Prince of Wales Clinical School, University of New South Wales, Randwick, NSW, Australia.
Prince of Wales Clinical School, University of New South Wales, Randwick, NSW, Australia; Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.
Contemp Clin Trials. 2018 Jul;70:135-138. doi: 10.1016/j.cct.2018.04.011. Epub 2018 Apr 20.
Chemotherapy-induced peripheral neuropathy (CIPN) is a significant side effect of cancer treatment, potentially leading to early cessation of chemotherapy, enduring symptoms and long-lasting disability. Evidence from preclinical and clinical studies suggests that duloxetine, a serotonin-noradrenaline reuptake inhibitor, may be effective in the symptomatic treatment of CIPN. This double blind, placebo controlled, phase II randomised cross-over trial aims to determine whether treatment with duloxetine results in a reduction in chronic neuropathic symptoms experienced as a result of neurotoxic chemotherapy treatment.
METHODS/DESIGN: Participants who have received neurotoxic chemotherapy and experience daily symptoms as a consequence of peripheral neuropathy will be randomly allocated to control or experimental group with a 1:1 allocation, stratified by chemotherapy type. The primary endpoint will be patient-reported CIPN symptoms, as assessed via the FACT/GOG-Ntx. As a secondary objective, the trial will investigate whether duloxetine improves neurophysiological parameters and functional status in patients who have received neurotoxic chemotherapy treatment.
This trial will investigate the effectiveness of duloxetine in reducing neuropathic symptoms following chemotherapy treatment, and aims to provide insight into the mechanisms underlying the symptomatic relief that duloxetine may provide. These results will be informative in advancing clinical knowledge regarding the treatment of CIPN.
化疗引起的周围神经病变(CIPN)是癌症治疗的一个显著副作用,可能导致化疗提前终止,出现持续症状和长期残疾。临床前和临床研究的证据表明,度洛西汀是一种 5-羟色胺-去甲肾上腺素再摄取抑制剂,可能对 CIPN 的症状治疗有效。这项双盲、安慰剂对照、II 期随机交叉试验旨在确定度洛西汀治疗是否会减少因神经毒性化疗而导致的慢性神经性症状。
方法/设计:已接受神经毒性化疗且因周围神经病而每天出现症状的参与者将按 1:1 比例随机分配到对照组或实验组,按化疗类型分层。主要终点将是通过 FACT/GOG-Ntx 评估的患者报告的 CIPN 症状。作为次要目标,试验将研究度洛西汀是否能改善接受神经毒性化疗治疗的患者的神经生理参数和功能状态。
这项试验将研究度洛西汀在减少化疗后神经病变症状方面的有效性,并旨在深入了解度洛西汀提供的症状缓解的潜在机制。这些结果将为推进关于 CIPN 治疗的临床知识提供信息。