Abstract P2-10-16: A randomized phase III clinical trial of yoga for chemotherapy-induced peripheral neuropathy treatment (YCT)

Abstract Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect among cancer survivors receiving neurotoxic chemotherapy that can cause functional disabilities and significantly increase the risk of falls. Currently, there are limited approaches to managing CIPN symptoms and related functional limitations. We conducted a pilot study that demonstrated yoga therapy's feasibility and preliminary efficacy in improving CIPN pain and functional outcomes. We then developed the YCT trial to assess the effect of yoga therapy on improving pain and balance symptoms among cancer survivors with CIPN pain. Methods: YCT is a prospective phase III multicenter, parallel three-arm randomized clinical trial at Dana-Farber Cancer Institute (DFCI) and Memorial Sloan Kettering Cancer Center (MSK) (ClinicalTrials.gov Identifier: NCT05121558). YCT aims to determine the efficacy of an eight-week yoga treatment vs. education control (EC) vs. usual care (UC) in improving CIPN pain and balance in cancer survivors. We plan to enroll and randomize 268 participants (2:1:1) to yoga, EC, and UC groups to detect an effect size of at least 0.48 for the primary pain outcome at eight weeks post-randomization between yoga vs. EC, with 80% power and a 2.5% Type I error rate, assuming 12% attrition by week 8 and 20% attrition by week 24. Major eligibility criteria include adults who 1) have no evidence of disease or stable diseases, 2) have completed neurotoxic chemotherapy such as platinum agents, taxanes, vinca alkaloids, and bortezomib at least three months before enrollment, 3) have a clinical diagnosis of CIPN with moderate to severe pain, defined as a score of at least four on the Brief Pain Inventory (BPI) average pain item, and 4) have experienced self-identified CIPN balance difficulty. Eligible subjects in the yoga arm will receive hourly gentle therapeutic yoga classes taught by protocol-trained oncology yoga instructors, twice weekly for eight weeks, and practice home-based yoga. Subjects in the EC arm will receive hourly education classes taught by protocol-trained healthcare instructors twice weekly for eight weeks. Subjects in the UC arm will continue usual care for eight weeks. We offer free yoga sessions for participants in control groups after study completion. Aside from patient-reported outcome measures (i.e., BPI, FACT/GOG-Ntx, QLQ-CIPN 20), we measured functional improvements by functional reach, timed up-and-go, and chair-to-stand tests. We also conducted quantitative sensory testing to assess changes in sensory function. Progress: 1) We are transitioning this trial to a multicenter trial, with DFCI as the coordinating center and MSK as a subsite; 2) As of July 9, 2024, 126 of the planned 268 participants have been enrolled. We anticipate initiating participant enrollment at DFCI in August 2024. The anticipated accrual completion is December 2025. Citation Format: Ting Bao, Mingxiao Yang, Marissa Mumford, Katherine Han, Anna M. Tanasijevic, Lauren Piulson, Mehul Shrivastava, Iris Zhi, Jun J. Mao. A randomized phase III clinical trial of yoga for chemotherapy-induced peripheral neuropathy treatment (YCT) [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-10-16.