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Completed

NCT Number: NCT01775449

Prevention of Oxaliplatin-induced Neuropathic Pain by a Specific Diet

Use lay language. Oxaliplatin is a reference anticancer drug in the treatment of colorectal cancer. However, its use is hampered by a specific neurotoxicity, which is characterized by acute thermal hypersensitivity, notably to cold temperatures, and by chronic neuropathy appearing with the repetition of chemotherapy cycles.

To this date there is no effective therapy able to prevent and/or to treat these adverse drug reactions. So oncologists are sometimes strained to decrease anticancer doses or to stop chemotherapy; Previously, a polyamine deficient diet has been able to prevent acute oxaliplatin-induced hypersensitivity in animals.

So we hypothesizes that a specific nutritional therapy, a polyamine deprived diet, may prevent acute oxaliplatin-induced hypersensitivity in patients.

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Key information

Age range

18 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

CHU de Clermont-Ferrand

Clermont-Ferrand, 63003, France

About this study

This is a prospective, single-center, controlled and interventional study with two parallel groups randomized in single-blind.

After obtaining informed consent, all included patients will be randomized, either:

  • in the group with a polyamines depleted diet : 2-4 cans per day of Polydol® (oral alimentation without polyamines), associated to predefined menus low in polyamines, according to the chemotherapy cycle and for 107 days
  • in the control group with a normal polyamines containing diet: 1 can per day of Polydol® associated with predefined menus with normal average in polyamines and for 107 days.

Randomization will be performed by considering stratification on the tumor presence or not, because it is one of the polyamines source (Linsalata and Russo, 2008) and could influence the results in the study.

In addition, patient compliance will be collected in the case report form all along the study, and included in the statistical analysis of the study.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • - Patients affected by gastrointestinal cancer, without cytotoxic neurotoxic chemotherapy, had to receive FOLFOX 4 chemotherapy (folinic acid + 5-FU + oxaliplatin) in the adjuvant, neoadjuvant or palliative situation with an expected period of 8 cures of treatment or 4 months.
  • Patients having given their written, free and informed consent
  • Patient's members of a social security scheme
  • Patients not having participated in another clinical trial within 15 days before its baseline (possibility of participating and / or participate in an observational trial)
  • Effective contraception for patients, male or female, in childbearing age.
  • Neutrophils > 2.109/L and/or platelet > 100.109/L before the first treatment cycle

Exclusion criteria

  • - Patient which cannot receive FOLFOX 4 whatever the reason
  • Patients < 18 years old and > 70 years old
  • Malnourished patient (French National Authority for Health, 2003)
  • Patients with all or part of an upper limb amputation
  • Diabetic patient
  • Patients with neuropathy
  • Oral nutrition impossible
  • Painful procedures scheduled after the baseline (e.g. surgical excision)
  • Neurological disorders (e.g. parkinsonism, stroke ...)
  • Alcohol consumption upper 3 alcohol units (30 g) for men and upper 2 alcohol units (20 g) for women
  • Patients having already received cytotoxic neurotoxic chemotherapy (taxanes, platinum salts or vinca alkaloids)
  • Patients treated for another cancer within 5 years except basal cell skin carcinoma or in situ cervical cancer
  • Any unbalanced progressive disease (hepatic failure, renal insufficiency (creatinine clearance <30 mL / min), respiratory failure, congestive heart failure, myocardial infarction within the past 6 months ...)
  • Patients requiring Ca2 + or Mg2 + perfusions
  • Hypersensitivity or allergy known about one of study product's component
  • Pregnant woman or breastfeeding woman
  • Legal disability (person deprived of liberty or under guardianship)
  • Patients for psychological, social, family or geographical reasons can not be monitored regularly and / or be compliant with the requirements of the study
  • Patients already included in another clinical trial

Treatment and study plan

Polyamines depleted diet, associating Polydol® cans and predefined menus low in polyamines

Behavioral

Primary outcomes

  1. Cold pain thresholds

    Time frame: day 42

Secondary outcomes

  1. Cold pain thresholds

    Time frame: day -7, 0, 2, 14, 16, 28, 30, 42, 70, 72, 98, 100, 154

  2. Heat pain thresholds

    Time frame: day -7, 0, 2, 14, 16, 28, 30, 42, 70, 72, 98, 100, 154

  3. DN4 (Douleur Neuropathique en 4 Questions) scores

    Time frame: day -7, 0, 2, 14, 16, 28, 30, 42, 70, 72, 98, 100, 154

  4. HADS (Hospital Anxiety and Depression Scale) score

    Time frame: day -7, 0, 14, 28, 42, 98, 154

  5. Adverse drug reactions (CTCAE (Common Terminology Criteria for Adverse Events))

    Time frame: day 0, 2, 14, 16, 28, 30, 42, 70, 72, 98, 100, 154

  6. Cancer response

    Time frame: day 154

  7. Oxaliplatin dose intensity

    Time frame: day 154

  8. Erythrocyte polyamine levels

    Time frame: day -7, 0, 14, 28, 42, 70, 98

  9. NPSI ( Neuropathic Pain Symptom Inventory)scores

    Time frame: day -7, 0, 2, 14, 16, 28, 30, 42, 70, 72, 98, 100, 154

  10. QLQ-C30 (Quality of Life questionnaire C30)scores

    Time frame: day -7, 0, 2, 14, 16, 28, 30, 42, 70, 72, 98, 100, 154

Sponsors and collaborators

Lead sponsor

University Hospital, Clermont-Ferrand

Other

Collaborators

  • Fondation Apicil
  • Ligue contre le cancer - Auvergne

Registry information

Acronym: NEUROXAPOL

Important dates

Study start
2013
Primary completion
2015
Study completion
2015
First posted
Jan 25, 2013
Registry last updated
Jul 11, 2017

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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