Early Lung Cancer Diagnosis in HIV Infected Population With an Important Smoking History With Low Dose CT: a Pilot Study (EP48 HIV CHEST)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Background Epidemiological studies in France and in the western world have shown that lung cancers are the first cause of mortality amongst the non-AIDS classifying cancers in HIV-infected individuals, despite the introduction of combination antiretroviral therapies. Compared to the general population, there is an increased risk of lung cancer in HIV-infected individuals, even after adjustment on smoking and age, estimated to be around 2.6 compared to the general population. Outcomes are dismal, as diagnoses in HIV-infected individuals are usually made at very advanced stages (usually stage III or IV) without screening. Two non-randomized studies of CT-screening in a non HIV-infected population exposed to smoking have shown an important rate of early lung cancer detection and a high level of survival at 5 or 10 years. Despite a probable high prevalence of lung cancer in the HIV-infected population, no lung cancer screening or early diagnosis studies have been realised, and the prevalence is yet to be determined. We deduced from different studies of non HIV-infected populations a 3% prevalence in the HIV-infected population.
Methods Prospective multicentric and national study evaluating the prevalence of lung cancers through low-dose CT of 450 individuals with a known HIV-infection, with a nadir level of TCD4 cells < 350/µl, ≥ 40 years old and with a smoking history ≥ 20 packs a year (either active or with <3 years of weaning). CT interpretations and lung biopsies are guided by a suggested workup algorithm, which is not imposed in each HIV-caring centre.
Inclusion and follow up period Inclusion period will be 9 months, followed, in case of the discovery of a small nodule, by a CT follow up scheme of up to two years from first diagnosis. The study closes after 26 months of follow up.
Awaited results For the first time, this prospective study of lung cancers will estimate the prevalence of these cancers screened in the HIV-infected population. Risks associated with the incidence of this cancer will be investigated, including potential immune factors. An increased number of stage I non small cell lung cancers are expected.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
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Montpellier, France, 34
- Makinson
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 40 years
- able to give written consent
- HIV positive serology
- Covered by French Social Security
- Nadir L TCD4 < 350/µl
- Rate of LTCD4 > 100/µl at inclusion
- Addiction to smoking > 20 packages years, active person or deprived since < 3 years
Exclusion Criteria:
- patients who suffered from comorbidity
- unaffiliated to the social healthy security french system
- Presence of an evolutionary cancer
- any evolutionary pathology classifying AIDS
- Pregnancy
- Recent lung infection (< 2 months)
- Be under protection (saving) of justice
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Other: CT screening
CT interpretations and lung biopsies are guided by a suggested workup algorithm, which is not imposed in each HIV-caring centre
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
the prevalence of lung cancers detected by lowdose computed tomography
Time Frame: Month 0
|
Month 0
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
the types of lung cancers in this population,
Time Frame: Month 1 Month 3 Month 12 Month 24 Month 26
|
Month 1 Month 3 Month 12 Month 24 Month 26
|
|
the staging of non small cell lung cancers,
Time Frame: Month 1 Month 3 Month 12 Month 24 Month 26
|
Month 1 Month 3 Month 12 Month 24 Month 26
|
|
description of risk factors for all lung cancers,
Time Frame: Month 1 Month 3 Month 12 Month 24 Month 26
|
Month 1 Month 3 Month 12 Month 24 Month 26
|
|
number of complications of diagnosis procedures during study
Time Frame: Month 1 Month 3 Month 12 Month 24 Month 26
|
Month 1 Month 3 Month 12 Month 24 Month 26
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Alain Makinson, University Hospital, Montpellier
- Principal Investigator: Antoine Cheret, CHU Tourcoing
- Principal Investigator: Sophie Abgrall, Hospital AVICENNE
- Principal Investigator: Pierre Delamonicca, CHU Nice
- Principal Investigator: Pierre Tattevin, Pontchaillou
- Principal Investigator: Isabelle Poizot Martin, St Marguerite Marseille
- Principal Investigator: Francois Raffi, Hotel Dieu Nantes
- Principal Investigator: Claudine Duvivier, Necker Paris
- Principal Investigator: David Zucman, Foch Suresnes
- Principal Investigator: Jean Louis Couderc, Foch Suresnes
- Principal Investigator: Tristan Ferry, La Croix Rousse Lyon
- Principal Investigator: Jean Marc Mauboussin, Nîmes, CH Caremeau
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Blood-Borne Infections
- Urogenital Diseases
- Genital Diseases
- Neoplasms by Site
- Neoplasms
- Immune System Diseases
- Infections
- RNA Virus Infections
- Virus Diseases
- Respiratory Tract Diseases
- Lung Diseases
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Communicable Diseases
- Sexually Transmitted Diseases, Viral
- Sexually Transmitted Diseases
- Lentivirus Infections
- Retroviridae Infections
- Immunologic Deficiency Syndromes
- Lung Neoplasms
- HIV Infections
Other Study ID Numbers
Other Study ID Numbers
- AO 781-38
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