- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02121626
The FOCCUS Study: "Focusing on Cancers Chemotherapys' Untreated Symptoms" (FOCCUS)
The FOCCUS Study: "Focusing on Cancer Chemotherapys' Untreated Symptoms"
Study Overview
Status
Conditions
Detailed Description
Chemotherapy (CT) remains an integral part of treatment for many types of cancer often in combination with surgery and/or radiotherapy. In the year March 2011 to April 2012, 1807 patients were referred to the Royal Marsden Hospital (RMH) Gastrointestinal Unit with a new gastro intestinal (GI) cancer of whom 709 were treated with chemotherapy alone or in combination with other long term outcome. GI symptoms are common in patients receiving chemotherapy. They may arise from the tumour, but may also result as a side effect of treatment. They include anorexia, borborygmi, bloating, constipation, diarrhoea, dysphagia, early satiety, frequency of defaecation, incontinence, mucus discharge, nausea, nocturnal defaecation, pain, reflux, regurgitation, steatorrhoea, tenesmus, urgency of defaecation, vomiting, weight loss and wind. Frequently, such symptoms have a significant impact on patients' quality of life. They may also interfere with the delivery of treatment prompting cessation of therapy or dose reduction resulting in sub optimal dosage with a potential impact on morbidity and mortality. Whilst clinicians have long focused on the management of vomiting and pain in cancer patients, less attention has been paid to the incidence, severity or optimal management of other GI symptoms. If the cause of these symptoms can be identified, then appropriate investigations and treatments can be prescribed. The GI Unit has successfully investigated and treated patients with symptoms emerging after radiotherapy. This experience has enabled the team to develop an algorithm for facilitating the investigation and treatment of cancer therapy induced symptoms. The algorithm has recently been shown to be effective in the management of patients with radiation induced bowel injury . In particular, it enables the rapid identification of required investigations and improves the management of symptoms that might otherwise be mislabeled as inevitable consequences of treatment. Five easily treatable causes for GI symptoms have so far been identified:
- Small bowel bacterial overgrowth
- Carbohydrate malabsorption
- Bile acid malabsorption
- Gastric bile reflux
- Pancreatic insufficiency
It is likely that additional causes such as viral infections (eg cytomegalovirus) are more frequent in patients undergoing chemotherapy than currently appreciated.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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London, United Kingdom, SW3 6JJ
- The Royal Marsden NHS Foundation Trust
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients aged 18 years or above able to give informed consent
- Patients referred to one of the five prescribing consultants described above
- Patients to be treated within the GI unit at the Royal Marsden Hospital (RMH Chelsea, Sutton or Kingston) with chemotherapy with or without other treatments.
Exclusion Criteria:
- Patients aged less than 18 years
- Patients unable to give informed consent
- Patients being treated privately
- Patients on studies with conflicting end-points
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
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Chemotheraphy Treatement
The study will be limited to NHS patients to reduce complications associated with the need for additional funding authorisations from private health care providers for algorithm-instigated investigations.
It is not envisaged that participation in other studies running within the GI unit at The Royal Marsden Hospital will preclude entry into this study except in the event of those rare studies where the study is specifically measuring toxicity of treatment as the primary end point.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Incidence of new onset GI symptoms per chemotherapy regimen
Time Frame: Every 4 weeks
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Every 4 weeks
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
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Change in Gastrointestinal Symptom Rating Scale (GSRS) scores
Time Frame: Every 4 weeks
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Every 4 weeks
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Change in Vaizey incontinence scores
Time Frame: Every 4 weeks
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Every 4 weeks
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Change in Bristol Stool Chart parameters (stool frequency, type, mode)
Time Frame: Every 4 weeks
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Every 4 weeks
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Change in Quality of Life scores (FACTG, version 4 questionnaires)
Time Frame: Every 4 weeks
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Every 4 weeks
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Change in neurotoxicity scores (FACT/GOGNTX13, version 4)
Time Frame: Every 4 weeks
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Every 4 weeks
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Competency (learning outcomes) GI research nurses
Time Frame: Every 2 months
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Every 2 months
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Identification of genetic profiles which predispose to specific chemotherapy induced toxicities.
Time Frame: 1 year
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1 year
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Collaborators and Investigators
Investigators
- Study Chair: Jervoise Andreyev, MBBS, Ph.D, Royal Marsden NHS Foundation Trust
- Principal Investigator: Linda Wedlake, RD MSc BSc, Royal Marsden NHS Foundation Trust
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
- Constipation
- Cancer
- Pain
- Incontinence
- Dysphagia
- Nausea
- Vomiting
- Weight loss
- Reflux
- Mucositis
- Diarrhoea
- Anorexia
- Regurgitation
- Bloating
- Small Bowel Bacterial Overgrowth
- Early satiety
- Pancreatic Insufficiency
- Chemotheraphy
- Bile Acid Malabsorption
- Carbohydrate Malabsorption
- Borborygmi
- Frequency of defaecation
- Mucus discharge
- Nocturnal defaecation
- Steatorrhoea
- Tenesmus
- Urgency of defaecation
- Wind.
Other Study ID Numbers
- CCR 3921
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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