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Early nerve-block procedure for pain in inoperable pancreatic cancer

Tests an endoscopic nerve-block procedure given early for pancreatic cancer pain in adults.

Key facts

Who runs it
Chinese University of Hong Kong
Where
Hong Kong, Hong KongSee the site
Trial code
Registry title
Upfront EUS CGN/CPN vs Conventional Step up Approach for Inoperable Painful Pancreatic Cancer
Status
Recruiting
People taking part
94 people, planned
Started
10 Nov 2023
Expected to end
31 Jul 2028
Type of study
Interventional, 2 groupsOne group gets an existing treatment, for comparison.
Treatments tested
  • EUS-guided coeliac ganglion neurolysis / celiac plexus neurolysis
Record updated
6 May 2026

Who can take part

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults with inoperable pancreatic cancer who have constant tumor pain and are planned for an EUS exam or biopsy of the tumor.

Age
18 years or older
Sex
Men and women can join
Disease stage
Inoperable pancreatic cancer with constant, centrally located tumor pain (VAS 3 or higher), no other obvious cause, and Karnofsky performance status 60 or higher
Earlier treatment
People already on opioids for pain control cannot join. People who had a previous CGN or CPN (percutaneous or EUS-guided) cannot join.

Main reasons for not taking part

  • Allergy to bupivacaine or alcohol
  • Tumor that may become operable after neoadjuvant therapy
  • Expected survival of less than 3 months
  • Pancreatic tumor that came back after an operation
  • Coagulopathy that cannot be corrected

The registry criteria, word for word

Show all 13 criteriaShow less

Who can take part

  • Age >= 18 years old
  • Diagnosed to have inoperable pancreatic cancer
  • Presence of tumor pain (centrally located, constant, with no other obvious cause) with a VAS >= 3
  • Karnofsky performance status >= 60
  • Planned for EUS examination and/or biopsy of the pancreatic tumor

Who cannot take part

  • Potentially operable after neoadjuvant therapy
  • Previous percutaneous or EUS-guided CGN/ CPN
  • Allergy to bupivacaine, or alcohol
  • Expected survival of less than 3 months
  • Patient who is already on opioids for pain control
  • Recurrent pancreatic tumors after operation
  • Uncorrectable coagulopathy
  • Inability or unwillingness to provide informed consent

Where in Hong Kong

  • Prince of Wales HospitalHong Kong, Hong KongContact: Shannon M Chan, FRCSTaking people

About the trial

What the trial wants to find out

Patients with unresectable pancreatic cancer are often demoralized by intractable, persistent and incapacitating pain. It must be managed aggressively and strong opioids are recommended as the mainstay of treatment. However, patients develop opioid-related adverse effects. EUS-guided celiac plexus neurolysis (CPN) and celiac ganglion neurolysis (CGN) has been shown to provide high efficacy for pain control. The optimal timing, however, is in debate.

The 2 groups in the trial

  • EUS-guided coeliac ganglion neurolysis / celiac plexus neurolysisExisting treatment, for comparison

    Patient would undergo a EUS diagnostic procedure with or without a biopsy. Patient would be blinded to the group they were assigned. The procedure will be performed with a linear array echoendoscope (EUS) under conscious sedation or monitored anaesthesia care. For cases in which celiac ganglia could not be visualized, EUS-guided coeliac plexus neurolysis (CPN) will be performed.

  • Conventional step-up approachExisting treatment, for comparison

    Patient would undergo a EUS diagnostic procedure with or without a biopsy. Patient would be blinded to the group they were assigned. The concept of the conventional step-up approach is to follow ESMO clinical practice guidelines for cancer pain. In case of inadequate pain control, the analgesics will be stepped up according to the guidelines. After 4 weeks, if patient's VAS score more than 7 or VAS score fails to improve by 20% despite optimal oral analgesics, patients are given the option of EUS-guided CGN/ CPN.

    Treatment: EUS-guided coeliac ganglion neurolysis / celiac plexus neurolysis

Questions to ask the study team

  1. How often do I need to come in, and for how long each time?
  2. Are travel costs paid?
  3. Can I keep my own doctor?
  4. What happens if I want to stop?

Contact the study team: see the registry record → Contacts and Locations

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Data and sources

Registry record
Listed on ClinicalTrials.gov.
Official title
Upfront Endoscopic Ultrasound-guided Celiac Ganglion Neurolysis Versus Conventional Step-up Approach for Patients With Painful, Inoperable Pancreatic Cancer
Plain-language title
Early nerve-block procedure for pain in inoperable pancreatic cancerGenerated from the registry record. The registry title is the official one.
AI summary
From the trial's eligibility criteria. Read by machine on 12 November 2026.
Record updated
6 May 2026