Target Muscle Re-innervation and Regenerative Peripheral Nerve Interfaces Alone and in Combination for the Treatment of Residual and Phantom Limb Pain in Cancer Patients Who Have Received an Amputation

NCT ID: NCT06840262

Last Updated: 2025-09-05

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

NA

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-10

Study Completion Date

2027-02-02

Brief Summary

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This clinical trial evaluates two surgical techniques (targeted muscle re-innervation \[TMR\] and regenerative peripheral nerve interfaces \[RPNI\]) alone and in combination for the alleviation of chronic residual limb and phantom limb pain in cancer patients who have had an amputation. Chronic residual limb pain and phantom limb pain are debilitating outcomes of traumatic and oncologic amputation. Emerging microsurgical treatments for post-amputation pain are very promising. TMR and RPNI are both approved surgical techniques that involve connecting cut nerves to parts of the muscle as a way to heal and protect the nerves. This trial evaluates these techniques alone and in combination for the treatment of residual and phantom limb pain in cancer patients who have received an amputation.

Detailed Description

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PRIMARY OBJECTIVE:

Determine the relative effectiveness of three surgical techniques, TMR, RPNI, and TMR with RPNI, on chronic and phantom limb pain in the oncologic amputee using the validated Numerical Rating Scale (NRS) and Patient-Reported Outcomes Measurement Information System (PROMIS) Behavior, Intensity, Interference, and Global Health Forms.

SECONDARY OBJECTIVES:

I. To estimate the rate and total quantity of any pain medication use among oncology amputees who received one of the three surgical techniques.

II. To estimate the rate of prosthetic use among oncologic amputees. III. To compare NRS and PROMIS among three surgical techniques to calculate the effect size and project the sample size which will be used to plan a multi-institutional study.

OUTLINE: Patients are randomized to 1 of 3 arms.

ARM 1: Patients undergo TMR procedure.

ARM 2: Patients undergo RPNI procedure.

ARM 3: Patients undergo TMR in combination with RPNI.

After completion of study procedure, patients are followed up at 3, 6, and 12 months.

Conditions

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Amputation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm 1 (targeted muscle reinnervation)

Patients undergo TMR procedure.

Group Type ACTIVE_COMPARATOR

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Targeted Muscle Reinnervation

Intervention Type PROCEDURE

Undergo targeted muscle reinnervation

Arm 2 (regenerative peripheral nerve interface)

Patients undergo RPNI procedure.

Group Type ACTIVE_COMPARATOR

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Regenerative Peripheral Nerve Interface Surgery

Intervention Type PROCEDURE

Undergo regenerative peripheral nerve interface surgery

Arm 3 (TMI + RPNI)

Patients undergo TMR in combination with RPNI.

Group Type EXPERIMENTAL

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Regenerative Peripheral Nerve Interface Surgery

Intervention Type PROCEDURE

Undergo regenerative peripheral nerve interface surgery

Targeted Muscle Reinnervation

Intervention Type PROCEDURE

Undergo targeted muscle reinnervation

Interventions

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Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Regenerative Peripheral Nerve Interface Surgery

Undergo regenerative peripheral nerve interface surgery

Intervention Type PROCEDURE

Targeted Muscle Reinnervation

Undergo targeted muscle reinnervation

Intervention Type PROCEDURE

Other Intervention Names

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Regenerative Peripheral Nerve Interface RPNI TMR

Eligibility Criteria

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Inclusion Criteria

* Patients greater than or equal to 18 years of age who are receiving an amputation for oncologic reasons
* Patients with available mixed major nerves and donor motor nerves in the amputation stump or reconstructive tissue
* Patients able to complete informed consent

Exclusion Criteria

* Patients under 18 years of age
* Patients unable to give consent
* Patients receiving an amputation for non-oncologic purposes
* Patients with amputations performed for immediate palliation (life expectancy less than 3 months), as this technique takes a minimum of 3-6 months for effect
* Patients with multiple limb amputations
* Patients receiving nerve management in a delayed fashion (patients who have previously received an amputation and present with neuroma)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Margaret S Roubaud

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

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M D Anderson Cancer Center

Houston, Texas, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Margaret S. Roubaud

Role: primary

713-794-1247

Related Links

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http://www.mdanderson.org

M.D. Anderson Cancer Center

Other Identifiers

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NCI-2021-08488

Identifier Type: REGISTRY

Identifier Source: secondary_id

2019-0971

Identifier Type: -

Identifier Source: org_study_id

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