Using methadone to relieve painful nerve damage from chemotherapy

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial investigates the effectiveness of methadone compared to duloxetine in treating chemotherapy-induced peripheral neuropathy (CIPN), a painful condition affecting many cancer patients. It involves adult participants with a cancer diagnosis who have experienced moderate to severe nerve pain for at least three months after chemotherapy. The study employs a double-blind, double-dummy randomized controlled design, where participants will be assigned to receive either methadone or duloxetine over a five-week period, with weekly follow-ups to assess pain reduction and quality of life improvements.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Age \>18 years old.
2. Estimated life expectancy greater than 12 weeks.
3. Opioid naïve or oral morphine equivalent use \<60 mg/day.
4. Greater than grade 1 CIPN based on CTCAE.
5. \>3/10 average CIPN-related neuropathic pain lasting ≥3 months beyond chemotherapy completion.
6. A cancer diagnosis.
7. Treatment with one of the following neurotoxic chemotherapies: platinums, taxanes, vinca alkaloids, bortezomib, or thalidomide.

Exclusion Criteria:

1. Other causes of peripheral neuropathy.
2. The following psychiatric illnesses: severe depression, suicidality, bipolar disease or psychotic disorder, alcohol or substance use disorder, DSM V criteria eating disorder.
3. The following medical illnesses: known or suspected mechanical gastrointestinal obstruction or any disease/conditions that affect bowel transit, suspected surgical abdomen, acute or severe asthma, COPD, acute respiratory depression, elevated serum CO2 and cor pulmonale, delirium tremens, convulsive disorders, severe CNS depression such as from cerebrospinal or intracranial pressure and head injury, diarrhea from pseudomembranous colitis, leptomeningeal disease.
4. Liver or renal dysfunction within the last 90 days as defined by MELD-Na score ≥17 and GFR ≤30 ml/min respectively.
5. QTC \>499ms within last 90 days.
6. Current pregnancy or lactation.
7. Inability to take oral medications.
8. Positive CAGE and/or Opioid Risk Tool - Revised questionnaire
9. Known allergy or hypersensitivity to opioids, duloxetine, or any ingredient in their formulation.
10. Concomitant use of excluded medications: methadone, other antidepressants (including within 14 days of discontinuing monoamine oxidase inhibitors), thioridazine, potent CYP1A2 inhibitors (such as fluvoxamine and some quinolone antibiotics).
11. Uncontrolled narrow-angle glaucoma.
12. If women of child-bearing potential (i.e. Menstruation within \<2 years) are unable or unwilling to use Health Canada approved highly effective methods of contraception (hormonal contraceptives, intrauterine device or system, vasectomy, tubal ligation, or double barrier method), or abstinence during the treatment period.

Note: Any use of prior co-analgesics will be continued (and must have been stable for more than 2 weeks), but the use of new co-analgesics or titration of current co-analgesics will not be permitted during the trial.

Where it's running

• BC Cancer Surrey
  Surrey, British Columbia, Canada Recruiting
• Nanaimo Regional Hospital
  Nanaimo, British Columbia, Canada Not yet recruiting
• BC Cancer Vancouver
  Vancouver, British Columbia, Canada Not yet recruiting
• BC Cancer Victoria
  Victoria, British Columbia, Canada Not yet recruiting

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Cryotherapy during weekly paclitaxel to reduce chemotherapy-induced numbness and tingling

  This study tests whether applying cryotherapy to hands and feet during weekly paclitaxel helps prevent CIPN in women with breast cancer.

  Recruiting at 3 sites Azienda Sanitaria dell'Alto Adige · Bolzano, Bolzano and 3 other locations · NCT07780955

• SIR2501 plus Paclitaxel for solid tumors

  This Phase 2 study tests SIR2501 in adults with solid tumors who are starting paclitaxel chemotherapy to see if it is safe and tolerable and to explore its effect on chemotherapy-induced neuropathy.

  Recruiting at 3 sites Phase 2 Sironax USA, Inc. · Hollywood, Florida and 4 other locations · NCT07765446

• Non-invasive brain stimulation to help chemotherapy-induced nerve problems in cancer survivors

  This trial tests whether a gentle brain stimulation method (tDCS) can help reduce numbness, tingling, and pain from CIPN in cancer survivors who are not currently in treatment.

  Recruiting University of Michigan Rogel Cancer Center · Ann Arbor, Michigan · NCT07673614

• Self-applied ear vagus nerve stimulation for chemotherapy-induced neuropathy

  Researchers are testing a small, at-home device that you wear on the ear to see if it eases nerve pain from chemotherapy.

  Recruiting University of Miami · Coral Gables, Florida · NCT07596030

• Blood extracellular vesicles to detect chemotherapy-related nerve damage.

  We will test whether tiny blood particles called extracellular vesicles can predict who will develop chemotherapy-induced peripheral neuropathy in adults receiving taxane, platinum, or antimitotic chemotherapy.

  Recruiting Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico · Milan · NCT07558447

• Virtual LASO-3 diet program to ease chemotherapy-related numbness and tingling

  This trial tests whether a virtual diet program that lowers added sugar and increases fiber and omega-3s can help cancer survivors who have numbness, tingling, or pain after neurotoxic chemotherapy.

  Recruiting University of Michigan Rogel Cancer Center · Ann Arbor, Michigan · NCT07365007

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.