METEL Study Which is to Collect Urine Samples From Patients to Analyse Their Chemistry to Assess How Close to Death the Patient is at Point of Sample When They Have a Solid Cancer Tumour Diagnosis (METEL)

Metabolic Changes at End of Life

Use of samples from patients with solid cancer tumour diagnosis to assess chemistry

Study Overview

• Status: Recruiting
• Conditions: Solid Tumor Cancer

Detailed Description

We do not know how people die from cancer. In the last two weeks of life, there is evidence for deranged respiratory and renal function variables (2), although few patients have evidence of organ failure. Pulmonary embolus and infection are thought to be the major causes of death based on post-mortem studies (3, 4). However, it is unusual for people with cancer to die suddenly as anticipated from a pulmonary embolus. About a third of patients with advanced cancer admitted to specialist palliative care units have a femoral deep vein thrombosis. Therefore, thromboembolism is considered a manifestation of advanced disease, rather than a cause of premature death (5). There is also a difference between the physiological deterioration leading to death in the acutely unwell patient compared to people dying from cancer (2); there is no evidence of sepsis in those with cancer (6).

This suggests cancer patients generally do not die from organ failure and in those that die with an infection or pulmonary embolus; they die with them, rather than from these events.

A systematic review of biomarkers associated with dying identified common themes in cancer patients, irrespective of the type of malignancy: systemic inflammation, haematological changes, cachexia, hepatic dysfunction, renal dysfunction, and electrolyte changes. (7). Given the common features shared in patients dying from cancer, a "dying process" has been proposed (7) but has not yet been described.

• Study Type: Observational
• Enrollment (Estimated): 1327

Contacts and Locations

• Study Contact: Name: Seamus Coyle Principal Investigator; Phone Number: 0151 556 5060; Email: s.coyle@liverpool.ac.uk

Study Locations

• United Kingdom
  • Merseyside
    • Liverpool, Merseyside, United Kingdom, L7 8YA
      • Recruiting
      • Clatterbridge Cancer Centre
      • Contact: Seamus Coyle Coyle; Phone Number: 0151 556 5060; Email: s.coyle@liverpool.ac.uk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients with a solid tumour cancer diagnosis

Description

Inclusion Criteria:

• Must have as solid cancer tumour diagnosis Must be over the age of 18 Must be able to understand and communicate in English Must be able to provide fully informed consent at the point of trial entry Must be able to urinate freely or be catheterised

Exclusion Criteria:

• Does not have a solid cancer tumour diagnosis Under the age of 18 Unable to communicate and understand English Unable to provide fully informed consent at the point of trial entry Is no cathetherised or able to urinate freely

Study Plan

How is the study designed?

Design Details

• Observational Models: CASE_ONLY
• Time Perspectives: PROSPECTIVE

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Solid Tumour Cancer; Solid Tumour Cancer

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Study Outcome	This work could identify mechanisms involved in the dying process and develop test predicting time until death. Understanding of the biology of dying will improve the recognition of people in the last days and weeks of life. This will; - - Improve the quality of a person's death by reducing uncertainty and facilitating preferred place of care. Reduce healthcare spending on futile diagnostic and therapeutic interventions. We will correct urine samples once per week from participants, to be able to analyse their metabolites for changes towards end of life.	18 months

Collaborators and Investigators

• Sponsor: The Clatterbridge Cancer Centre NHS Foundation Trust

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2026
• Primary Completion (Estimated): February 28, 2028
• Study Completion (Estimated): February 28, 2028

Study Registration Dates

• First Submitted: September 7, 2026
• First Submitted That Met QC Criteria: September 29, 2026
• First Posted (Actual): September 30, 2026

Study Record Updates

• Last Update Posted (Actual): September 30, 2026
• Last Update Submitted That Met QC Criteria: September 29, 2026
• Last Verified: September 1, 2026

More Information

Terms related to this study

• Keywords: Solid Cancer Tumour
• Other Study ID Numbers: 337603; 337603 (Other Identifier: IRAS)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No