- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04734704
Defining the Role of the Skin Microbiome in Immune-related Adverse Events (SKINBIOTA)
January 27, 2021 updated by: University Hospital, Bordeaux
Defining the Role of the Skin Microbiome in Vitiligo and Immune-related Adverse Events in Advanced Melanoma Patients Treated With Anti-PD1
The skin microbiome has been implicated in several cutaneous autoimmune pathologies such as psoriasis and atopic dermatitis.
However, its role in vitiligo and vitiligo lesions occuring in patients receiving anti-PD-1 for metastatic melanoma
Study Overview
Status
Not yet recruiting
Conditions
Intervention / Treatment
Detailed Description
Melanoma is the most dangerous skin cancer accounting for the highest skin cancer deaths.
The prognosis for metastatic melanoma has improved considerably in recent years thanks to advances in the field of immunotherapy.
The development of molecules blocking certain immunological "checkpoints" (checkpoints exerted by the CTLA-4 (Cytotoxic T lymphocytes Associated protein 4) and PD-1 (Programmed cell Death protein 1) has made it possible to obtain a significant improvement of the overall survival (OS) of patients treated for metastatic melanoma.
Ipilimumab, an antibody blocking CTLA-4, is the first immunotherapy marketed, demonstrating for the first time a therapeutic response, however in a small number of patients (10 to 15%) and with significant toxicity (25% of grade 3-4).
Subsequently, a second generation of more effective checkpoint blockers (30 to 40% good response) and less toxic, anti-PD-1 antibodies (pembrolizumab and nivolumab), quickly obtained a marketing authorization in the first line treatment of metastatic melanoma treatment and recently in an adjuvant situation after lymph node dissection in order to limit the risk of recurrence.
However, despite these advances, a certain number of patients do not respond to treatment and it remains difficult to predict this therapeutic response.
Furthermore, patients treated with ICI often experience cutaneous immune-related adverse events manifesting as skin rash, dermatitis, epidermal necrolysis, and in some cases as vitiligo like depigmentation of the skin, testifying to the development of a specific immunogenicity towards the melanocytes, cells causing melanoma, and responsible for a discoloration of the skin.
Several studies have reported that a modification of certain bacteria in the digestive microbiota was predictive of the antitumor response to immunotherapy, while others were predictive of the appearance of significant autoimmune ICI-related toxicities (colitis).
Several phase 1 studies have evaluated the impact of taking probiotics or fecal transplants on the tumor response of patients receiving immunotherapy for cancer (NCT 03819296; NCT03817125; NCT03643289).
Thus by these new concepts, it would be interesting to assess the composition of the skin microbiota in patients treated with anti-PD-1 immunotherapy for the management of metastatic melanoma and developing during their follow-up vitiligo; predictive side effect of improved survival.
These data will be compared to those obtained from patients with common vitiligo.
This will be examined in patients skin swabs sampled at lesional and non-lesional sites.
Functionally, we will characterize the microbial pathways using shotgun sequencing of microbial genomes and meta-transcriptomics (RNA sequencing of microbial communities of the skin).
Study Type
Interventional
Enrollment (Anticipated)
175
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 Contact
- Name: Julien SENESCHAL, MD, PhD
- Phone Number: +335 57 82 25 00
- Email: julien.seneschal@chu-bordeaux.fr
Study Contact Backup
- Name: Maya SALEH, PhD
- Phone Number: +335 57 57 11 24
- Email: maya.saleh@u-bordeaux.fr
Study Locations
-
-
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Bordeaux, France, 33075
- Service de Dermatologie - Hôpital Saint-André
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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
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Adult patients diagnosed with Vitiligo according to usual criteria.
- Adult patients with metastatic melanoma, under anti-PD-1 who developed vitiligo
- Adult patients with metastatic melanoma who did not develop Immune related adverse events under anti-PD-1
- Adult patients with metastatic melanoma who developed vitiligo under anti-PD-1 and discontinued the treatment
- Free, informed by the participant and the investigator (at the latest on the day of inclusion and before any examination required by the research).
Exclusion Criteria:
- Patients under 18 years old.
- No treatment for vitiligo in the past 4 weeks
- Patients under legal protection or unable to express their consent.
- Patients not affiliated to a health insurance system.
- Patients deprived of liberty by judiciary or administrative decision or hospitalized without consent or admitted in a sanitary or social institution for another reason than research.
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: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: vitiligo patients
Adult patients diagnosed with Vitiligo according to usual criteria
|
It will be examined in patients skin swabs sampled at lesional and non-lesional sites
|
Experimental: metastatic melanoma patients under anti-PD-1 who did not develop cutaneous irAEs
metastatic melanoma patients under anti-PD-1 who did not develop Cutaneous Immune-Related Adverse Events (cutaneous irAEs).
|
It will be examined in patients skin swabs sampled on skin
|
Experimental: Metastatic melanoma patients under anti-PD-1 who developed vitiligo lesions
patients with metastatic melanoma, under anti-PD-1 who developed vitiligo lesions
|
It will be examined in patients skin swabs sampled at lesional and non-lesional sites
|
Experimental: metastatic melanoma patients with vitiligo lesions under anti-PD-1 who discontinued
Metastatic melanoma who developed vitiligo lesions under anti-PD-1 who discontinued the treatment
|
It will be examined in patients skin swabs sampled at lesional and non-lesional sites
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Determine skin microbiota by sequencing with vitiligo in advanced melanoma patients under immune-checkpoint inhibitors (ICI) immunotherapy.
Time Frame: Day 1
|
The composition of the skin microbiota will be characterized on skin swabs using shotgun sequencing of microbial genomes and meta-transcriptomics (RNA sequencing of microbial communities of the skin).
|
Day 1
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
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 (Anticipated)
May 1, 2021
Primary Completion (Anticipated)
May 1, 2023
Study Completion (Anticipated)
May 1, 2023
Study Registration Dates
First Submitted
January 27, 2021
First Submitted That Met QC Criteria
January 27, 2021
First Posted (Actual)
February 2, 2021
Study Record Updates
Last Update Posted (Actual)
February 2, 2021
Last Update Submitted That Met QC Criteria
January 27, 2021
Last Verified
January 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CHUBX 2020/41
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
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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