Pain Phenotyping of Patients With Bone Cancer Pain

NCT ID: NCT03908853

Last Updated: 2021-03-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-02-05

Study Completion Date

2023-02-01

Brief Summary

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The study aims to describe and quantify pain related to metastatic bone disease. The study will include 50 subjects with disseminated breast cancer and 20 healthy subjects. The pain will be described and quantified through (1) pain specific questionnaires, (2) quantitative sensory testing that assess sensory changes to cold, heat and mechanical stimulation of the skin overlying the metastatic site, and (3) conditioned pain modulation that investigates impairment of the endogenous inhibitory pain pathway in humans.

Detailed Description

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Cancer patients in palliative care point to pain as their most important and most feared symptom. Bone metastases are a common cause of cancer pain, and the patients are prone to transient severe pain exacerbations (breakthrough pain), which can occur spontaneously or be triggered by movement. Patients with bone metastases experience pain of such high intensity, that it affects not only physical activity, but also sleep, mood and social relations. This results in poor quality of life for the patients and poses an increasing clinical and socio-economical problem. The pain is difficult to treat and often requires high opioid doses which results in unacceptable adverse effects, and there is an unmet need of novel therapeutic options and treatment strategies.

Animal models of cancer-induced bone pain have suggested that pain arising from metastatic bone disease involve neuropathic and nociceptive pain mechanisms and, importantly, mechanisms that are specific to cancer-induced bone pain. Significant neuronal sprouting can occur at the metastatic site, and the inherent pain control system is found altered in animal models of cancer-induced bone pain; a system that can be exploited for treatment strategies and in the development of new analgesia. Yet, it is not known how the pre-clinical findings translate to patients.

Quantitative sensory testing is a psychophysical method that uses a battery of sensory stimuli with predetermined physical properties, thus allowing the capture and quantification of stimulus-evoked negative and positive sensory phenomena in humans. Conditioned pain modulation is a psychophysical experimental measure of the endogenous pain inhibitory pathway in humans, which can be used to detect an impairment of the descending inhibitory pain pathway.

This study aims to perform pain phenotyping of patients suffering from cancer-induced bone pain, through pain specific questionnaires, quantitative sensory testing and conditioned pain modulation.

Conditions

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Pain Bone Metastases Metastatic Breast Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Patients

Subjects with painful bone metastases caused by primary breast cancer.

No interventions assigned to this group

Controls

Gender and age matched healthy volunteers.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Woman
* Primary breast cancer
* Bone metastases
* Competent

Exclusion Criteria

* Not fluent in spoken Danish
* Chemotherapy or radiation within the last 3 months
* Other chronic pain disease that may affect the quantitative sensory testing or conditioned pain modulation
* Alcohol or medicine abuse
* Pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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The Novo Nordic Foundation

OTHER

Sponsor Role collaborator

University of Copenhagen

OTHER

Sponsor Role lead

Responsible Party

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Anne-Marie Heegaard

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anne-Marie Heegaard, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Copenhagen

Locations

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Department of Oncology, Rigshospitalet

Copenhagen, , Denmark

Site Status RECRUITING

The Department of Oncology, Herlev Hospital

Herlev, , Denmark

Site Status RECRUITING

Countries

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Denmark

Central Contacts

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Anne-Marie Heegaard, PhD

Role: CONTACT

+45 35336322

Rie B Hansen, PhD

Role: CONTACT

+45 35332139

Facility Contacts

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Rie B Hansen, PhD

Role: primary

Rie B Hansen, PhD

Role: primary

References

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Stromgren AS, Sjogren P, Goldschmidt D, Petersen MA, Pedersen L, Groenvold M. Symptom priority and course of symptomatology in specialized palliative care. J Pain Symptom Manage. 2006 Mar;31(3):199-206. doi: 10.1016/j.jpainsymman.2005.07.007.

Reference Type BACKGROUND
PMID: 16563314 (View on PubMed)

Banning A, Sjogren P, Henriksen H. Treatment outcome in a multidisciplinary cancer pain clinic. Pain. 1991 Nov;47(2):129-134. doi: 10.1016/0304-3959(91)90195-4. No abstract available.

Reference Type BACKGROUND
PMID: 1762805 (View on PubMed)

Mercadante S. Managing difficult pain conditions in the cancer patient. Curr Pain Headache Rep. 2014 Feb;18(2):395. doi: 10.1007/s11916-013-0395-y.

Reference Type BACKGROUND
PMID: 24407750 (View on PubMed)

Laird BJ, Walley J, Murray GD, Clausen E, Colvin LA, Fallon MT. Characterization of cancer-induced bone pain: an exploratory study. Support Care Cancer. 2011 Sep;19(9):1393-401. doi: 10.1007/s00520-010-0961-3. Epub 2010 Aug 1.

Reference Type BACKGROUND
PMID: 20680354 (View on PubMed)

Hald A, Nedergaard S, Hansen RR, Ding M, Heegaard AM. Differential activation of spinal cord glial cells in murine models of neuropathic and cancer pain. Eur J Pain. 2009 Feb;13(2):138-45. doi: 10.1016/j.ejpain.2008.03.014. Epub 2008 May 21.

Reference Type BACKGROUND
PMID: 18499488 (View on PubMed)

Bloom AP, Jimenez-Andrade JM, Taylor RN, Castaneda-Corral G, Kaczmarska MJ, Freeman KT, Coughlin KA, Ghilardi JR, Kuskowski MA, Mantyh PW. Breast cancer-induced bone remodeling, skeletal pain, and sprouting of sensory nerve fibers. J Pain. 2011 Jun;12(6):698-711. doi: 10.1016/j.jpain.2010.12.016. Epub 2011 Apr 15.

Reference Type BACKGROUND
PMID: 21497141 (View on PubMed)

Donovan-Rodriguez T, Urch CE, Dickenson AH. Evidence of a role for descending serotonergic facilitation in a rat model of cancer-induced bone pain. Neurosci Lett. 2006 Jan 30;393(2-3):237-42. doi: 10.1016/j.neulet.2005.09.073. Epub 2005 Oct 25.

Reference Type BACKGROUND
PMID: 16256273 (View on PubMed)

Honore P, Rogers SD, Schwei MJ, Salak-Johnson JL, Luger NM, Sabino MC, Clohisy DR, Mantyh PW. Murine models of inflammatory, neuropathic and cancer pain each generates a unique set of neurochemical changes in the spinal cord and sensory neurons. Neuroscience. 2000;98(3):585-98. doi: 10.1016/s0306-4522(00)00110-x.

Reference Type BACKGROUND
PMID: 10869852 (View on PubMed)

Falk S, Patel R, Heegaard A, Mercadante S, Dickenson AH. Spinal neuronal correlates of tapentadol analgesia in cancer pain: a back-translational approach. Eur J Pain. 2015 Feb;19(2):152-8. doi: 10.1002/ejp.530. Epub 2014 Jun 11.

Reference Type BACKGROUND
PMID: 24917026 (View on PubMed)

Kennedy DL, Kemp HI, Ridout D, Yarnitsky D, Rice ASC. Reliability of conditioned pain modulation: a systematic review. Pain. 2016 Nov;157(11):2410-2419. doi: 10.1097/j.pain.0000000000000689.

Reference Type BACKGROUND
PMID: 27559835 (View on PubMed)

Rolke R, Magerl W, Campbell KA, Schalber C, Caspari S, Birklein F, Treede RD. Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain. 2006 Jan;10(1):77-88. doi: 10.1016/j.ejpain.2005.02.003.

Reference Type BACKGROUND
PMID: 16291301 (View on PubMed)

Yarnitsky D, Granot M, Nahman-Averbuch H, Khamaisi M, Granovsky Y. Conditioned pain modulation predicts duloxetine efficacy in painful diabetic neuropathy. Pain. 2012 Jun;153(6):1193-1198. doi: 10.1016/j.pain.2012.02.021. Epub 2012 Apr 3.

Reference Type BACKGROUND
PMID: 22480803 (View on PubMed)

Other Identifiers

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H-18041465

Identifier Type: -

Identifier Source: org_study_id

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