Role of Myostatin, Activin A and Follistatin Cachexia of ENT Cancers (MYOCACH)

May 19, 2017 updated by: University Hospital, Clermont-Ferrand
The main objective of our study was to determine the modifications of blood myostatin and activin A concentrations associated with head and neck cancers. Secondary objectives consisted in studying their influence on the occurrence of cachexia, bringing the proof of a tumoral secretion of these factors, and then determining the effect of tumor removal.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Myostatin and activin A, two members of the superfamily TGF-β, have been shown to play a role on skeletal muscle mass regulation. In Humans, high plasma concentrations of activin A were observed in cancer patients, especially in cachectic subpopulations, suggesting their involvement in the development of cachexia.

55 patients were included in the study : 32 in the cancer group (only squamous cell carcinoma) and 23 in the control group. The patients underwent a complete nutritional assessment and multiple samples : blood before and 7 days after surgery, skeletal muscle biopsies, tumor biopsies. Plasma concentrations of myostatin, activin and follistatin were measured before and after tumor removal surgery. Concentrations of myostatin, activin and follistatin were also measured in an incubation medium of a tumor biopsy. Activin A and follistatin plasma concentrations were significantly increased in the cancer group (320 vs. 203 pg/ml ; p <0.001) (3593 vs 2148 pg/ml ; p <0.001), while myostatin plasma concentration was significantly decreased in this group (1542 vs. 2100 pg/ml ; p = 0.010). Surprisingly, data of the 7th postoperative day showed an increase in plasma activin A concentration (379 vs 320 pg /ml ; p <0.001) while concentrations of myostatin and follistatin were not modified. A high postoperative systemic inflammation is one hypothesis to explain these later results. Myostatin, activin A and follistatin proteins were systematically detected in the medium of tumor a 48 hour-incubation period, providing a strong proof of the tumor production of these factors by squamous cell carcinoma. The activin A/myostatin/follistatin is modified in the context of head and neck cancer. Activin A particularly seems to play a role in the occurrence of cachexia while follistatin could have a protective role for skeletal muscle mass. This system could aimed in therapeutic ways to reduce cachexia in a context of cancer in order to improve the quality of life and survival of patients.

Study Type

Observational

Enrollment (Actual)

60

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Auvergne
      • Clermont-Ferrand, Auvergne, France, 63003
        • Chu Clermont-Ferrand

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 75 years (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

55 patients were included in the study : 32 in the cancer group (only squamous cell carcinoma) and 23 in the control group.

Description

Inclusion Criteria:

For case group :

  • head and neck cancer
  • squamous cell carinoma only
  • head and neck surgery chosen as treatment of cancer
  • age 18-75

For control group :

  • Neck surgery for non oncologic disease
  • age 18-75

Exclusion Criteria:

  • heart failure, respiratory failure (requiring a long-term oxygen therapy), chronic renal failure (MDRD clearance < 60 ml/min), moderate or severe chronic obstructive pulmonary disease and insulin-dependent diabeta for the two groups
  • cachexia for control group

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Squamous cell carcinoma
55 patients were included in the study : 32 in the cancer group (only squamous cell carcinoma) and 23 in the control group.
Surgery
Control group
55 patients were included in the study : 32 in the cancer group (only squamous cell carcinoma) and 23 in the control group.
Surgery

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Measure of plasma activin A (pg/ml)
Time Frame: at day 1
determine the modifications of blood myostatin and activin A concentrations associated with head and neck cancers
at day 1
Measure of plasma follistation (pg/ml)
Time Frame: at day 1
determine the modifications of blood myostatin and activin A concentrations associated with head and neck cancers
at day 1
Measure of plasma myostatin (pg/ml)
Time Frame: at day 1
determine the modifications of blood myostatin and activin A concentrations associated with head and neck cancers
at day 1

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Influence on the occurrence of cachexia
Time Frame: at day 1
Bringing the proof of a tumoral secretion of these factors, and then determining the effect of tumor removal.
at day 1

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

November 2, 2015

Primary Completion (ACTUAL)

February 1, 2016

Study Completion (ACTUAL)

May 1, 2017

Study Registration Dates

First Submitted

May 5, 2017

First Submitted That Met QC Criteria

May 19, 2017

First Posted (ACTUAL)

May 22, 2017

Study Record Updates

Last Update Posted (ACTUAL)

May 22, 2017

Last Update Submitted That Met QC Criteria

May 19, 2017

Last Verified

May 1, 2017

More Information

Terms related to this study

Other Study ID Numbers

  • CHU-326
  • 2015-A00833-46 (OTHER: 2015-A00833-46)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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