Trial Outcomes & Findings for Surgical Treatment of Post-surgical Mastectomy Pain Utilizing the Regenerative Peripheral Nerve Interface (NCT NCT04530526)

NCT ID: NCT04530526

Last Updated: 2025-12-24

Results Overview

Data will be derived from standard clinical care for patients seeking surgical management of post-mastectomy chronic pain. Ultrasound will be performed at the time of patient enrollment and subsequent follow-up visits, as part of routine clinical evaluation, up to approximately 9 months after RPNI surgery. Patients enrolled during the first year of the study's 2-year recruitment period may be followed until the study stops.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

26 participants

Primary outcome timeframe

24 months post enrollment

Results posted on

2025-12-24

Participant Flow

Participant milestones

Participant milestones
Measure
Regenerative Peripheral Nerve Interface (RPNI)
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Overall Study
STARTED
26
Overall Study
COMPLETED
20
Overall Study
NOT COMPLETED
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Regenerative Peripheral Nerve Interface (RPNI)
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Overall Study
Withdrawal by Subject
6

Baseline Characteristics

Surgical Treatment of Post-surgical Mastectomy Pain Utilizing the Regenerative Peripheral Nerve Interface

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Regenerative Peripheral Nerve Interface (RPNI)
n=26 Participants
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Age, Customized
20-29 years
1 Participants
n=30 Participants
Age, Customized
30-39 years
1 Participants
n=30 Participants
Age, Customized
40-49 years
9 Participants
n=30 Participants
Age, Customized
50-59 years
5 Participants
n=30 Participants
Age, Customized
60-69 years
8 Participants
n=30 Participants
Age, Customized
70-79 years
2 Participants
n=30 Participants
Sex: Female, Male
Female
25 Participants
n=30 Participants
Sex: Female, Male
Male
1 Participants
n=30 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=30 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
25 Participants
n=30 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=30 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=30 Participants
Race (NIH/OMB)
Asian
1 Participants
n=30 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=30 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=30 Participants
Race (NIH/OMB)
White
22 Participants
n=30 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=30 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=30 Participants

PRIMARY outcome

Timeframe: baseline, and 9 months post surgery

The use of RPNI surgery to reduce post-mastectomy pain will be evaluated by validated patient-reported outcome (PRO) surveys administered at 4 timepoints: at baseline (at time of enrollment), at the RPNI pre-operative visit (approximately 3 months after enrollment), and at approximately 3 and 9 months after RPNI surgery. The average time of study involvement for each patient will be 12 months. Patients enrolled during the first year of the study's 2-year recruitment period may be followed until the study stops. Numerical Pain Rating Scale (0-10)- 10 indicating more pain Short Form McGill Pain Questionnaire 2 (0-10)- 10 indicating more pain Pain Catastrophizing Score (0-52)- 52 indicating more pain PROMIS Intensity (0-12)- 12 indicating more pain PROMIS Interference (0-24)- 24 indicating more pain PROMIS Neuropathic (0-20)- 20 indicating more pain

Outcome measures

Outcome measures
Measure
Regenerative Peripheral Nerve Interface (RPNI)
n=20 Participants
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Change in Pain Level
Numerical Pain Rating Scale- Preoperative Score
6.9 score on a scale
Standard Error 0.4
Change in Pain Level
Numerical Pain Rating Scale- Postoperative Score
0.6 score on a scale
Standard Error 0.3
Change in Pain Level
Short Form McGill Pain Questionnaire 2- Preoperative
4.4 score on a scale
Standard Error 0.5
Change in Pain Level
Short Form McGill Pain Questionnaire 2- Postoperative
2.5 score on a scale
Standard Error 0.6
Change in Pain Level
Pain Catastrophizing Score- Preoperative
27.5 score on a scale
Standard Error 3.0
Change in Pain Level
Pain Catastrophizing Score- Postoperative
14.1 score on a scale
Standard Error 2.9
Change in Pain Level
PROMIS Intensity- Preoperative
7.9 score on a scale
Standard Error 0.5
Change in Pain Level
PROMIS Intensity- Postoperative
4.9 score on a scale
Standard Error 0.8
Change in Pain Level
PROMIS Interference- Preoperative
16.2 score on a scale
Standard Error 1.3
Change in Pain Level
PROMIS Interference- Post Operative
11.0 score on a scale
Standard Error 2.0
Change in Pain Level
PROMIS Neuropathic- Preoperative
8.6 score on a scale
Standard Error 1.4
Change in Pain Level
PROMIS Neuropathic- Postoperative
6.0 score on a scale
Standard Error 1.4

PRIMARY outcome

Timeframe: baseline, and 9 months post surgery

Evaluated by validated patient-reported outcome (PRO) surveys administered at 4 timepoints: at baseline (at time of enrollment), at the RPNI pre-operative visit (approximately 3 months after enrollment), and at approximately 3 and 9 months after RPNI surgery. The average time of study involvement for each patient will be 12 months. Patients enrolled during the first year of the study's 2-year recruitment period may be followed until the study stops. Patient Health Questionnaire-9 range is 0-27. 27 indicates a worse outcome. Generalized Anxiety Disorder-7 range is 0-21. 21 indicates a worse outcome.

Outcome measures

Outcome measures
Measure
Regenerative Peripheral Nerve Interface (RPNI)
n=20 Participants
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Change in Depression/Anxiety Scores
Patient Health Questionnaire-9- Preoperative
10.3 score on a scale
Standard Error 1.3
Change in Depression/Anxiety Scores
Patient Health Questionnaire-9- Postoperative
7.2 score on a scale
Standard Error 1.4
Change in Depression/Anxiety Scores
Generalized Anxiety Disorder-7- Preoperative
7.3 score on a scale
Standard Error 1.1
Change in Depression/Anxiety Scores
Generalized Anxiety Disorder-7- postoperative
4.3 score on a scale
Standard Error 1.2

PRIMARY outcome

Timeframe: baseline, and 9 months post surgery

Evaluated by validated patient-reported outcome (PRO) surveys administered at 4 timepoints: at baseline (at time of enrollment), at the RPNI pre-operative visit (approximately 3 months after enrollment), and at approximately 3 and 9 months after RPNI surgery. The average time of study involvement for each patient will be 12 months. Patients enrolled during the first year of the study's 2-year recruitment period may be followed until the study stops.

Outcome measures

Outcome measures
Measure
Regenerative Peripheral Nerve Interface (RPNI)
n=20 Participants
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Change in Opioid Consumption (Number of Opioid Medications)
Number of Opioid Medications- Preoperative
1.3 Opioid medications
Standard Error 0.2
Change in Opioid Consumption (Number of Opioid Medications)
Number of Opioid Medications- Postoperative
0.4 Opioid medications
Standard Error 0.2

PRIMARY outcome

Timeframe: 24 months post enrollment

Data will be derived from standard clinical care for patients seeking surgical management of post-mastectomy chronic pain. Physical examinations will be performed at the time of patient enrollment and subsequent follow-up visits, as part of routine clinical evaluation, up to approximately 9 months after RPNI surgery. Patients enrolled during the first year of the study's 2-year recruitment period may be followed until the study stops.

Outcome measures

Outcome measures
Measure
Regenerative Peripheral Nerve Interface (RPNI)
n=20 Participants
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Freedom From Neuroma Recurrence Evaluated by Physical Exam
20 Participants

PRIMARY outcome

Timeframe: 24 months post enrollment

Data will be derived from standard clinical care for patients seeking surgical management of post-mastectomy chronic pain. Ultrasound will be performed at the time of patient enrollment and subsequent follow-up visits, as part of routine clinical evaluation, up to approximately 9 months after RPNI surgery. Patients enrolled during the first year of the study's 2-year recruitment period may be followed until the study stops.

Outcome measures

Outcome measures
Measure
Regenerative Peripheral Nerve Interface (RPNI)
n=20 Participants
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Freedom From Neuroma Recurrence Evaluated by Ultrasound
20 Participants

PRIMARY outcome

Timeframe: baseline, and 9 months post surgery

Evaluated by validated patient-reported outcome (PRO) surveys administered at 4 timepoints: at baseline (at time of enrollment), at the RPNI pre-operative visit (approximately 3 months after enrollment), and at approximately 3 and 9 months after RPNI surgery. The average time of study involvement for each patient will be 12 months. Patients enrolled during the first year of the study's 2-year recruitment period may be followed until the study stops.

Outcome measures

Outcome measures
Measure
Regenerative Peripheral Nerve Interface (RPNI)
n=20 Participants
Using evaluative ultrasound measurements and a standard panel of patient-reported outcome measures (PROMs) to measure pain experience, anxiety and depression, patients will be evaluated at baseline (T1=0months), pre-operatively following 3 months of standard neuropathic pain management therapy (T2=3months) and at three months (T3=6months) and nine months (T4=12months) post RPNI surgery. Regenerative Peripheral Nerve Interface: The regenerative peripheral nerve interface (RPNI) has emerged as a novel strategy to treat neuromas in peripheral nerves. The RPNI consists of the residual peripheral nerve end implanted in a skeletal muscle graft, following surgical resection of the injured terminal nerve portion (neuroma). The free muscle graft is separated from its native nerve innervation, leaving open neuromuscular junctions for ingrowth and attachment of nerve fibers from the implanted nerve.
Change in Opioid Consumption (Oral Morphine Equivalents)
Oral Morphine Equivalents (mg)- Preoperative
43.3 mg morphine equivalent
Standard Error 11.4
Change in Opioid Consumption (Oral Morphine Equivalents)
Oral Morphine Equivalents (mg)- Postoperative
12.0 mg morphine equivalent
Standard Error 4.9

Adverse Events

Regenerative Peripheral Nerve Interface (RPNI)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

University of Michigan Rogel Cancer Center ClinicalTrials.gov Admin

University of Michigan Rogel Cancer Center

Phone: 734-936-9499

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place