Breast cancer surgery pain relief trial awarded $4.3 million MRFF grant

The Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network (CTN) has secured funding from the Medical Research Future Fund (MRFF) to perform a clinical trial in 4400 patients undergoing breast cancer surgery.

The project received $4.3 million, the highest amount awarded in the recent MRFF neurological disorders grant initiative announced by the Australian Federal Minister for Health Greg Hunt on 25 June.

It is estimated that nearly half of breast cancer patients experience some chronic pain after surgery. The five year LOLIPOP (Long-term Outcomes of Lidocaine Infusions for persistent Postoperative Pain) study will administer lidocaine intravenously to patients during and up to 24 hours after breast cancer surgery.

It will also employ a novel approach using examination of the patient’s genes to determine whether genetic makeup alters the body’s response to lidocaine.

Although lidocaine has long been used to numb particular parts of the body for procedures such as dental extractions, anaesthetists have only recently started to infuse lidocaine into the general circulation of patients. This approach may stop the nervous system re-wiring that causes chronic pain.

The trial’s chief investigator (CIA) is Professor Tomás Corcoran, Director of Research in the Department of Anaesthesia and Pain Medicine, Royal Perth Hospital and Adjunct Clinical Professor in the School of Public Health and Preventive Medicine at Monash University. He has previously led the PADDI trial, which was also a large multicentre trial, funded by the NHMRC. CIB is Professor Paul Myles, who heads the ANZCA CTN within the Central Clinical School. (L-R in the picture, Tomas Corcoran and Paul Myles).

Professor Corcoran says the trial is important as the incidence of chronic pain after surgery, especially following breast cancer surgery, has long been under-recognised in anaesthesia and surgical care.

“Preventing the occurrence of chronic pain after surgery is considered the “holy grail” because treating such pain, once established, can be very difficult. The LOLIPOP trial really does have the potential to revolutionise our approach to chronic post-surgical pain if lidocaine is found to be effective, because at present, there is nothing the anaesthetist can do to prevent this complication.” he explained.

Psychological and quality of life outcomes for patients will also be assessed as part of the trial which will involve dozens of public hospitals in all Australian states and territories, New Zealand, Hong Kong and some European sites.

The hospitals are part of the Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network (CTN), a leading organisation internationally for anaesthesia and pain medicine trials.

The MRFF grant follows an earlier LOLIPOP pilot study, led by Dr Andrew Toner in Western Australia in 2018 which received seed funding of $70,000 from the ANZCA Research Foundation and the Harry Secomb Foundation. That study is complete and the results are expected to be released shortly.