- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04500301
Pharmacogenomic Testing to Personalize Supportive Oncology
January 23, 2024 updated by: Wake Forest University Health Sciences
Evaluating the Use of Preemptive Pharmacogenomic Testing to Personalize Supportive Oncology
The purpose of this study is to evaluate pharmacogenomics (PGx) guided drug prescribing for pain and depression in patients with cancer.
The investigators aim to understand how PGx testing can be used to improve medication management for pain and depression, and whether PGx-guided prescribing improves these symptoms and quality of life compared to historical controls.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This is a prospective clinical trial of adult cancer patients presenting with pain and depression, newly referred to the Department of Supportive Oncology, and receiving preemptive PGx testing for genes related to supportive care prior to the first clinic visit.
Genotyping results will be returned within approximately 4-5 business days.
A PGx specialist will provide detailed clinical interpretations to the referring provider and upload a copy of the test results into the subject's medical chart.
A consultation note will also be placed in each subject's chart detailing the PGx results.
Supportive Oncology clinicians will be instructed to consult a pharmacist to evaluate PGx test results prior to prescribing supportive care therapies, especially pain and depression medications.
The number of consults and recommendations will be documented, in addition to test results, demographic data, medical/medication history, ESAS symptom scores, PHQ9 depression scores, and side effects of supportive therapy.
The number of ambulatory clinic visits and hospitalizations will be used to estimate health care utilization and costs.
Subjects will complete a short survey at the end of the study period regarding their knowledge about PGx, and whether access to PGx information improves satisfaction with care and communication.
Study Type
Interventional
Enrollment (Actual)
70
Phase
- Not Applicable
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
-
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North Carolina
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Charlotte, North Carolina, United States, 28204
- Levine Cancer Institute
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-
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 and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria
- Written informed consent and HIPAA authorization for release of personal health information.
- Completion of ESAS at initial palliative medicine clinic visit, presenting with moderate to high pain (≥ 4/10) and/or depression (≥ 3/10).
- New patients ≥ 18 years of age who have had an initial visit in the Department of Supportive Oncology's palliative medicine clinic with hematologic malignancy or any stage solid tumor malignancy according to the provider.
- Agree to at least one additional palliative medicine clinic visit per protocol.
- Able to provide a buccal sample for PGx testing.
Exclusion Criteria
- Psychiatric illness, social situations, or active/recent (within 30 days) history of illicit substance (e.g. cocaine, heroin) abuse that would limit compliance with study requirements (e.g. clinic visits, medication compliance, etc.) as determined by the Investigator.
- Patients who have had prior multiple visits in palliative medicine clinic.
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
- Primary Purpose: Supportive Care
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Pharmacogenomic Testing
A pharmacogenomic (PGx) panel will be performed to test for genetic variations in genes related to drug response.
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The use of a pharmacogenomic (PGx) testing to help manage drugs prescribed to subjects for pain and depression.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Utilization of PGx results
Time Frame: 21, 42, 63 and 84 days after the baseline visit
|
Estimate the proportions of subjects undergoing PGx testing who receive at least one drug/dose selection or modification based on PGx test results within any of the study visits after the Baseline study visit.
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21, 42, 63 and 84 days after the baseline visit
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain Scores Impact
Time Frame: 21, 42, 63 and 84 days after the baseline visit
|
Determine the impact of PGx on treatment outcomes by measuring pain scores on a scale of 0-10 (0 no pain, 10 worst possible severity) using the Edmonton Symptom Assessment Scale (ESAS) at study visits after the Baseline study visit.
Symptom scores will also be compared between those receiving PGx testing and a matched control receiving clinical management alone.
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21, 42, 63 and 84 days after the baseline visit
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Depression Scores Impact
Time Frame: 21, 42, 63 and 84 days after the baseline visit
|
Determine the impact of PGx on treatment outcomes by measuring depression on a scale of 0-27 (0 no depression, 27 severe depression) using the Patient Health Questionnaire 9 (PHQ9) at study visits after the Baseline study visit.
Symptom scores will also be compared between those receiving PGx testing and a matched control receiving clinical management alone.
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21, 42, 63 and 84 days after the baseline visit
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Compare Health Care Utilization
Time Frame: 84 days
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Compare health care utilization (HCRU) using cost in USD, including but not limited to cost associated with inpatient, emergency department, outpatient, and pharmacy encounters between subjects receiving PGx testing and matched controls receiving clinical management alone.
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84 days
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Subject Perspectives
Time Frame: Assessed at the final study visit (day 84)
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Describe subject perspectives of PGx testing using a survey administered to subjects after/at the Final visit (or sooner if withdrawn).
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Assessed at the final study visit (day 84)
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Frequency of Actionable Genotypes
Time Frame: 84 days
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Determine the frequencies of actionable genotypes that result in drug/dose selection or modification(s) during the study period.
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84 days
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Types of New Medications Prescribed
Time Frame: 84 days
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Describe the types of new medications prescribed or medication/dose adjustments based on the PGx results.
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84 days
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Frequency of Drug/Gene Interactions
Time Frame: Baseline (day 0) and day 84
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Determine the frequency of drug/gene interactions present at the Baseline and the Final study visit using CPIC guidelines and FDA's pharmacogenomics table.
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Baseline (day 0) and day 84
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Jai Patel, PhD, Wake Forest University Health Sciences
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)
December 2, 2020
Primary Completion (Actual)
December 13, 2023
Study Completion (Actual)
December 13, 2023
Study Registration Dates
First Submitted
July 27, 2020
First Submitted That Met QC Criteria
August 4, 2020
First Posted (Actual)
August 5, 2020
Study Record Updates
Last Update Posted (Actual)
January 24, 2024
Last Update Submitted That Met QC Criteria
January 23, 2024
Last Verified
January 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB00081754
- Pro00045081
- LCI-SUPP-NOS-PGX-001 (Other Identifier: Atrium Health)
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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