About this trial
Chemotherapy induced peripheral neuropathy (CIPN) is one of the most limiting side effects of chemotherapy and often leads to adaptations in the protocol of the chemotherapy including dose reduction or even discontinuation of treatment. In general, the symptoms of CIPN are sensory, often distributed in a "stocking and glove" manner, and include pain, tingling, and numbness. CIPN has a marked negative influence on quality of life of patients and their families. It may result in serious limitations in daily functioning and affect the enjoyment, social relationships, and ability to perform work. Current management of CIPN (i.e. prevention and treatment) includes dose reduction or delay of chemotherapy cycles and treatment discontinuation. Unfortunately, this reduces the chance of an effective cancer treatment. Current guidelines of the American Society of Clinical Oncology (ASCO) on the Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy do not conclusively recommend any agent for the prevention of CIPN. Due to the scarcity of drugs that are effective for preventing and treating CIPN, the distress of patients who suffer from CIPN, and the major societal and economic costs, new approaches and effective treatment strategies are required.
The proposed trial is a parallel, double blind, placebo controlled, randomised, phase III superiority trial, aiming to determine whether treatment with SMP prevents incidence of or reduces the severity symptoms of paclitaxel-induced peripheral neuropathy, as compared to placebo.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age ≥ 18
Individuals with early breast cancer, stage I to IIIC, who are about to receive a paclitaxel-based neo-adjuvant or adjuvant chemotherapy, with a planned dosing regimen of 80 mg of paclitaxel per square meter of body surface by intravenous infusion weekly for 12 doses.
Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
Ability to provide informed consent as documented by signature
Disqualifiers
Patients with pre-existing neuropathy
Prior chemotherapy with taxanes or other neurotoxic agents
Concomitant medications that are known to cause neuropathy
Pregnancy or lactation
Trial design
Parallel
Treatments tested in this trial
Stibium metallicum praeparatum 6x
DrugStibium metallicum praeparatum 6x will be administered with subcutaneous injections 3 times a week at 1 ampoule at 1 mL during the chemotherapy and shall be continued during 6 weeks after the end of chemotherapy . The first injection will be administered on the day of the first dose of chemotherapy, before the injection of the first dose of chemotherapy.
Placebo
DrugPlacebo will be administered with subcutaneous injections 3 times a week at 1 ampoule at 1 mL during the chemotherapy and shall be continued during 6 weeks after the end of chemotherapy . The first injection will be administered on the day of the first dose of chemotherapy, before the injection of the first dose of chemotherapy.
Treatment groups
Trial outcomes
Primary outcomes
Reduction in neuropathy severity
Measured by the neurotoxicity subscale (NTX-subscale) of the Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity (FACT/GOG-NTX)
Secondary outcomes
Reduction of occurrence (incidence) of paclitaxel- or nab-paclitaxel-induced peripheral neuropathy
Measured as per the statistical analysis protocol
Benefit of study medication on Quality of life
Measured using the 27-item questionnaire FACT-G
Benefit of study medication on pain
Measured with the Brief Pain Inventory (BPI).
Benefit of study medication on depression
Measured with the Patient Health Questionnaire (PHQ-9)
Other outcomes
Adherence to study medication
Measured by the total number of unused study drugs returned by the patient
Severe adverse events
Any (serious) adverse event (AE) will be recorded, including time of onset, duration, resolution, action to be taken, assessment of intensity and relationship with study treatment
Locations
Sponsors and contacts
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University of Bern
Lead sponsor
Insel Gruppe AG, University Hospital Bern
Collaborator
Hospital of Thun
Collaborator
Tumor- und BrustZentrum Ostschweiz
Collaborator
Gesundheitszentrum Fricktal AG
Collaborator
Kantonsspital Winterthur KSW
Collaborator
Kantonsspital Graubünden
Collaborator
Kantonsspital Aarau
Collaborator
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