Resiniferatoxin to Treat Severe Pain Associated With Advanced Cancer
Recruiting now · Phase 1
Conditions studied: Intractable Pain, Palliative Care
In brief
This study will examine the safety of giving the experimental drug, resiniferatoxin (RTX), to treat severe pain in patients with advanced cancer. RTX is a chemical extracted from a cactus-like plant. It is similar to capsaicin, the active ingredient in hot pepper. RTX has relieved pain and reduced the need for pain medication in several animal experiments. It works by destroying nerves that transmit pain information. People at least 18 years of age with severe pain from advanced cancer at or below the level of the chest that cannot be controlled with standard treatments may be eligible for this study. Participants undergo the following procedures: Pretreatment Visit Before beginning treatment with RTX, patients give a medical history and undergo a physical examination that includes: * Electrocardiogram (EKG) * Blood draw * Urinalysis * Neurological examinations * Peak expiratory flow rate (PEFR) * Eye examination * MRI * Urology assessment * Pregnancy test, when appropriate * Questionnaires to collect information on health, personality, mood, pain levels and symptoms. 2-Day Hospitalization Patients are hospitalized for 2 days for RTX injection and monitoring, as follows: * RTX injection: RTX is injected in the operating room under general anesthesia. It is given through a catheter placed in the patient s spine. The catheter is also used to obtain samples of cerebrospinal fluid (CSF) the clear fluid that bathes the spinal cord. The fluid is examined to assess drug effects and side effects, chemical changes in the content of the CSF associated with RTX, and how RTX is handled by the body. * Post-injection monitoring, including: * Surveys about symptoms such as pain or weakness * Neurological examinations * Blood and CSF sampling * EKG * AEs Outpatient followup * Vitals * Blood draw, Urinalysis, neurological and sensory testing, EKG on days 7, 14 and 30 after the injection * MRI scans of the head and back, Urology assessment and PEFR on day 15 after the injection * Eye examination * Follow-up phone calls monthly for 6 months
Key facts
- Study ID
- NCT00804154
- Run by
- National Institute of Dental and Craniofacial Research (NIDCR)
- People needed
- 45
- Starts
- 2009-08-14
- Expected to finish
- 2027-02-07
- Last updated by the study team
- 2026-07-23
Who can join
Age: 18 and older, up to 99. Sex: any. Healthy volunteers: not accepted.
You may not qualify if…
- Subjects will be excluded from the study if they meet any of the following criteria:
- Primary pain source from anatomical regions at T5 dermatome or above.
- Pain due to causes other than cancer or its treatment that is moderate to severe in intensity.
- Anatomic abnormality or pathology of the spinal cord and/or IT space on magnetic resonance imaging (MRI) that could increase the risk of adverse effects of catheter placement or interfere with CSF flow.
- Evidence of advanced brain pathology or elevated intracranial pressure as determined by symptoms, history, physical examination (including neurological and eye examination), and/or MRI.
- Presence of an IT shunt device (e.g., ventriculo-peritoneal and ventriculo-atrial shunts).
- Anticipating initiation of palliative anti-tumor therapy or significant changes to current palliative anti-tumor therapy before completion of the Day 15 visit.
- Documented allergy to chili peppers or capsaicin (e.g., hives, wheal).
- Contraindication to MRI or MRI contrast.
- Female subjects who are pregnant or lactating.
- Clinically significant disorder or condition that might interfere with study participation or greatly increase safety risk to the subject, as judged by a study investigator.
- Planned use of another investigational agent, therapy, or device within 30 days after dosing.
- Have a history of heart failure or unexplained fainting (syncope).
- Have an EKG abnormality in which the baseline QTc interval exceeds 450 milliseconds.
- Have a known family history of long QT syndrome.
- Have abnormal electrolyte levels (i.e., low potassium) that cannot be corrected.
- Have urinary retention that does not resolve with medical or surgical treatment.
- Have skin ulceration that does not resolve with medical or surgical treatment.
- Have a history of seizure activity in the previous month.
- Have experienced symptoms of opioid toxicity in the past month (i.e. myoclonus, seizures, and/or hallucinations)
Where it is running
- National Institutes of Health Clinical Center — Bethesda, Maryland, United States (enrolling)
Full record on ClinicalTrials.gov
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