Finding an Effective Dose of GM1 to Reduce or Prevent Neuropathy (Numbness or Weakness) Due to Treatment With Paclitaxel (Phase II)

Last updated: March 28, 2025
Sponsor: Alliance for Clinical Trials in Oncology
Overall Status: Active - Recruiting

Phase

2

Condition

Neurologic Disorders

Treatment

Quality-of-life assessment

Monosialotetrahexosylganglioside

Placebo Administration

Clinical Study ID

NCT05751668
A222101
NCI-2022-04929
  • Ages > 18
  • All Genders

Study Summary

This phase II trial tests the safety, side effects, and best dose of monosialotetrahexosylganglioside (GM1) and whether it works in reducing or preventing chemotherapy-induced peripheral neuropathy (CIPN) in patients with breast cancer that has spread from where it first started (primary site) to other places in the body (metastatic) who are receiving treatment with paclitaxel. Chemotherapy drugs, such as paclitaxel, work in different ways to stop the growth of cancer cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading. Exposure to chemotherapy drugs like paclitaxel may cause a side effect called CIPN, which is a condition of weakness, numbness, and pain from nerve damage (usually in the hands and feet). GM1 is a part of the body's natural system that insulates nerves and helps to protect nerves from damage. Giving GM1 may help reduce or prevent CIPN in breast cancer patients receiving treatment with paclitaxel.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Documentation of disease: Histologic diagnosis of metastatic breast cancer in womenor men

  • Prior treatment- No previous exposure to GM1

  • Planned administration of paclitaxel, either given weekly, or weekly 3 weeks on/1week off, to patients with metastatic cancer at a dose of 80 mg/m^2

  • No planned treatment with concurrent immunotherapy

  • Score of 1 (none) and/or 2 (a little) on the six individual European Organizationfor Research and Treatment of Cancer (EORTC) Quality of Life questionnaire (QLQ)-chemotherapy-induced peripheral neuropathy (CIPN)20 questions that quantify numbness (N), tingling (T), and pain in the fingers/hands and toes/feet (Items #31-36)

  • No diagnosis of fibromyalgia

  • No history of significant respiratory tract infection and/or infectious diarrheawithin 14 days before registration

  • No history of stroke or cerebrovascular accident in the past 6 months prior toregistration

  • No history of diagnosed neurologic or psychiatric disorders, including epilepsy ordementia

  • For women of childbearing potential, not pregnant and not nursing, because thisstudy involves an investigational agent whose genotoxic, mutagenic and teratogeniceffects on the developing fetus and newborn are unknown.

Therefore, for women of childbearing potential, a negative pregnancy test done =< 7 days prior to registration is required. Of note, a female of childbearing potential is a sexually mature female who: 1) has not undergone a hysterectomy or bilateral oophorectomy; or 2) has not been naturally postmenopausal for at least 12 consecutive months (i.e., has had menses at any time in the preceding 12 consecutive months)

  • Ability to complete questionnaires by themselves or with assistance

  • In order to complete the mandatory patient-completed measures, participants must beable to speak and/or read English and/or Spanish

  • Persons with impaired decision making such that they cannot understand the benefitsor risks of trial participation, per the judgement of the consenting clinician, willnot be eligible

  • Age >= 18 years

  • Eastern Cooperative Oncology Group (ECOG) performance status 0-2

  • Absolute neutrophil count (ANC) >= 1,000/mm^3

  • Platelet count >= 100,000/mm^3

  • Creatinine =< 1.5 x upper limit of normal (ULN)

  • Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) =< 2.5 x upperlimit of normal (ULN)

  • Total bilirubin =< 1.5 x ULN

  • No planned use of duloxetine

  • No planned use of cryotherapy, compression therapy, or cryocompression therapy atstudy entry

Exclusion

Exclusion Criteria:

  • N/A

Study Design

Total Participants: 98
Treatment Group(s): 5
Primary Treatment: Quality-of-life assessment
Phase: 2
Study Start date:
November 02, 2023
Estimated Completion Date:
May 31, 2030

Study Description

PRIMARY OBJECTIVES:

I. To obtain data to further support the safety of increasing monosialotetrahexosylganglioside (GM1) doses when given on day 1, concomitantly with paclitaxel. (Early phase) II. To evaluate the preliminary efficacy of GM1 compared with placebo at preventing paclitaxel-induced peripheral neuropathy sensory symptoms as measured by the six individual Quality of Life Questionnaire-Chemotherapy-Induced Peripheral Neuropathy 20 (QLQ-CIPN20) questions that quantify numbness (N), tingling (T), and pain in the fingers/hands and toes/feet. (Phase II)

SECONDARY OBJECTIVES:

I. To obtain additional data to support the safety of GM1 in the treated population. (Phase II) II. To obtain data to support that GM1 looks promising for preventing/decreasing acute paclitaxel pain syndrome as measured by the Acute Pain Syndrome Questionnaire. (Phase II)

EXPLORATORY OBJECTIVES:

I. Conduct of this clinical trial provides the opportunity to facilitate the better understanding of the natural history of paclitaxel-induced neuropathy, akin to what is being examined in a currently active trial, S1714. (Phase II) II. This clinical trial also provides an opportunity to conduct correlative studies to understand the mechanism of CIPN and/or identify biomarkers of CIPN or GM1 efficacy. (Phase II) III. To obtain efficacy data to assess the impact of GM1 on the anti-tumor activity of paclitaxel as evaluated by progression-free survival and overall survival. (Phase II)

OUTLINE: This is an early phase dose-escalation study of GM1 followed by a phase II study.

EARLY PHASE: Patients receive GM1 intravenously (IV) over 1 hour either once every 7 days, or once every 7 days for 3 doses followed by one week off, prior to paclitaxel administration.

PHASE II: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive GM1 IV 1 hour prior to paclitaxel administration and paclitaxel IV weekly for 12 weeks or 3 weeks on/1 week off for 12 doses.

ARM II: Patients receive placebo IV 1 hour prior to paclitaxel administration and paclitaxel IV weekly for 12 weeks or 3 weeks on/1 week off for 12 doses.

Connect with a study center

  • UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care

    Irvine, California 92612
    United States

    Active - Recruiting

  • UC Irvine Health/Chao Family Comprehensive Cancer Center

    Orange, California 92868
    United States

    Active - Recruiting

  • Morton Plant Hospital

    Clearwater, Florida 33756
    United States

    Active - Recruiting

  • Mount Sinai Medical Center

    Miami Beach, Florida 33140
    United States

    Active - Recruiting

  • Saint Anthony's Hospital Cancer Care Center

    Saint Petersburg, Florida 33705
    United States

    Active - Recruiting

  • Mission Cancer and Blood - Ankeny

    Ankeny, Iowa 50023
    United States

    Active - Recruiting

  • UI Health Care Mission Cancer and Blood - Ankeny Clinic

    Ankeny, Iowa 50023
    United States

    Active - Recruiting

  • Mercy Hospital

    Cedar Rapids, Iowa 52403
    United States

    Active - Recruiting

  • Oncology Associates at Mercy Medical Center

    Cedar Rapids, Iowa 52403
    United States

    Active - Recruiting

  • Mission Cancer and Blood - West Des Moines

    Clive, Iowa 50325
    United States

    Active - Recruiting

  • UI Health Care Mission Cancer and Blood - West Des Moines Clinic

    Clive, Iowa 50325
    United States

    Active - Recruiting

  • Iowa Methodist Medical Center

    Des Moines, Iowa 50309
    United States

    Active - Recruiting

  • Medical Oncology and Hematology Associates-Des Moines

    Des Moines, Iowa 50309
    United States

    Active - Recruiting

  • Mission Cancer and Blood - Des Moines

    Des Moines, Iowa 50309
    United States

    Active - Recruiting

  • Mission Cancer and Blood - Laurel

    Des Moines, Iowa 50314
    United States

    Active - Recruiting

  • UI Health Care Mission Cancer and Blood - Des Moines Clinic

    Des Moines, Iowa 50309
    United States

    Active - Recruiting

  • UI Health Care Mission Cancer and Blood - Laurel Clinic

    Des Moines, Iowa 50314
    United States

    Active - Recruiting

  • University of Maryland/Greenebaum Cancer Center

    Baltimore, Maryland 21201
    United States

    Active - Recruiting

  • Mayo Clinic in Rochester

    Rochester, Minnesota 55905
    United States

    Active - Recruiting

  • Coborn Cancer Center at Saint Cloud Hospital

    Saint Cloud, Minnesota 56303
    United States

    Active - Recruiting

  • Saint Luke's Hospital

    Chesterfield, Missouri 63017
    United States

    Active - Recruiting

  • Southeastern Medical Oncology Center-Clinton

    Clinton, North Carolina 28328
    United States

    Active - Recruiting

  • Southeastern Medical Oncology Center-Goldsboro

    Goldsboro, North Carolina 27534
    United States

    Active - Recruiting

  • Southeastern Medical Oncology Center-Jacksonville

    Jacksonville, North Carolina 28546
    United States

    Active - Recruiting

  • Ohio State University Comprehensive Cancer Center

    Columbus, Ohio 43210
    United States

    Active - Recruiting

  • Toledo Clinic Cancer Centers-Toledo

    Toledo, Ohio 43623
    United States

    Suspended

  • University of Oklahoma Health Sciences Center

    Oklahoma City, Oklahoma 73104
    United States

    Active - Recruiting

  • Legacy Mount Hood Medical Center

    Gresham, Oregon 97030
    United States

    Site Not Available

  • Legacy Good Samaritan Hospital and Medical Center

    Portland, Oregon 97210
    United States

    Site Not Available

  • Legacy Meridian Park Hospital

    Tualatin, Oregon 97062
    United States

    Site Not Available

  • Legacy Cancer Institute Medical Oncology and Day Treatment

    Vancouver, Washington 98684
    United States

    Site Not Available

  • Legacy Salmon Creek Hospital

    Vancouver, Washington 98686
    United States

    Site Not Available

  • Marshfield Medical Center-EC Cancer Center

    Eau Claire, Wisconsin 54701
    United States

    Active - Recruiting

  • Marshfield Medical Center-Marshfield

    Marshfield, Wisconsin 54449
    United States

    Active - Recruiting

  • Marshfield Clinic-Minocqua Center

    Minocqua, Wisconsin 54548
    United States

    Active - Recruiting

  • Marshfield Medical Center - Minocqua

    Minocqua, Wisconsin 54548
    United States

    Active - Recruiting

  • Marshfield Medical Center-Rice Lake

    Rice Lake, Wisconsin 54868
    United States

    Active - Recruiting

  • Marshfield Medical Center-River Region at Stevens Point

    Stevens Point, Wisconsin 54482
    United States

    Active - Recruiting

  • Marshfield Medical Center - Weston

    Weston, Wisconsin 54476
    United States

    Active - Recruiting

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