The CONTRoL Trial: Cryotherapy vs. cOmpression Neuropathy TRiaL
Condition: CIPN - Chemotherapy-Induced Peripheral Neuropathy
MeSH terms: Peripheral Nervous System Diseases
Study type: Interventional

Summary: 
      The primary objective of this study is to select the best intervention from cold therapy,
      compression therapy and placebo at reducing neuropathic pain as measured by the change in the
      Neurotoxicity (NTX) component of the Functional Assessment of Cancer Therapy (FACT) - Taxane
      questionnaire, following 12 weeks of neoadjuvant/adjuvant chemotherapy with paclitaxel or
      docetaxel among breast cancer patients.
    

Detailed description: 
      Chemotherapy-induced peripheral neuropathy (CIPN) is a frequent side effect resulting from
      the administration of cytotoxic chemotherapeutic agents. The incidence of CIPN can vary on
      the type of agent used, the frequency with which it is given, and the cumulative dose.
      Unfortunately, for some patients, symptoms may persist even after discontinuation of the drug
      due to irreversible nerve damage. As of now, there are no established agents for CIPN
      prevention.

      This is a randomized, placebo-controlled clinical selection trial of interventions for CIPN
      in patients treated with docetaxel every 3 weeks or paclitaxel on a weekly schedule. Patients
      will be randomly assigned to receive either frozen gloves and socks, compression gloves and
      socks, or "loose" gloves and socks (placebo arm) during chemotherapy infusion to study the
      best intervention at reducing neuropathic pain.
    

Intervention name(s): Cryotherapy; Compression Therapy; Loose glove/sock
Intervention type(s): Device; Device; Device
Intervention description(s): Study subjects will wear NatraCure flexible socks on bilateral hands and feet. The sock will act as a mitten and covers the entire hand until past the wrist. There are 2 gel packs inserted into the sock, to provide cooling to the dorsal and frontal aspect of the hand. For the feet, the sock will cover the entire foot until above the ankle. Garments will be refrigerated for at least 3 hours at -25 to -30 Celsius prior to use. With each infusion, patients will wear the frozen garments on their hands and feet for a total of 90-120 minutes, beginning 15 minutes before the start of the infusion and until 15 minutes after the end of the infusion. Two sets of socks will be used during each session for 45-60 minutes each to maintain a consistently low temperatures of the extremities.; Study participants will wear Sigvaris Secure Arm Sleeves and Gloves on bilateral upper extremities. The sleeves and gloves provide 20-30mmHg of compression. Subjects will wear Sigvaris CompreFlex Lite compression garments on the lower extremities which includes a transition liner with a compressive foot, providing 20-30mmHg of compression on the lower leg and 15mmHg on the toes and feet. AccuTabs will be placed along the CompreFlex Lite to easily and accurately set the compression level at 20-30mmHg. With each chemotherapy infusion, patients will wear the sleeves/gloves and socks for a total of 90-120 minutes, beginning 15 minutes before the start of the infusion and until 15 minutes after the end of the infusion.; Study participants will wear a non-compressive sleeve and loosely fitting glove on bilateral arms and hands. They will also wear a non-compressive Sigvaris Basic Liner with the CompreFlex Lite loosely applied over it. The investigators will verify that no compression is applied via using an interface pressure sensor (PicoPress). The maximum level of allowed pressure for garments will be 3mmHg. If the pressure reading is greater than 3mmHg, then a larger garment size will be used. Measurements with the pressure sensor will be repeated as needed to ensure a low pressure level of less than 3mmHg. With each chemotherapy infusion, patients will wear the gloves and socks for a total of 90-120 minutes, beginning 15 minutes before the start of the infusion and until 15 minutes after the end of the infusion.
Allocation: Randomized
Intervention model: Sequential Assignment
Intervention model description: The preferred intervention can be selected during the ongoing enrollment as soon as the pre-specified selection criteria are met, and further enrollment will cease.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Neuropathy; CIPN; Cryotherapy; Compression therapy