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Trial registered on ANZCTR
Registration number
ACTRN12611000514909
Ethics application status
Approved
Date submitted
13/05/2011
Date registered
18/05/2011
Date last updated
10/07/2019
Date data sharing statement initially provided
10/07/2019
Date results provided
10/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Does Riluzole reduce the incidence of chemotherapy-induced nerve injury in patients with colorectal cancer?
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Scientific title
NEU-HORIZONS: The neuroprotection and therapeutic use of riluzole for the prevention of oxaliplatin neurotoxicity in patients with colorectal cancer
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Secondary ID [1]
262128
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none
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Universal Trial Number (UTN)
U1111-1121-2382
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Trial acronym
NEU-HORIZONS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Oxaliplatin-induced neurotoxicity
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Colorectal cancer
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Condition category
Condition code
Neurological
265957
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0
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Other neurological disorders
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Cancer
266006
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0
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Bowel - Back passage (rectum) or large bowel (colon)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients receiving oxaliplatin chemotherapy for colorectal cancer will be randomised into either the study drug arm or placebo control arm. Participants will be started on either riluzole 50 mg oral tablet twice daily or the twice daily lactose placebo tablet. Following randomisation, therapy will be continued for the duration of oxaliplatin treatment (4-6 months) and for 2 weeks following treatment cessation.
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Intervention code [1]
264544
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Prevention
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Comparator / control treatment
Routine clinical care involving standard review by oncology physician and placebo lactose tablet. Symptomatic relief of neuropathic symptoms as required.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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To assess whether treatment with riluzole results in a reduction in the development of chronic neuropathy and neuropathic symptoms
The severity of neuropathy will be assessed using the Total Neuropathy Score (TNS). This will be used to evaluate neuropathy in a number of different categories; sensory neuropathic symptoms, examination findings and nerve conduction results.
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Assessment method [1]
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Timepoint [1]
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Assessed at 6 monthly intervals following randomisation for 2 years
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Secondary outcome [1]
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1. Nerve conduction measures (sural sensory amplitude).
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Assessment method [1]
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Timepoint [1]
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Assessed at baseline, pre cycle 10 and 12, post treatment 4 weeks and 12 weeks.
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Secondary outcome [2]
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2. Peripheral nerve excitability (composite score: threshold electrotonus, refractoriness, superexcitability).
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Assessment method [2]
276369
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Timepoint [2]
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Assessed at baseline, 7-10 days after initial dose of riluzole/placebo, pre cycle 10 and 12, post treatment 4 weeks and 12 weeks.
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Secondary outcome [3]
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3. Severity of acute neuropathy: Assessed with the oxaliplatin-specific neurotoxicity scale: Graded from 1 to 4.
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Assessment method [3]
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Timepoint [3]
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Assessed at baseline, pre cycle 10 and 12, post treatment 4 weeks and 12 weeks.
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Secondary outcome [4]
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4. Nine-hole pegboard test: measuring upper limb dexterity.
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Assessment method [4]
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Timepoint [4]
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Assessed at baseline, pre cycle 10 and 12, post treatment 4 weeks and 12 weeks.
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Secondary outcome [5]
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5. FACT questionnaire (FACT-GOG-NTX-13): a validated13-item questionnaire relating to neuropathy-quality of life
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Assessment method [5]
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Timepoint [5]
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Assessed at baseline, pre cycle 10 and 12, post treatment 4 weeks and 12 weeks.
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Secondary outcome [6]
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6. Response rate: assessed qualitatively to ensure that there is no adverse effect of the intervention on cancer-related outcomes.
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Assessment method [6]
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Timepoint [6]
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Assessed at baseline, pre cycle 10 and 12, post treatment 4 weeks and 12 weeks.
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Eligibility
Key inclusion criteria
1. Receiving oxaliplatin chemotherapy.
2. 18-80 years of age.
3. Able to provide written informed consent.
4. Histological or cytological confirmation of colorectal cancer.
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Baseline clinical and nerve conduction evidence of pre-existing neuropathy.
2. Past history of neurotoxic chemotherapy treatment.
3. Concurrent use of anticonvulsant medications that modulate axonal Na+ conductances (carbamazepine, topiramate, phenytoin).
4. Evidence of baseline elevation of hepatic transaminases (greater than 3 times the upper limit of normal) on liver function testing.
5. Administration of another investigational drug within 30 days prior to randomisation.
6. A history of severe hypersensitivity reactions to riluzole or any of the tablet components
7. Significant neurological or psychiatric disorders.
8. Pregnancy or lactation. Contraception is required in pre-menopausal female patients.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Stratified random sampling, undertaken by NHMRC clinical trials centre or Prince of Wales Clinical Trial Pharmacy.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be stratified according to the treatment regime of 2 weekly versus 3 weekly chemotherapy treatment.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/06/2011
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Actual
4/07/2011
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Date of last participant enrolment
Anticipated
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Actual
11/11/2015
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Date of last data collection
Anticipated
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Actual
19/09/2016
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Sample size
Target
100
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Accrual to date
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Final
52
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Prince of Wales Hospital - Randwick
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Recruitment postcode(s) [1]
27153
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2031 - Randwick
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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National Health and Medical Research Council
GPO Box 1421, Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Prince of Wales Hospital/South Eastern Sydney Local Health Network
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Address
Prince of Wales Hospital, Barker Street, Randwick NSW 2031
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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University of New South Wales
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Address [1]
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Gate 9, High Street
Kensington NSW 2052
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Country [1]
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Australia
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Cindy Lin
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Address [1]
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University of New South Wales and Institute of Neurological Sciences, Prince of Wales Hospital, Barker Street, Randwick NSW 2031
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Country [1]
251992
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Australia
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Other collaborator category [2]
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Individual
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Name [2]
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Prof David Goldstein
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Address [2]
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Department of Medical Oncology, Prince of Wales Hospital, Barker Street, Randwick NSW 2031
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Country [2]
251993
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Australia
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Other collaborator category [3]
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Individual
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Name [3]
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Prof Michael Friedlander
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Address [3]
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Department of Medical Oncology, Prince of Wales Hospital, Barker Street, Randwick NSW 2031
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Country [3]
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Australia
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Other collaborator category [4]
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Individual
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Name [4]
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Dr Andrew Martin
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Address [4]
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NHMRC Clinical Trials Centre Locked Bag 77, Camperdown NSW1450
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Country [4]
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Australia
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Other collaborator category [5]
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Individual
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Name [5]
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Dr Susanna Park
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Address [5]
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University of New South Wales and Institute of Neurological Sciences, Prince of Wales Hospital, Barker Street, Randwick NSW 2031
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Country [5]
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Australia
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Other collaborator category [6]
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Individual
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Name [6]
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Ms Jenna Murray
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Address [6]
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University of New South Wales and Institute of Neurological Sciences, Prince of Wales Hospital, Barker Street, Randwick NSW 2031
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Country [6]
251997
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Australia
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Other collaborator category [7]
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Individual
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Name [7]
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Ms Hannah Pickering
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Address [7]
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University of New South Wales and Institute of Neurological Sciences, Prince of Wales Hospital, Barker Street, Randwick NSW 2031
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Country [7]
251998
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Australia
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Other collaborator category [8]
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Individual
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Name [8]
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Prof Matthew Kiernan
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Address [8]
251999
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University of New South Wales and Institute of Neurological Sciences, Prince of Wales Hospital, Barker Street, Randwick NSW 2031
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Country [8]
251999
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Australia
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Other collaborator category [9]
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Individual
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Name [9]
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Dr Arun Krishnan
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Address [9]
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Room 313, Wallace Wurth Building, University of New South Wales, Sydney 2052
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Country [9]
252000
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Eastern Sydney Local Health Network
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Ethics committee address [1]
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Room G71, East Wing Edmund Blackett Building Prince of Wales Hospital High St Randwick NSW 2031
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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14/04/2011
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Approval date [1]
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29/04/2011
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Ethics approval number [1]
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10/236
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Summary
Brief summary
This study aims to determine whether a drug called Riluzole can prevent chemotherapy-induced nerve injury in patients with colorectal cancer. Who is it for? You can join this study if you are aged 18-80 years and are scheduled to undergo chemotherapy with the drug, oxaliplatin, for the treatment of colorectal cancer. Trial details In this study, participants are randomly (by chance) divided into two groups. One group will take the study drug, Riluzole, at a dose of 50 mg oral tablet twice daily for the duration of chemotherapy treatment (4-6 months), and for 2 weeks following treatment cessation. The other group will receive a placebo (sham) treatment consisting of lactose tablets. During the trial, participants will not know whether they are receiving the active drug or placebo. Participants will be assessed at regular intervals over 2 years to assess their nerve function, quality of life, and cancer-related outcomes.
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Trial website
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Trial related presentations / publications
1. Park SB, Goldstein D, Lin CSY, Krishnan AV, Friedlander ML & Kiernan MC (In press) Neuroprotection for Oxaliplatin-induced neurotoxicity: What happened to objective assessment? Journal of Clinical Oncology. 2. Park SB, Lin CS, Krishnan AV, Goldstein D, Friedlander ML & Kiernan MC (In press) Long-term Neuropathy after Oxaliplatin Treatment: Challenging the Dictum of Reversibility? The Oncologist. 3. Park SB, Lin CS, Krishnan AV & Kiernan MC (In Press) The contributions of SK3 polymorphisms to acute oxaliplatin-induced neurotoxicity: Direct or indirect effects? Cancer, Chemotherapy, and Pharmcology. 4. Park SB, Lin CSY, Krishnan AV, Goldstein D, Friedlander ML & Kiernan MC (2011) Dose effects of oxaliplatin on persistent and transient Na+ conductances and the development of Neurotoxicity. PLoS ONE 6(4): e18469. 5. Park SB, Lin CS, Krishnan AV, Goldstein D, Friedlander ML, & Kiernan MC. (2011) Utilizing natural activity to dissect the pathophysiology of acute oxaliplatin-induced neuropathy. Experimental Neurology. 227(1): 120-127. 6. Park SB, Lin CS, Krishnan AV, Goldstein D, Friedlander ML & Kiernan MC. (2009). Oxaliplatin-induced neurotoxicity: changes in axonal excitability precede development of neuropathy. Brain 132: 2712-2723. 7. Park SB, Goldstein D, Lin CSY, Krishnan AV, Friedlander ML & Kiernan MC. (2009) Acute abnormalities of sensory nerve function associated wtih oxaliplatin-induced neurotoxicity. Journal of Clinical Oncology 27(8): 1243-1249. 8. Park SB, Lin CSY, Krishnan AV, Goldstein D, Friedlander ML & Kiernan MC. (2009) Oxaliplatin-induced Lhermitte’s phenomenon as a manifestation of severe generalized nerve dysfunction. Oncology 77:342 – 348. 9. Park SB, Krishnan AV, Lin CSY, Goldstein D, Friedlander ML & Kiernan MC. (2008) Mechanisms underlying chemotherapy-induced neurotoxicity and the potential for neuroprotective strategies. Current Medicinal Chemistry 15(29):3081 – 3094. (Invited Review)
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Public notes
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Contacts
Principal investigator
Name
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Prof Arun Krishnan
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Address
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Prince of Wales Hospital
Department of Neurological Sciences
Level 2, room G104 High Street,
Randwick 2031
NSW, Australia
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Country
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Australia
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Phone
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+61 2 9382 2414
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Arun Krishnan
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Address
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Prince of Wales Hospital
Department of Neurological Sciences
Level 2, room G104 High Street,
Randwick 2031
NSW, Australia
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Country
15827
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Australia
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Phone
15827
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+61 2 9382 2414
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Fax
15827
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+61 2 9382 2428
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Email
15827
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[email protected]
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Contact person for scientific queries
Name
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Arun Krishnan
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Address
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Prince of Wales Hospital
Department of Neurological Sciences
Level 2, room G104 High Street,
Randwick 2031
NSW, Australia
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Country
6755
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Australia
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Phone
6755
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+61 2 9382 2414
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Fax
6755
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+61 2 9382 2428
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
This was a preliminary study in a small cohort. It cannot be translated in clinical practice and has no direct benefit for participants.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
2808
Study protocol
336902-(Uploaded-04-07-2019-11-59-19)-Study-related document.doc
2809
Statistical analysis plan
336902-(Uploaded-04-07-2019-11-59-19)-Study-related document.docx
2810
Informed consent form
336902-(Uploaded-04-07-2019-12-00-32)-Study-related document.doc
2811
Ethical approval
336902-(Uploaded-09-07-2019-16-35-17)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Neu-horizons: neuroprotection and therapeutic use of riluzole for the prevention of oxaliplatin-induced neuropathy-a randomised controlled trial.
2021
https://dx.doi.org/10.1007/s00520-020-05591-x
N.B. These documents automatically identified may not have been verified by the study sponsor.
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