The Purpose of This Study is to Determine if Tetrodotoxin (TTX) is Effective in the Treatment of Pain Resulting From Chemotherapy Treatment
Condition: Pain; Peripheral Neuropathy; Neuropathic Pain
MeSH terms: Neuralgia; Peripheral Nervous System Diseases
Intervention: Placebo; Tetrodotoxin
Intervention description: Sham treatment acting as control arm; Comparison of different dosages of Tetrodotoxin
Intervention MeSH terms: Tetrodotoxin
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 125.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Pain; Puffer fish; Tetrodotoxin; TTX; Neuropathy; Chemotherapy; WEX Pharmaceuticals

Summary:

      Chemotherapy-induced peripheral neuropathy (CIPN) is a major dose-limiting side effect of
      many chemotherapeutic agents including vincristine, paclitaxel, cisplatin, oxaliplatin,
      bortezomib and ixabepilone. Chemotherapy-induced peripheral neuropathy commonly occurs in
      greater than 40% of patients. To improve the peripheral neuropathy, the chemotherapy dosing
      is often either decreased or discontinued potentially affecting tumor responsiveness,
      prognosis, and survival.

      There is an unmet medical need for treatment of cancer patients with chemotherapy induced
      neuropathic pain (CINP) and the proposed study will investigate the efficacy and safety of
      multiple dose levels of tetrodotoxin (TTX) versus placebo in moderate to severe neuropathic
      pain caused by chemotherapy.
    

Eligibility criteria:

        Inclusion Criteria:

          -  If female, not of childbearing potential.

          -  Patients with documented neuropathic pain

          -  Cancer Patients who have completed a chemotherapy regimen which included taxanes or
             platinums (or both) and have no evidence actively progressive disease. Concurrent
             hormonal therapies are allowed

          -  Patients with stable moderate to severe neuropathic pain

          -  Patients with an Eastern Cooperative Oncology Group (ECOG) Performance Status score of
             0 or 1.

          -  Patients who are able to complete the study-related questionnaires independently in
             either English or Spanish.

        Exclusion Criteria:

          -  History of peripheral neuropathy attributed to any cause other than chemotherapy.

          -  Patients receiving any concurrent agents known to cause peripheral neuropathy within
             30 days of Randomization.

          -  Current use of other therapy (ies), including "alternative" therapies, for treatment
             of peripheral neuropathy within 30 days of Randomization (with the exception of
             protocol allowed concurrent medications).

          -  Patients who used controlled release opioids within seven days of baseline period or
             who expect to use controlled release opioids at any time from baseline to end of
             study.

          -  Patients with abnormal kidney function.

          -  Patients with bone metastases.

          -  Patients scheduled for treatment for their cancer with chemotherapy or radiotherapy
             between screening and the end of study visit.

          -  Current use of lidocaine and other types of antiarrhythmic drugs within 30 days of
             Randomization.

          -  Current use of scopolamine and acetylcholinesterase-inhibiting drugs such as
             physostigmine within 30 days of Randomization.

          -  Current cause of Chemotherapy Induced Neuropathic Pain attributed to Velcade
             (Bortezomib) or vinca alkaloids or analogues such as vincristine, vinblasine,
             vinorelbine and vindesine.

          -  Current use of tricyclic antidepressant medication, anticonvulsants and monoamine
             oxidase inhibitors.

          -  Patients with current uncontrolled asthma or lung disease.

          -  Patients with significant heart disease.

          -  Use of an investigational agent within 30 days prior to screening or is scheduled to
             receive an investigational drug other than TTX during the course of the study.

          -  Females who are pregnant or nursing