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.
研究概览
地位
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Yi Feng, M.D
- 电话号码:+86-010-88325590
- 邮箱:fengyi@pkuph.edu.cn
研究联系人备份
- 姓名:Pei Li, M.D
- 电话号码:+86-13126762029
- 邮箱:pli@stu.pku.edu.cn
学习地点
-
-
Beijing Municipality
-
Beijing、Beijing Municipality、中国、100044
- Peking University People's Hospital
-
接触:
- Pei Li, M.D
- 电话号码:+86-13126762029
- 邮箱:pli@stu.pku.edu.cn
-
-
参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
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.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
有源比较器: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.
其他名称:
|
|
假比较器: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.
|
研究衡量的是什么?
主要结果指标
结果测量 |
大体时间 |
|---|---|
|
The pain relief rate of patients at the end of the 4-week treatment period
大体时间:From enrollment to the end of treatment at 4 weeks.
|
From enrollment to the end of treatment at 4 weeks.
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Pain relief rate at follow-up
大体时间:At 1, 2, 3, and 6 months after completion of treatment.
|
At 1, 2, 3, and 6 months after completion of treatment.
|
|
|
Dosage of analgesic drugs
大体时间:At 1, 2, 3, and 6 months after completion of treatment.
|
At 1, 2, 3, and 6 months after completion of treatment.
|
|
|
Depression scores
大体时间:At 1, 2, 3, and 6 months after completion of treatment.
|
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.
|
At 1, 2, 3, and 6 months after completion of treatment.
|
|
Anxiety scores
大体时间:At 1, 2, 3, and 6 months after completion of treatment.
|
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.
|
At 1, 2, 3, and 6 months after completion of treatment.
|
|
Quality of life score
大体时间:At 1, 2, 3, and 6 months after completion of treatment.
|
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.
|
|
Plasma inflammatory marker levels
大体时间:Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
|
Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
|
|
|
The proportion of T cells in the blood
大体时间:Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
|
Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
|
|
|
The count of T cells in the blood
大体时间:Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
|
Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
|
其他结果措施
结果测量 |
大体时间 |
|---|---|
|
Tumor marker levels
大体时间:Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
|
Baseline, immediately after completion of treatment, and 6 months after completion of treatment.
|
|
Adverse events and serious adverse events
大体时间:Adverse events and serious adverse events will be recorded throughout the study.
|
Adverse events and serious adverse events will be recorded throughout the study.
|
合作者和调查者
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- 2026PHB256-001
- 82571385 (其他赠款/资助编号:National Natural Science Foundation of China)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.