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| ID | Type | Description | Link |
|---|---|---|---|
| NCI-2016-00368 | Registry Identifier | CTRP (Clinical Trial Reporting Program) | |
| MC15C1 | Other Identifier | Mayo Clinic | |
| P30CA015083 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Cancer Institute (NCI) | NIH |
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This randomized clinical trial studies how well MC5-A scrambler therapy or transcutaneous electrical nerve stimulation (TENS) therapy work in treating patients with chemotherapy-induced peripheral neuropathy (a nerve problem that causes pain, numbness, tingling, swelling, or muscle weakness in different parts of the body). MC5-A scrambler therapy is a type of treatment for nerve pain that uses electrodes placed on the skin, where electricity is carried from the electrodes through the skin and blocks the pain. TENS is a procedure in which mild electric currents are applied to some areas of the skin. It is not yet known whether TENS therapy is more effective than MC5-A scrambler therapy in treating chemotherapy-induced peripheral neuropathy.
PRIMARY OBJECTIVES:
I. Evaluate the efficacy of scrambler therapy (MC5-A scrambler therapy) compared to TENS therapy for pain and/or tingling related to chemotherapy-induced peripheral neuropathy (CIPN).
II. Evaluate the tolerability of scrambler therapy and compare it to TENS therapy, in this population.
III. Evaluate whether scrambler therapy, compared to TENS therapy, can decrease the use of pain medication for CIPN.
IV. Explore whether messenger ribonucleic acid (mRNA) gene expression before and after scrambler therapy shows similar findings to what Starkweather et al observed.
V. Utilizing high-field magnetic resonance imaging (MRI), to define alterations in functional differences (using resting state blood-oxygen-level dependent [BOLD] measures to measure differences in functional connectivity) in treated with the scrambler device in the setting of chemotherapy induced peripheral neuropathy pain.
VI. Explore whether scrambler therapy will alter sensation.
OUTLINE: Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients undergo MC5-A scrambler therapy over 30 minutes for 10 consecutive weekdays.
ARM II: Patients undergo TENS therapy over 30 minutes daily for 14 days.
Patients in both Arms, may crossover to the opposite Arm for an additional 2 weeks of treatment if they elect.
After completion of study treatment, patients are followed up weekly for 8 weeks.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm I (MC5-A scrambler therapy) | Experimental | Patients undergo MC5-A scrambler therapy over 30 minutes for 10 consecutive weekdays. |
|
| Arm II (TENS therapy) | Active Comparator | Patients undergo TENS therapy over 30 minutes daily for 14 days. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laboratory Biomarker Analysis | Other | Correlative studies |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Who Achieve at Least a 50% Reduction in Their Primary Problematic Symptom (Either Pain or Tingling) From Baseline on Day 14 | The number of participants who achieve at least a 50% reduction in their primary problematic symptom (either pain or tingling) from baseline on Day 14. The participant specified their primary problematic symptom (either pain or tingling) and primary problematic area (either upper or lower extremity) at registration; the respective items used to measure each symptom are considered for this outcome measure. Pain and tingling are measured using either item #6 (How much tingling have you had in your [fingers or hands; toes or feet] on average over the past 24 hours?) or item #9 (How much pain have you had in your [fingers or hands; toes or feet] on average over the past 24 hours?). Both items use the same scale: 0=None, 10=As bad as can be, with higher scores indicating worse outcome on either the Patient Questionnaire: Before Each Treatment for Upper Extremity Neuropathy or Patient Questionnaire: Before Each Treatment for Lower Extremity Neuropathy at baseline and Day 14. | Baseline to Day 14 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants Indicating Yes, No, or Unsure for Therapy Recommendation to Other Patients With Similar Problems on the Subjective Global Impression of Change Instrument | The number of participants indicating 'Yes' for 'Therapy recommendation to other patients with similar problems' on the Subjective Global Impression of Change (SGIC) instrument. The SGIC questionnaire is used to assess the change in quality of life. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in mRNA Gene Expression | In a descriptive manner, the gene expression will be compared to what was previously reported by Starkweather et al. | Baseline to up to 10 weeks |
| Change in Functional MRI (fMRI) |
Inclusion Criteria:
Pain or symptoms of CIPN of >= 3 months duration, for which the patient wants intervention
Patients have to relate that tingling or pain was at least a four out of ten problem =< 7 days prior to registration, on a 0-10 scale where zero was no problem and ten was the worst possible problem
Eastern Cooperative Oncology Group (ECOG) performance status (PS) = 0, 1, or 2
Life expectancy >= 6 months
Ability to complete questionnaire(s) by themselves or with assistance
Ability to provide informed written consent
Case review by the study chair, or designate, as a case where treatment should be tried
Exclusion Criteria:
Any of the following:
Existing operational implantable drug delivery systems, e.g. Medtronic Synchromed
Existing implantable medical electronic devices, life-supporting medical devices, and medical monitoring devices
History of myocardial infarction or ischemic heart disease within the past six months
History of epilepsy, brain damage, use of anticonvulsants for seizure prevention, concurrently using ketamine, symptomatic brain metastases
Skin conditions such as open sores that would prevent proper application of the electrodes
Other medical or other condition(s) that in the opinion of the investigators might compromise the objectives of the study
Currently receiving gabapentin or pregabalin and not willing to be weaned off of these medications prior to Scrambler therapy initiation
History of peripheral neuropathy prior to receiving neurotoxic chemotherapy
Prior treatment with Scrambler therapy
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| Name | Affiliation | Role |
|---|---|---|
| Charles Loprinzi | Mayo Clinic | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mayo Clinic | Rochester | Minnesota | 55905 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33249081 | Derived | Childs DS, Le-Rademacher JG, McMurray R, Bendel M, O'Neill C, Smith TJ, Loprinzi CL. Randomized Trial of Scrambler Therapy for Chemotherapy-Induced Peripheral Neuropathy: Crossover Analysis. J Pain Symptom Manage. 2021 Jun;61(6):1247-1253. doi: 10.1016/j.jpainsymman.2020.11.025. Epub 2020 Nov 27. | |
| 28257145 | Derived | Cathcart-Rake EJ, Hilliker DR, Loprinzi CL. Chemotherapy-induced neuropathy: Central resolution of a peripherally perceived problem? Cancer. 2017 Jun 1;123(11):1898-1900. doi: 10.1002/cncr.30650. Epub 2017 Mar 3. No abstract available. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Arm I (MC5-A Scrambler Therapy) | Patients undergo MC5-A scrambler therapy over 30 minutes for 10 consecutive weekdays. |
| FG001 | Arm II (TENS Therapy) | Patients undergo TENS therapy over 30 minutes daily for 14 days. |
| Title | Milestones | Reasons Not Completed | ||||
|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Aug 12, 2016 |
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| MC5-A Scrambler Therapy | Other | Undergo Scrambler therapy |
|
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| Questionnaire Administration | Other | Ancillary studies |
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| Transcutaneous Electrical Nerve Stimulation | Other | Undergo TENS |
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| At 10 weeks |
| Change in Sensory, Motor, and Autonomic Neuropathy Subscale Scores From Baseline to Week 10 | The change in Sensory, Motor, and Autonomic Neuropathy Subscale Scores from Baseline to Week 10 will be derived by subtracting the baseline score from the scores at Week 10. The European Organisation for Research and Treatment of Cancer Chemotherapy-Induced Peripheral Neuropathy Module (EORTC QLQ CIPN-20) Instrument contains 20 items assessing sensory (9 items), motor (8 items), and autonomic symptoms (3 items), using a 4-point Likert scale (1 = "not at all," 2 = "a little," 3 = "quite a bit," and 4 = "very much"). The range of change in subscale scores is -3 to 3. With a total range for sensory being -27 to 27 and motor being -24 to 24 and autonomic being -9 to 9. With negatives meaning a decrease in neuropathy and positive being an increase. | Up to 10 weeks |
| Number of Participants Using Acetaminophen as Pain Medication | The number of participants using acetaminophen as pain medication is reported below. | Up to 10 weeks |
Changes in fMRI following Scrambler therapy will be described in the subset of patients selected for this component of the study.
| Baseline to up to 10 weeks |
| Change in Sensation | Descriptive statistics will be used for the data from Quantitative Sensory Testing. | Baseline to up to 10 weeks |
|
| Started Treatment |
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| COMPLETED | Completed Treatment |
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| NOT COMPLETED |
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All Participants
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| ID | Title | Description |
|---|---|---|
| BG000 | Arm I (MC5-A Scrambler Therapy) | Patients undergo MC5-A scrambler therapy over 30 minutes for 10 consecutive weekdays. |
| BG001 | Arm II (TENS Therapy) | Patients undergo TENS therapy over 30 minutes daily for 14 days. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median | Full Range | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| ECOG Performance Status | Eastern Cooperative Oncology Group PS Scale: 0)Fully active, able to carry on all pre-disease performance without restriction; 1)Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work; 2)Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours; 3)Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours; 4)Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair. | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants Who Achieve at Least a 50% Reduction in Their Primary Problematic Symptom (Either Pain or Tingling) From Baseline on Day 14 | The number of participants who achieve at least a 50% reduction in their primary problematic symptom (either pain or tingling) from baseline on Day 14. The participant specified their primary problematic symptom (either pain or tingling) and primary problematic area (either upper or lower extremity) at registration; the respective items used to measure each symptom are considered for this outcome measure. Pain and tingling are measured using either item #6 (How much tingling have you had in your [fingers or hands; toes or feet] on average over the past 24 hours?) or item #9 (How much pain have you had in your [fingers or hands; toes or feet] on average over the past 24 hours?). Both items use the same scale: 0=None, 10=As bad as can be, with higher scores indicating worse outcome on either the Patient Questionnaire: Before Each Treatment for Upper Extremity Neuropathy or Patient Questionnaire: Before Each Treatment for Lower Extremity Neuropathy at baseline and Day 14. | All Participants | Posted | Count of Participants | Participants | Baseline to Day 14 |
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| Secondary | Number of Participants Indicating Yes, No, or Unsure for Therapy Recommendation to Other Patients With Similar Problems on the Subjective Global Impression of Change Instrument | The number of participants indicating 'Yes' for 'Therapy recommendation to other patients with similar problems' on the Subjective Global Impression of Change (SGIC) instrument. The SGIC questionnaire is used to assess the change in quality of life. | Participants who completed the SGIC 'Therapy recommendation to other patients with similar problems' item at Week 10 are included in this analysis. | Posted | Count of Participants | Participants | At 10 weeks |
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| Secondary | Change in Sensory, Motor, and Autonomic Neuropathy Subscale Scores From Baseline to Week 10 | The change in Sensory, Motor, and Autonomic Neuropathy Subscale Scores from Baseline to Week 10 will be derived by subtracting the baseline score from the scores at Week 10. The European Organisation for Research and Treatment of Cancer Chemotherapy-Induced Peripheral Neuropathy Module (EORTC QLQ CIPN-20) Instrument contains 20 items assessing sensory (9 items), motor (8 items), and autonomic symptoms (3 items), using a 4-point Likert scale (1 = "not at all," 2 = "a little," 3 = "quite a bit," and 4 = "very much"). The range of change in subscale scores is -3 to 3. With a total range for sensory being -27 to 27 and motor being -24 to 24 and autonomic being -9 to 9. With negatives meaning a decrease in neuropathy and positive being an increase. | Participants who completed all subscale items from the EORTC QLQ CIPN-20 at baseline and Week 10 are included in this analysis. | Posted | Median | Full Range | score on a scale | Up to 10 weeks |
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| Secondary | Number of Participants Using Acetaminophen as Pain Medication | The number of participants using acetaminophen as pain medication is reported below. | All Participants | Posted | Count of Participants | Participants | Up to 10 weeks |
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| Other Pre-specified | Change in mRNA Gene Expression | In a descriptive manner, the gene expression will be compared to what was previously reported by Starkweather et al. | Not Posted | Baseline to up to 10 weeks | Participants | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Other Pre-specified | Change in Functional MRI (fMRI) | Changes in fMRI following Scrambler therapy will be described in the subset of patients selected for this component of the study. | Not Posted | Baseline to up to 10 weeks | Participants | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Other Pre-specified | Change in Sensation | Descriptive statistics will be used for the data from Quantitative Sensory Testing. | Not Posted | Baseline to up to 10 weeks | Participants |
Up to 10 weeks
Participants who completed the study and did not withdraw prior to starting treatment are evaluable for adverse events.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Arm I (MC5-A Scrambler Therapy) | Patients undergo MC5-A scrambler therapy over 30 minutes for 10 consecutive weekdays. | 0 | 24 | 0 | 24 | 0 | 24 |
| EG001 | Arm II (TENS Therapy) | Patients undergo TENS therapy over 30 minutes daily for 14 days. | 0 | 25 | 0 | 25 | 1 | 25 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Fracture | Injury, poisoning and procedural complications | MedDRA 12 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Charles L Loprinzi MD | Mayo Clinic | 507/284-2511 | cloprinzi@mayo.edu |
| May 28, 2020 |
| Prot_SAP_000.pdf |
| ID | Term |
|---|---|
| D010146 | Pain |
| D010523 | Peripheral Nervous System Diseases |
| D010292 | Paresthesia |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
| D020886 | Somatosensory Disorders |
| D012678 | Sensation Disorders |
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| ID | Term |
|---|---|
| D004561 | Transcutaneous Electric Nerve Stimulation |
| ID | Term |
|---|---|
| D004599 | Electric Stimulation Therapy |
| D013812 | Therapeutics |
| D026741 | Physical Therapy Modalities |
| D012046 | Rehabilitation |
| D000698 | Analgesia |
| D000760 | Anesthesia and Analgesia |
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| Male |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
|
| 1 |
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| 2 |
|
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| Units | Counts |
|---|
| Participants |
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