cancer Consortium
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Wisconsin
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Green Bay, Wisconsin, Verenigde Staten, 54301
- CCOP - St. Vincent Hospital Cancer Center, Green Bay
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
DISEASE CHARACTERISTICS:
- Diagnosis of cancer
Received, or are currently receiving, neurotoxic chemotherapy, including any of the following:
- Taxanes (e.g., paclitaxel or docetaxel)
- Platinum-based compounds (e.g., carboplatin, cisplatin, or oxaliplatin)
- Vinca alkaloids (e.g., vincristine or vinblastine)
Experiencing pain or symptoms of peripheral neuropathy for at least 1 month attributed to chemotherapy
- Average daily pain rating of at least 4 out of 10 OR
- Peripheral neuropathy at least grade 1 out of 3 using ECOG sensory neuropathy rating
PATIENT CHARACTERISTICS:
Age
- 18 and over
Life expectancy
- At least 6 months
Hepatic
- Bilirubin < 2 times upper limit of normal (ULN)
Renal
- Creatinine ≤ 1.5 times ULN
Other
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception
- No prior allergic reaction or intolerance to lamotrigine
- No extreme difficulty swallowing pills
No other identified causes of painful paresthesia preceding chemotherapy, including any of the following:
- Radiation or malignant plexopathy
- Lumbar or cervical radiculopathy
Pre-existing peripheral neuropathy of another etiology, such as any of the following:
- Cyanocobalamin deficiency
- AIDS
- Monoclonal gammopathy
- Diabetes
- Heavy metal poisoning amyloidosis
- Syphilis
- Hyperthyroidism or hypothyroidism
- Inherited neuropathy
- No significant psychiatric illness (e.g., mania, psychosis, or schizophrenia) that would preclude study participation
- Able to complete questionnaires
PRIOR CONCURRENT THERAPY:
Chemotherapy
- See Disease Characteristics
- More than 7 days since prior methotrexate or other dihydrofolate inhibitors
Other
More than 7 days since prior, and no concurrent use of any of the following:
Tricyclic antidepressants (e.g., amitriptyline, nortriptyline, or desipramine)
- Concurrent selective serotonin reuptake inhibitors allowed
- Monoamine oxidase inhibitors
- Opioid analgesics
- Anticonvulsants (e.g., gabapentin, topiramate, valproic acid, or clonazepam)
Adjuvant analgesics (e.g., mexiletine)
- Prior nonsteroidal anti-inflammatory drugs allowed
- Topical analgesics (e.g., lidocaine gel or patch) to the affected area
- Amifostine
- More than 30 days since prior investigational agents for pain control
- No other concurrent investigational agents for pain control
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: Arm I - lamotrigine
Patients receive oral lamotrigine once daily for 2 weeks and then twice daily for 8 weeks. Treatment continues for 10 weeks in the absence of unacceptable toxicity. Quality of life, pain, mood states, and symptom distress are assessed at baseline and at 4, 6, 8, and 10 weeks. Patients are followed at 3-7 days. |
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Ander: Arm II - placebo
Patients receive oral placebo once daily for 2 weeks and then twice daily for 8 weeks. Treatment continues for 10 weeks in the absence of unacceptable toxicity. Quality of life, pain, mood states, and symptom distress are assessed at baseline and at 4, 6, 8, and 10 weeks. Patients are followed at 3-7 days. |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change in Average Daily Pain Score as Measured Using a Pain Intensity Rating (NRS)
Tijdsspanne: From baseline to week 10
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The change in mean score for average daily pain from baseline to week 10 using the Pain Intensity Rating (NRS) are reported below.
The NRS scale ranges from 0 to 10 with higher scores corresponding to having more pain.
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From baseline to week 10
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Change in Average Pain Score as Measured Using the European Cooperative Oncology Group (ECOG) Neuropathy Scale (ENS)
Tijdsspanne: From baseline to week 10
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The change in mean score for average daily pain from baseline to week 10 using the European Cooperative Oncology Group (ECOG) neuropathy scale (ENS) are reported below.
The ENS scale goes from 0 to 3 with 0=none, 1=mild paresthesias, 2=mild or moderate sensory loss and/or moderate paresthesias, and 3=severe sensory loss or paresthesias that interfere with function.
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From baseline to week 10
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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The Change in Overall Quality of Life as Measured by the Uniscale QOL From Baseline to Week 10
Tijdsspanne: From baseline to week 10
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The change in overall quality of life as measured by the Uniscale QOL (Week 10 minus Baseline) using the Wilcoxon test is reported for each arm below.
The Uniscale is a score that ranges from 0 to 100, with 0 being QOL as bad as it can be and 100 being as good as it can be.
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From baseline to week 10
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Change in Brief Pain Inventory (BPI) Worst Pain Score [Week 10 Minus Baseline]
Tijdsspanne: From baseline to week 10
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The average change in Brief Pain Inventory (BPI) Worst Pain scores between baseline and week 10 using Wilcoxon test are reported for each arm below.
The BPI scales range from 0 to 10 with 0 meaning no pain and 10 meaning pain as bad as you can imagine.
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From baseline to week 10
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Change in Brief Pain Inventory (BPI) Least Pain Score [Week 10 Minus Baseline]
Tijdsspanne: From baseline to week 10
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The average change in Brief Pain Inventory (BPI) Least Pain scores between baseline and week 10 using Wilcoxon test are reported for each arm below. The BPI scales range from 0 to 10 with 0 meaning no pain and 10 meaning pain as bad as you can imagine. Time Frame: Up to 1 week post-treatment |
From baseline to week 10
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Change in Brief Pain Inventory (BPI) Average Pain Score [Week 10 Minus Baseline]
Tijdsspanne: From baseline to week 10
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The average change in Brief Pain Inventory (BPI) Average Pain scores between baseline and week 10 using Wilcoxon test are reported for each arm below.
The BPI scales range from 0 to 10 with 0 meaning no pain and 10 meaning pain as bad as you can imagine.
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From baseline to week 10
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Change in Brief Pain Inventory (BPI) Pain Now Score [Week 10 Minus Baseline]
Tijdsspanne: From baseline to week 10
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The average change in Brief Pain Inventory (BPI) Pain Now scores between baseline and week 10 using Wilcoxon test are reported for each arm below.
The BPI scales range from 0 to 10 with 0 meaning no pain and 10 meaning pain as bad as you can imagine.
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From baseline to week 10
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Change in Brief Pain Inventory (BPI) Pain Relief Score [Week 10 Minus Baseline]
Tijdsspanne: From baseline to week 10
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The average change in Brief Pain Inventory (BPI) Pain Relief scores between baseline and week 10 using Wilcoxon test are reported for each arm below.
The BPI scales range from 0 to 10 with 0 meaning no pain and 10 meaning pain as bad as you can imagine.
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From baseline to week 10
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Change in Brief Pain Inventory (BPI) Pain Interference Score [Week 10 Minus Baseline]
Tijdsspanne: From baseline to week 10
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The average change in Brief Pain Inventory (BPI) Pain Interference scores between baseline and week 10 using Wilcoxon test are reported for each arm below.
The BPI scales range from 0 to 10 with 0 meaning no pain and 10 meaning pain as bad as you can imagine.
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From baseline to week 10
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Change in POMS Total Score [Week 10 Minus Baseline]
Tijdsspanne: From baseline to week 10
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The average change in POMS Total scores between baseline and week 10 using Wilcoxon test are reported for each arm below.
The POMS scales are calculated from patient responses on 30 questions asking how they have been feeling during the past week.
The scores are all transformed so that 0 is the worst possible value and 100 is the best possible value.
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From baseline to week 10
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Medewerkers en onderzoekers
Medewerkers
Publicaties en nuttige links
Algemene publicaties
- Renno SI, Rao RD, Sloan J, et al.: The efficacy of lamotrigine in the management of chemotherapy-induced peripheral neuropathy: a phase III randomized, double blind, placebo-controlled NCCTG trial, N01C3. [Abstract] J Clin Oncol 24 (Suppl 18): A-8530, 475s, 2006.
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Chemisch veroorzaakte aandoeningen
- Ziekten van het zenuwstelsel
- Neuromusculaire aandoeningen
- Vergiftiging
- Ziekten van het perifere zenuwstelsel
- Neurotoxiciteitssyndromen
- Fysiologische effecten van medicijnen
- Moleculaire mechanismen van farmacologische werking
- Depressiva van het centrale zenuwstelsel
- Antipsychotica
- Rustgevende agenten
- Psychotrope medicijnen
- Membraantransportmodulatoren
- Anticonvulsiva
- Natriumkanaalblokkers
- Calciumregulerende hormonen en middelen
- Calciumantagonisten
- Lamotrigine
Andere studie-ID-nummers
- NCCTG-N01C3
- CDR0000322830 (Register-ID: PDQ (Physician Data Query))
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