- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05727020
Volatile Organic Compound Assessment in Pancreatic Ductal Adenocarcinoma (VAPOR)
Volatile Organic Compound Assessment in Pancreatic Ductal Adenocarcinoma (VAPOR 1 / BIORESOURCE)
Patients with early pancreatic cancer often have symptoms that could also be caused by many common benign conditions, or no symptoms at all. Jaundice, weight loss and pain are 'red flag' symptoms of pancreatic cancer that are linked to incurable disease. At the moment only patients with 'red flag' symptoms are urgently referred for diagnostic testing to find out if they have the cancer. As a result, late diagnosis is a common feature of pancreatic cancer. This leads to limited treatment options being available to patients by the time they are diagnosed, and ultimately results in poor survival rates.
There is a clear need to improve earlier detection of pancreatic cancer so that patients with pancreatic cancer can be identified earlier and faster, enabling them to start treatment more quickly.
The study team is developing a non-invasive breath test that detects small molecules called volatile organic compounds (VOCs) that may be altered by pancreatic cancers. For patients with non-specific symptoms, this test would help general practitioners (GPs) to identify those patients that may indeed have an underlying pancreatic cancer, who would benefit from referral for specialised pancreatic cancer tests.
Study Overview
Status
Detailed Description
Bioresource study to identify pathways responsible for VOC production: A total of 192 patients will be recruited to provide samples to create a pancreatic biobank. This will be comprised of two groups, each containing 96 patients: (i) patients undergoing resection for pancreatic ductal adenocarcinoma (PDAC); (ii) control patients undergoing pancreatic resection for benign pancreatic disorders (e.g. intraductal papillary mucinous neoplasms, pancreatic mucinous cystic neoplasms, chronic pancreatitis). The following biosamples will be collected from each patient: breath, saliva, blood, urine, pancreatic tissue, duodenal aspirate. Collected samples will be stored in a biobank and will be utilised in a wide range of studies to investigate the mechanisms of VOC production in PDAC. The following analyses will be undertaken: volatolomics, metabonomics / lipidomics, metagenomics / microbiome analysis, transcriptomics, and culture experiments (to establish bacterial, immune and organoid cultures).
VAPOR 1 clinical study: A total of 771 patients will be recruited for the development of this non-invasive PDAC detection model. This will be comprised of three groups, each containing 257 patients: (i) patients with PDAC; (ii) control patients with specified benign pancreatic disorders (new-onset diabetes mellitus, or chronic pancreatitis); (iii) control patients with non-specific gastrointestinal symptoms but a radiologically-normal pancreas. Participants will be required to fast for 6 hours prior to breath sampling. After rinsing their mouth with water, patients will be asked to provide breath samples by exhaling into single-use breath collection bags. Breath will be transferred using a precision pump into thermal desorption (TD) storage tubes. Breath samples will be analysed in accordance with existing quality-controlled processes.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Miss Caoimhe M Walsh, MBBS, MRCS
- Phone Number: +44 (0)20 7594 3396
- Email: vapor@imperial.ac.uk
Study Locations
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-
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London, United Kingdom
- Recruiting
- Imperial College Healthcare NHS Trust
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Contact:
- VAPOR Trial Manager
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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:
- Males and females
- Adult patients ≥ 18 years old
- VAPOR 1: patients with either a) Histologically confirmed PDAC*; b) New-onset diabetes mellitus or chronic pancreatitis; or c) Non-specific gastrointestinal symptoms, but a radiologically-normal pancreas
- VAPOR Bioresource: patients undergoing pancreatic resection for a) Histologically confirmed PDAC*; or b) Benign pancreatic disorders e.g. intraductal papillary mucinous neoplasms, pancreatic mucinous cystic neoplasms, chronic pancreatitis
Note: *Patients undergoing surgery for suspected PDAC (without pre-operative histological confirmation) may be recruited assuming PDAC is confirmed within the resected specimen.
Exclusion Criteria:
- Patients who have already received chemotherapy, radiotherapy or surgery for their PDAC
- Patients with active infection, receiving immunosuppressive medications or antibiotics within the preceding eight weeks
- History of another cancer within the previous five years
- Previous upper gastrointestinal surgery
- Patients who are unable to provide a breath sample
- Pregnant women
- Patients unable to provide informed written consent
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
VAPOR 1 - PDAC (pancreatic ductal adenocarcinoma)
257 treatment-naive patients with histologically-confirmed* PDAC will be recruited to provide breath samples. *Patients that are due to undergo surgery for suspected PDAC (without pre-operative histological confirmation) may still be recruited despite the lack of pre-operative histological confirmation, assuming PDAC is subsequently confirmed within the resected specimen. |
Patients must be fasted for a minimum of six hours prior to sample collection.
For patients undergoing surgery or a procedure (e.g.
endoscopy), breath samples must be obtained pre-operatively / prior to the administration of sedation, anaesthetic or other pharmacological agents.
|
VAPOR 1 - Control patients with benign pancreatic disorders
257 patients with new-onset diabetes mellitus or chronic pancreatitis will be recruited to provide breath samples. New-onset diabetes is defined as: HbA1c≥48mmol/mol (6.5%), diagnosed within the preceding 6 months. |
Patients must be fasted for a minimum of six hours prior to sample collection.
For patients undergoing surgery or a procedure (e.g.
endoscopy), breath samples must be obtained pre-operatively / prior to the administration of sedation, anaesthetic or other pharmacological agents.
|
VAPOR 1 - Control patients with non-specific GI symptoms and a normal pancreas
257 patients with non-specific gastrointestinal symptoms but a radiologically-normal pancreas will be recruited to provide breath samples. Imaging to confirm a normal pancreas (CT / MRI / ultrasound) must have occurred within the preceding 12 months. |
Patients must be fasted for a minimum of six hours prior to sample collection.
For patients undergoing surgery or a procedure (e.g.
endoscopy), breath samples must be obtained pre-operatively / prior to the administration of sedation, anaesthetic or other pharmacological agents.
|
VAPOR Bioresource - PDAC (pancreatic ductal adenocarcinoma)
96 treatment-naive patients with histologically-confirmed* PDAC will be recruited to provide samples of breath, saliva, blood, urine, pancreatic tissue and duodenal aspirate. *Patients that are due to undergo surgery for suspected PDAC (without pre-operative histological confirmation) may still be recruited despite the lack of pre-operative histological confirmation, assuming PDAC is subsequently confirmed within the resected specimen. |
In accordance with routine clinical practices, patients will be fasted for a minimum of six hours prior to surgery.
Exhaled breath, saliva, blood and urine will be collected immediately prior to surgery (before induction of general anaesthesia).
Pancreatic tissue samples and duodenal aspirate which will be collected upon resection of the pancreatic specimen.
|
VAPOR Bioresource - Control patients with benign pancreatic disorders
96 patients with benign pancreatic disorders (such as intraductal papillary mucinous neoplasms, pancreatic mucinous cystic neoplasms, chronic pancreatitis) will be recruited to provide samples of breath, saliva, blood, urine, pancreatic tissue and duodenal aspirate.
|
In accordance with routine clinical practices, patients will be fasted for a minimum of six hours prior to surgery.
Exhaled breath, saliva, blood and urine will be collected immediately prior to surgery (before induction of general anaesthesia).
Pancreatic tissue samples and duodenal aspirate which will be collected upon resection of the pancreatic specimen.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Levels of VOCs present in breath of subjects with PDAC and controls
Time Frame: 24 months
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Gas Chromatography-Mass Spectrometry (GC-MS) will be used to identify the levels (measured in parts per billion, ppb) of certain cancer-associated VOCs in breath
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24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Levels of volatile metabolites present in headspace of the urine of subjects with PDAC and controls
Time Frame: 24 months
|
Headspace sampling techniques will be used for headspace collection from urine samples.
GC-MS will be used to determine the levels (measured in parts per billion, ppb) of certain cancer-associated VOCs within the headspace of urine.
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24 months
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Characterisation of bacterial species in saliva samples, pancreatic tissue samples and duodenal aspirate samples of subjects with PDAC compared to controls
Time Frame: 24 months
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Bacterial species present will be identified (measured) using sequencing techniques such as 16s or whole genome sequencing.
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24 months
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Levels of VOCs produced by the bacteria isolated from saliva samples, pancreatic tissue samples and duodenal aspirate samples of subjects with PDAC
Time Frame: 24 months
|
The cancer-associated bacterial species isolated and identified as part of Outcome Measure 3 will then be re-cultured within a controlled environment.
Headspace and media sampling will be performed to identify and measure the levels of volatile metabolites (measured in parts per billion, ppb) present using GC-MS and LC-MS (Liquid Chromatography-Mass Spectrometry) techniques.
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24 months
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Professor George B Hanna, PhD, FRCS, Imperial College London
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ESTIMATE)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 22HH7787
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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