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Neuropathic PainPhase 2PrevTelNCT05322889

Prevention of Paclitaxel-induced Neuropathic Pain in Patients With Planned Paclitaxel Chemotherapy (PrevTel)

A Phase 2 study testing Telmisartan tablets in people with Neuropathic Pain and Chemotherapy Effect, run by Dr. Frank Behrens at 1 site in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Phase IIa clinical trial will be conducted with patients requiring in-label paclitaxel-chemotherapy due to ovarian or breast cancer. The efficacy of a 12-week telmisartan treatment, starting one week before planned paclitaxel-administration to prevent PIPNP (paclitaxel-induced peripheral neuropathic pain) will be… Read more about this study

Who is it for?
Ages 18 to 80 years, women only
Conditions the study is for
Neuropathic Pain, Chemotherapy Effect
What is being tested?
Telmisartan tablets
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
35 participants
Where
1 siteGermany
Study dates
9 Apr 2020to 30 Jun 2023
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with a diagnosis of ovarian or breast cancer who are clinically eligible for paclitaxel therapy and for whom paclitaxel chemotherapy is planned (with use of standard treatment) in clinical routine care.
  • Female patients ≥ 18 years and ≤ 80 years
  • The patient must have completed radiotherapy or surgery for central nervous system (CNS) metastases > 2 weeks prior to screening (SCR). Patients must be neurologically stable, having no new neurological deficits on clinical examination, and no new findings on CNS imaging as documented in clinical routine care. If patients require steroids for management of CNS metastases, they must have been on a stable dose of steroids for 2 weeks preceding SCR.
  • Written informed consent obtained prior to the initiation of any protocol-required procedures
  • Willingness to comply to study procedures and study protocol

Who cannot join

  • Previously diagnosed or current peripheral neuropathic pain
  • Other severe pain that might impair the assessment of neuropathic pain
  • DN4 score ≥ 4
  • Previous chemotherapy (incl. paclitaxel) within the last 5 years (treatment with cyclophosphamide and an anthracycline as part of an ongoing adjuvant or neo-adjuvant regimen is allowed)
  • Current or planned combinational chemotherapy-regimens, e.g., with platinum-based drugs (Her2 antibodies are allowed; paclitaxel combination with trastuzumab +/- pertuzumab is allowed)
  • All primary central nervous system (CNS) tumors or symptomatic CNS metastases that are neurologically unstable (Note: Only patients with controlled CNS metastases may participate in this trial)
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  • Previously reported intolerance to Angiotensin II (AT1) -receptor-blockers
  • Hypotension (blood pressure < 110/70 mmHg; median from 3 measurements; start of measurement after patients has been seated for at least 5 minutes)
  • Current intake of aliskiren, digoxin or Angiotensin-converting-enzyme (ACE)-inhibitors at baseline (BL) (treatment change from ACE-inhibitors to telmisartan is allowed, with treatment start of telmisartan at BL)
  • Current intake of antidepressants (e.g., amitriptylin), antiepileptics (e.g., gabapentin, pregabalin, lamotrigine), duloxetine, glutamin, vitamin E
  • Current intake of telmisartan at SCR
  • Insufficient hepatic or renal function at SCR:
  • Serum creatinine ≥ 1.5 x upper limit of normal (ULN)
  • Total bilirubin > 1.5 x ULN
  • Glutamate-Oxalacetete-Transaminase/Glutamate-Pyruvate-Transaminase (GOT/GPT) ≥ 3 x ULN or >5 in case of documented liver metastasis
  • Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of study drug (e.g., ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, small bowel resection)
  • History of or current severe psychological illness or condition
  • Uncontrolled coronary angina or symptomatic congestive heart failure (NYHA (New York Heart Association) Class III or IV)
  • Patients with current malignant disease, other than that being treated in this study. Exceptions to this exclusion criterion include the following: malignancies that were treated curatively and have not recurred within 2 years prior to SCR; completely resected basal cell and squamous cell skin cancers; and completely resected carcinoma in situ of any type
  • Evidence of significant uncontrolled concomitant diseases or serious and/or uncontrolled diseases that are likely to interfere with the evaluation of the patient's safety and of the study outcome
  • History of or evidence of current active Hepatitis B or C or Human Immunodeficiency Virus (HIV) infection with documentation not older than 8 weeks (due to blood sample processing for lipid profile analysis)

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • Department of Haematology/Medical Onkology, University Hospital, Goethe-University Frankfurt

    Frankfurt, 60590

Other trials in Germany

About this study

Official title: Prevention of Paclitaxel-induced Neuropathic Pain by Telmisartan in Patients With Planned Paclitaxel Chemotherapy Due to Ovarian or Breast Cancer (PrevTel)

Phase IIa clinical trial will be conducted with patients requiring in-label paclitaxel-chemotherapy due to ovarian or breast cancer. The efficacy of a 12-week telmisartan treatment, starting one week before planned paclitaxel-administration to prevent PIPNP (paclitaxel-induced peripheral neuropathic pain) will be assessed by measurement of occurrence of clinical symptoms of PIPNP as well as lipid profiles

Read the detailed description

Paclitaxel is a cytostatic drug that is widely used for the first-line treatment of breast- and ovarian cancer and causes neuropathic pain in up to 87% of treated patients Treating mice with telmisartan causes a strong reduction of PIPNP, thus indicating that telmisartan may be a promising pharmacological treatment option for PIPNP in patients. It is proposed that telmisartan reduces the inflammatory component of PIPNP.

Telmisartan has a good risk profile, low occurrence of side effects and is generally well tolerated in patients.These collective characteristics make it a suitable, already approved and appropriate substance for combination therapy with paclitaxel.

Therefore, telmisartan is a promising candidate to potentially prevent PIPNP in patients whose safety profile is well known due to preclinical and clinical trials for the indication of hypertension and coronary heart disease. Moreover, due to its mechanisms it might as well reduce symptoms of PIPNP sufficiently without severe side effects.

To validate these observations clinically, this phase IIa clinical trial will be conducted with breast and ovarian cancer patients requiring in-label paclitaxel-chemotherapy. The efficacy of a 12-week telmisartan treatment initiated before the first administration of paclitaxel to prevent PIPNP will be assessed.

Moreover, beside lipid profiles, quantitative sensoric testing of pain characteristics in focus on biomarker detection and development that may be useful for a precision medicine approach will be assessed.

Being tested
Telmisartan tablets
Keywords
chemotherapy induced peripheral neuropathic pain, breast cancer; ovarian cancer; paclitaxel
Medical subject headings
Neuralgia, Breast Neoplasms, Ovarian Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Telmisartan tabletsDrug

    12 weeks treatment

Study groups in NCT05322889
Study groupRoleWhat they receive
Intervention with TelmisartanExperimentalTelmisartan (open), 80 mg daily p.o. (after run-in phase with 40 mg for 7 days). for 12 weeks
Receives: Drug: Telmisartan tablets

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. efficacy of telmisartan to prevent new onset of Paclitaxel- induced peripheral neuropathic pain (PIPNP)

    Proportion of patients without onset of PIPNP measured by median Quality of life questionaire (doleur neuropathic questionnaire) DN4, DN4 < 4

    Measured: week 12

Secondary outcomes (37)
  1. Proportion of patients with new onset of PIPNP

    Douleur Neuropathique 4 (DN4) questionnaire (DN4 ≥ 4) higher score means more pain, minimum 0 to maximum 10 points

    Measured: Day 14

  2. Proportion of patients with new onset of PIPNP

    DN4 questionnaire (DN4 ≥ 4) higher score means more pain, minimum 0 to maximum 10 points

    Measured: Day 28

  3. Proportion of patients with new onset of PIPNP

    DN4 questionnaire (DN4 ≥ 4) higher score means more pain, minimum 0 to maximum 10 points

    Measured: Day 49

  4. Proportion of patients with new onset of PIPNP

    DN4 questionnaire DN4 ≥ 4

    Measured: Day 70

  5. Proportion of patients with new onset of PIPNP

    DN4 questionnaire DN4 ≥ 4 higher score means more pain, minimum 0 to maximum 10 points

    Measured: Day 84

  6. Change of pain intensity to baseline - Paindetect

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 14

  7. Change of pain intensity to baseline - Paindetect

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 28

  8. Change of pain intensity to baseline - Paindetect

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 49

  9. Change of pain intensity to baseline - Paindetect

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 70

  10. Change of pain intensity to baseline - Paindetect

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 84

  11. Change of pain intensity to baseline - VAS

    patient global pain visual analogue scale (VAS-Pain), minimum 0 to 10, higher score means more pain

    Measured: Day 14

  12. Change of pain intensity to baseline - VAS

    patient global pain visual analogue scale (VAS-Pain), minimum 0 to 10, higher score means more pain

    Measured: Day 28

  13. Change of pain intensity to baseline - VAS

    patient global pain visual analogue scale (VAS-Pain), minimum 0 to 10, higher score means more pain

    Measured: Day 49

  14. Change of pain intensity to baseline - VAS

    patient global pain visual analogue scale (VAS-Pain), minimum 0 to 10, higher score means more pain

    Measured: Day 70

  15. Change of pain intensity to baseline - VAS

    patient global pain visual analogue scale (VAS-Pain), minimum 0 to 10, higher score means more pain

    Measured: Day 84

  16. Change in pain pattern to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 14

  17. Change in pain pattern to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 28

  18. Change in pain pattern to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 49

  19. Change in pain pattern to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 70

  20. Change in pain pattern to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 84

  21. Change of pain quality to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 14

  22. Change of pain quality to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 28

  23. Change of pain quality to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 49

  24. Change of pain quality to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 70

  25. Change of pain quality to baseline

    PainDetect questionnaire, higher score means more pain, minimum 0 to 38 maximum

    Measured: Day 84

  26. Change in quality of life (QoL) to baseline

    Functional Assessment of Cancer Therapy/Gynecologic Oncology (FACT/ GOG-NTX), 38 items questionaire each to be scored from 0 (Not at all) to 4 (Very much) - total score could be between 0 and 152 Group-Neurotoxicity (FACT/GOG-NTX questionnaire) - some items are reverse scored. Subscale scores, total scores possible

    Measured: Day 14

  27. Change in quality of life (QoL) to baseline

    Functional Assessment of Cancer Therapy/Gynecologic Oncology (FACT/ GOG-NTX), 38 items questionaire each to be scored from 0 (Not at all) to 4 (Very much) - total score could be between 0 and 152 Group-Neurotoxicity (FACT/GOG-NTX questionnaire) - some items are reverse scored. Subscale scores, total scores possible

    Measured: Day 49

  28. Change in quality of life (QoL) to baseline

    Functional Assessment of Cancer Therapy/Gynecologic Oncology (FACT/ GOG-NTX), 38 items questionaire each to be scored from 0 (Not at all) to 4 (Very much) - total score could be between 0 and 152

    Measured: Day 28

  29. Change in quality of life (QoL) to baseline

    Functional Assessment of Cancer Therapy/Gynecologic Oncology (FACT/ GOG-NTX), 38 items questionaire each to be scored from 0 (Not at all) to 4 (Very much) - total score could be between 0 and 152

    Measured: Day 70

  30. Change in quality of life (QoL) to baseline

    Functional Assessment of Cancer Therapy/Gynecologic Oncology (FACT/ GOG-NTX), 38 items questionaire each to be scored from 0 (Not at all) to 4 (Very much) - total score could be between 0 and 152

    Measured: Day 84

  31. cumulative incidence of neuropathic pain

    documented by physician

    Measured: throughout study treatment - 12 weeks

  32. Quantification of the incidence of paclitaxel-associated acute pain syndrome (PAPS)

    documented by physician

    Measured: throughout study treatment - 12 weeks

  33. proportion of patients in need of PIPNP symptomatic therapy

    determined by treating physician - documented in case report form

    Measured: throughout study treatment - 12 weeks

  34. Assessment of frequency of adverse events

    determined by using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

    Measured: throughout study treatment - 12 weeks

  35. Assessment of severity of adverse events

    determined by using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

    Measured: throughout study treatment - 12 weeks

  36. Assessment relatedness of adverse events

    determined by using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

    Measured: throughout study treatment - 12 weeks

  37. Assessment of type of adverse events

    determined by using Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

    Measured: throughout study treatment - 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Apr 2022
  2. Study start9 Apr 2020
  3. Primary completion4 Oct 2022
  4. Study completion30 Jun 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Model description
monocentric, open label, single-arm trial
Masking
None (open label)
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05322889
Sponsor's protocol ID
TMP-0315-2018
Acronym
PrevTel
Status last verified
Aug 2024
First submitted
4 Apr 2022
Last updated
28 Aug 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Telmisartan tablets in people with Neuropathic Pain and Chemotherapy Effect, run by Dr. Frank Behrens at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 28 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

efficacy of telmisartan to prevent new onset of Paclitaxel- induced peripheral neuropathic pain (PIPNP) (time frame: week 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Aug 2024.

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