Enhanced Pain Coping in Cancer (EPIC): A Study of Managing Treatment-Related Joint Pain in Breast Cancer Survivors

NCT ID: NCT06728579

Last Updated: 2025-11-13

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-06

Study Completion Date

2028-12-31

Brief Summary

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The researchers are doing this study to compare two different types of group therapy and find out whether they are effective approaches for helping breast cancer survivors manage joint pain caused by aromatase inhibitors (AI). This type of joint pain is called AI-associated arthralgia, or AIA, and it is common in people taking AIs. AIA and its associated symptoms can make some people decide to stop taking their medication. The study will look at the effects of two different types of group therapy on participants' cancer-related symptoms (such as pain, fatigue, and anxiety), their ability to continue taking AIs on a regular schedule, and their quality of life. We will measure participants' quality of life by having them fill out questionnaires.

Both groups will have 2-hour group therapy sessions once a week, over the course of 8 weeks. During the sessions, you will be in a group of 6-10 participants, who may be a mixture of patients from both MSK and University of California San Diego (UCSD).

Detailed Description

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Conditions

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Breast Cancer Survivor

Keywords

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Enhanced Pain Coping in Cancer Mindfulness Oriented Recovery Enhancement Aromatase inhibitors Arthralgia Ache Cancer Pain Cancer Survivors

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two-arm, parallel group, RCT
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
This is a double-blind study where PIs, biostatisticians, and the CRC who performs outcome assessments are blinded.

Study Groups

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MORE Treatment Group

Participants randomized to the MORE arm will participate in eight weekly, two-hour group sessions following an established protocol. MORE sessions involve instruction in three therapeutic skills: 1) mindfulness to reduce pain and increase self regulation over maladaptive pain coping habits, (2) reappraisal to decrease psychological distress and negative affect, and 3) savoring to amplify natural reward processing and evoke positive emotion (see Figure 2). Participants will be asked to engage in 15 minutes per day of skill practice at home guided by audio recording, and to record the number of minutes they engaged in skill practice via a weekly Research Electronic Data Capture (REDCap) survey.

Group Type EXPERIMENTAL

Mindfulness Oriented Recovery Enhancement (MORE)

Intervention Type BEHAVIORAL

eight weekly two-hour MORE sessions

Questionnaires

Intervention Type OTHER

filled out up to 24 weeks

Supportive Psychotherapy Control Group

Participants randomized to SG will participate in eight weekly two-hour SG sessions led by the same instructors who deliver MORE interventions. The instructors will lead discussions on themes pertinent to chronic pain and cancer survivorship (see Figure 3) but will not teach MORE skills. To match the MORE homework requirement, SG participants will be asked to journal for 15 minutes/day on weekly session topics. Providers will employ empathic responding, elicit emotional expression, and promote a positive group climate.

Group Type ACTIVE_COMPARATOR

Questionnaires

Intervention Type OTHER

filled out up to 24 weeks

Supportive Psychotherapy (SG)

Intervention Type BEHAVIORAL

eight weekly two-hour SG sessions

Interventions

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Mindfulness Oriented Recovery Enhancement (MORE)

eight weekly two-hour MORE sessions

Intervention Type BEHAVIORAL

Questionnaires

filled out up to 24 weeks

Intervention Type OTHER

Supportive Psychotherapy (SG)

eight weekly two-hour SG sessions

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years
* English-proficient women with a history of stage I, II, or III breast cancer
* Free of oncologic disease by clinical examination and history;
* Receiving third-generation AI therapy (anastrozole, letrozole, or exemestane) for at least 28 days prior to consent with plan to continue for at least another 12 months;
* Worst joint pain rated at least 4 or greater on a 0-10 numeric rating scale in the preceding week prior to consent;
* Reporting at least 15 days with pain in the preceding 30 days prior to consent;
* Experiencing joint pain for at least one month;
* Pain attributed to AI therapy;
* Willing to adhere to all study-related procedures, including randomization to one of two treatment arms: Mindfulness-Oriented Recovery Enhancement (MORE) or Supportive Group Psychotherapy (SG);
* Able to attend video-call sessions in a quiet/private location.

Exclusion Criteria

* Metastatic breast cancer (stage IV);
* Completed chemotherapy, surgery, or radiation therapy less than 4 weeks prior to enrollment;
* Pain attributed to inflammatory arthritis (i.e. rheumatoid arthritis, gout, pseudogout);
* Surgery or joint injection involving the affected joints within the last month or planned within the next six months;
* Active suicidality or psychosis as determined by the Mini-International Neuropsychiatric Interview.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Memorial Sloan Kettering Cancer Center

OTHER

Sponsor Role lead

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jun Mao, MD, MSCE

Role: PRINCIPAL_INVESTIGATOR

Memorial Sloan Kettering Cancer Center

Locations

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University of California San Diego (Data collection and Data analysis)

San Diego, California, United States

Site Status RECRUITING

Florida State University

Tallahassee, Florida, United States

Site Status NOT_YET_RECRUITING

Memorial Sloan Kettering Basking Ridge (All Protocol Activities)

Basking Ridge, New Jersey, United States

Site Status RECRUITING

Memorial Sloan Kettering Monmouth (All Protocol Activities)

Middletown, New Jersey, United States

Site Status RECRUITING

Memorial Sloan Kettering Bergen (All Protocol Activities)

Montvale, New Jersey, United States

Site Status RECRUITING

Memorial Sloan Kettering Suffolk- Commack (All Protocol Activities)

Commack, New York, United States

Site Status RECRUITING

Memorial Sloan Kettering Westchester (All Protocol Activities)

Harrison, New York, United States

Site Status RECRUITING

Memorial Sloan Kettering Cancer Center (All Protocol Activities)

New York, New York, United States

Site Status RECRUITING

Memorial Sloan Kettering Nassau (All Protocol Activities)

Uniondale, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jun Mao, MD, MSCE

Role: CONTACT

Phone: 646-608-8553

Email: [email protected]

Karolina Bryl, PhD

Role: CONTACT

Phone: 646-608-8573

Email: [email protected]

Facility Contacts

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Eric Garland, PhD, LCSW

Role: primary

Adam Hanley, PhD

Role: primary

Jun Mao, MD, MSCE

Role: primary

Jun Mao, MD, MSCE

Role: primary

Jun Mao, MD, MSCE

Role: primary

Jun Mao, MD, MSCE

Role: primary

Jun Mao, MD, MSCE

Role: primary

Jun Mao, MD, MSCE

Role: primary

Jun Mao, MD, MSCE

Role: primary

Related Links

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http://www.mskcc.org/mskcc/html/44.cfm

Memorial Sloan Kettering Cancer Center

Other Identifiers

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24-171

Identifier Type: -

Identifier Source: org_study_id