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Molekulární profilování ve vzorcích tkání od pacientů s rakovinou, kteří výjimečně reagují na léčbu

10. listopadu 2026 aktualizováno: National Cancer Institute (NCI)

Pilotní studie výjimečných reagujících: Molekulární profilování nádorů u pacientů s rakovinou, kteří jsou výjimečně reagující

This pilot research trial studies molecular profiling in tissue samples from patients with cancer who got better with treatment that didn't work for most other patients with the same disease. Studying samples of tissue from patients with cancer in the laboratory may help doctors learn more about changes that occur in deoxyribonucleic acid (DNA) and identify biomarkers related to how well patients respond to treatment.

Přehled studie

Postavení

Aktivní, ne nábor

Podmínky

Intervence / Léčba

Detailní popis

PRIMARY OBJECTIVES:

I. To identify molecular indicators in malignant tissues from patients who were exceptional responders on clinical trials or standard systemic treatments using whole exome and/or targeted deep sequencing, as well as potentially other sequencing and other molecular characterization methods (if adequate tissue exists).

II. To explore associations between the identified molecular indicators and the putative mechanism of action of the treatment received by the patient.

III. To test the feasibility of identifying "exceptional responders", obtaining the relevant tumor and normal tissue and clinical data, and performing whole exome and/or targeted deep sequencing on these samples.

OUTLINE:

Previously collected tissue samples are analyzed via whole exome sequencing and/or targeted next generation sequencing (NGS) assay deep sequencing. Cases for which sufficient nucleic acid amounts are available will undergo additional analyses including whole genome sequencing, messenger ribonucleic acid (RNA) (mRNA)-sequencing, micro (miRNA) sequencing, promoter methylation analysis, and single nucleotide polymorphism (SNP) analysis.

Typ studie

Pozorovací

Zápis (Aktuální)

170

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • California
      • Duarte, California, Spojené státy, 91010
        • City of Hope Comprehensive Cancer Center
      • Fresno, California, Spojené státy, 93720
        • Kaiser Permanente-Fresno
      • Oakland, California, Spojené státy, 94611
        • Kaiser Permanente-Oakland
      • Richmond, California, Spojené státy, 94801
        • Kaiser Permanente-Richmond
      • San Francisco, California, Spojené státy, 94158
        • UCSF Medical Center-Mission Bay
      • Santa Clara, California, Spojené státy, 95051
        • Kaiser Permanente Medical Center - Santa Clara
      • Santa Rosa, California, Spojené státy, 95403
        • Kaiser Permanente-Santa Rosa
      • Stockton, California, Spojené státy, 95210
        • Kaiser Permanente-Stockton
      • Walnut Creek, California, Spojené státy, 94596
        • Kaiser Permanente-Walnut Creek
    • Colorado
      • Aurora, Colorado, Spojené státy, 80045
        • UCHealth University of Colorado Hospital
      • Fort Collins, Colorado, Spojené státy, 80524
        • Poudre Valley Hospital
    • Connecticut
      • Greenwich, Connecticut, Spojené státy, 06830
        • Greenwich Hospital
    • Delaware
      • Newark, Delaware, Spojené státy, 19713
        • Helen F Graham Cancer Center
      • Newark, Delaware, Spojené státy, 19713
        • Medical Oncology Hematology Consultants PA
    • District of Columbia
      • Washington D.C., District of Columbia, Spojené státy, 20016
        • Sibley Memorial Hospital
    • Georgia
      • Atlanta, Georgia, Spojené státy, 30322
        • Emory University Hospital/Winship Cancer Institute
      • Columbus, Georgia, Spojené státy, 31904
        • John B Amos Cancer Center
      • Valdosta, Georgia, Spojené státy, 31602
        • South Georgia Medical Center/Pearlman Cancer Center
    • Idaho
      • Boise, Idaho, Spojené státy, 83706
        • Saint Alphonsus Cancer Care Center-Boise
    • Illinois
      • Chicago, Illinois, Spojené státy, 60631
        • Presence Resurrection Medical Center
      • Chicago, Illinois, Spojené státy, 60612
        • Rush MD Anderson Cancer Center
      • Decatur, Illinois, Spojené státy, 62526
        • Decatur Memorial Hospital
      • Decatur, Illinois, Spojené státy, 62526
        • Cancer Care Specialists of Illinois - Decatur
      • Evanston, Illinois, Spojené státy, 60201
        • NorthShore University HealthSystem-Evanston Hospital
      • Peoria, Illinois, Spojené státy, 61615
        • Illinois CancerCare-Peoria
      • Springfield, Illinois, Spojené státy, 62702
        • Springfield Clinic
    • Iowa
      • Cedar Rapids, Iowa, Spojené státy, 52402
        • Physicians' Clinic of Iowa PC
    • Maine
      • York Village, Maine, Spojené státy, 03909
        • York Hospital
    • Maryland
      • Bethesda, Maryland, Spojené státy, 20892
        • NCI - Center for Cancer Research
      • Bethesda, Maryland, Spojené státy, 20892
        • National Cancer Institute Developmental Therapeutics Clinic
    • Michigan
      • Ann Arbor, Michigan, Spojené státy, 48109
        • University of Michigan Rogel Cancer Center
      • Ann Arbor, Michigan, Spojené státy, 48106
        • Trinity Health Saint Joseph Mercy Hospital Ann Arbor
      • Brighton, Michigan, Spojené státy, 48114
        • Trinity Health Medical Center - Brighton
      • Detroit, Michigan, Spojené státy, 48201
        • Wayne State University/Karmanos Cancer Institute
      • Grand Rapids, Michigan, Spojené státy, 49503
        • Corewell Health Grand Rapids Hospitals - Butterworth Hospital
      • Marquette, Michigan, Spojené státy, 49855
        • UP Health System Marquette
      • Marquette, Michigan, Spojené státy, 49855
        • UP Health System Hematology Oncology Marquette
      • Southfield, Michigan, Spojené státy, 48075
        • Henry Ford Health Providence Southfield Hospital
    • Missouri
      • Cape Girardeau, Missouri, Spojené státy, 63703
        • Saint Francis Medical Center
      • Springfield, Missouri, Spojené státy, 65807
        • CoxHealth South Hospital
      • Springfield, Missouri, Spojené státy, 65804
        • Mercy Hospital Springfield
      • St Louis, Missouri, Spojené státy, 63110
        • Washington University School of Medicine
      • St Louis, Missouri, Spojené státy, 63131
        • Missouri Baptist Medical Center
      • St Louis, Missouri, Spojené státy, 63141
        • Mercy Hospital Saint Louis
    • Montana
      • Great Falls, Montana, Spojené státy, 59405
        • Benefis Sletten Cancer Institute
    • New Hampshire
      • Portsmouth, New Hampshire, Spojené státy, 03802
        • Portsmouth Regional Hospital
    • New Mexico
      • Albuquerque, New Mexico, Spojené státy, 87106
        • University of New Mexico Cancer Center
    • New York
      • Rochester, New York, Spojené státy, 14642
        • University of Rochester
    • North Carolina
      • Durham, North Carolina, Spojené státy, 27710
        • Duke University Medical Center
      • Winston-Salem, North Carolina, Spojené státy, 27157
        • Wake Forest University Health Sciences
    • North Dakota
      • Fargo, North Dakota, Spojené státy, 58122
        • Sanford Roger Maris Cancer Center
    • Ohio
      • Columbus, Ohio, Spojené státy, 43214
        • Riverside Methodist Hospital
    • Oklahoma
      • Lawton, Oklahoma, Spojené státy, 73505
        • Cancer Centers of Southwest Oklahoma Research
      • Oklahoma City, Oklahoma, Spojené státy, 73104
        • University of Oklahoma Health Sciences Center
    • Oregon
      • Portland, Oregon, Spojené státy, 97227
        • Kaiser Permanente Northwest
    • Pennsylvania
      • Phoenixville, Pennsylvania, Spojené státy, 19460
        • Reading Hospital McGlinn Cancer Institute at Phoenixville
      • West Chester, Pennsylvania, Spojené státy, 19380
        • Chester County Hospital
      • West Reading, Pennsylvania, Spojené státy, 19611
        • Reading Hospital
    • South Carolina
      • Greenville, South Carolina, Spojené státy, 29605
        • Prisma Health Cancer Institute - Faris
      • Greenville, South Carolina, Spojené státy, 29605
        • Prisma Health Cancer Institute - Butternut
      • Seneca, South Carolina, Spojené státy, 29672
        • Prisma Health Cancer Institute - Seneca
    • South Dakota
      • Sioux Falls, South Dakota, Spojené státy, 57117-5134
        • Sanford USD Medical Center - Sioux Falls
      • Sioux Falls, South Dakota, Spojené státy, 57104
        • Sanford Cancer Center Oncology Clinic
    • Tennessee
      • Kingsport, Tennessee, Spojené státy, 37660
        • Wellmont Holston Valley Hospital and Medical Center
    • Texas
      • Houston, Texas, Spojené státy, 77030
        • Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
      • Houston, Texas, Spojené státy, 77030
        • Ben Taub General Hospital
      • San Antonio, Texas, Spojené státy, 78229
        • University of Texas Health Science Center at San Antonio
    • Utah
      • Salt Lake City, Utah, Spojené státy, 84112
        • Huntsman Cancer Institute/University of Utah
    • Virginia
      • Charlottesville, Virginia, Spojené státy, 22908
        • University of Virginia Cancer Center
    • West Virginia
      • Martinsburg, West Virginia, Spojené státy, 25401
        • WVUH-Berkely Medical Center
    • Wisconsin
      • Madison, Wisconsin, Spojené státy, 53792
        • University of Wisconsin Carbone Cancer Center - University Hospital
      • Summit, Wisconsin, Spojené státy, 53066
        • Aurora Medical Center in Summit
      • Waukesha, Wisconsin, Spojené státy, 53188
        • UW Cancer Center at ProHealth Care

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let a starší (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Metoda odběru vzorků

Vzorek nepravděpodobnosti

Studijní populace

Patients with cancer participating in the Exceptional Cases Initiative

Popis

Inclusion Criteria:

  • Documented exceptional response, defined as patients meeting the following criteria:

    • Complete response to a regimen in which complete response is expected in < 10% of similarly treated patients

    • Partial response (PR) > 6 months in a regimen in which PRs > 6 months are expected in < 10% of patients with similar disease treated with same or similar regimen

    • Complete response (CR) or PR of unusual duration, such that the internal review committee considers it to be an exceptional response; examples below:

      • PR of duration > 3 x the median expected PR duration (in cases where PR is expected in > 10% of patients with the same disease treated with the same regimen)
      • CR or duration > 3 x the median expected CR duration (in cases where CR may be seen in > 10% of patients with same disease treated with same regimen)
      • The observed duration of CR (or PR) is longer than expected for 90% of patients with same disease treated with same regimen
    • Note: it is not required that the patient be enrolled on a clinical trial when the exceptional response was observed

  • Reports of radiologic scans or other evidence documenting response will be submitted for review; cases where response is not assessable (e.g. adjuvant treatment) will not be eligible because the outcome can not be attributed to a specific treatment

  • Treatment history must be available, for prior treatment and for the drug to which the exceptional response occurred

  • Patient must meet consent criteria; this requires: (i) current exceptional responder (ER) consent by a living participant not lost to follow-up, (ii) prior consent for future research by a participant not known to be deceased, but lost to follow-up, or (iii) if patient is deceased and did not decline to participate in research at the time of tissue removal for any tissue that would be used in this study, then no consent is required

  • Tumor sample available that meets study requirements

  • Required tumor samples MUST exist and be able to be submitted; investigators wishing to submit samples must not have made agreements that would prohibit the free use of data from such samples; the National Cancer Institute (NCI) will provide investigators with a letter for the collaborator amending their existing agreement to allow for the case to be submitted

    • Tumor tissue from prior to administration of the drug to which the exceptional response occurred is required; ideally this sample will have been collected just prior to treatment, but other prior tissue will be considered; tissue may be fresh frozen or formalin-fixed paraffin embedded
    • Tumor tissue amount must be at least a core biopsy, and meet minimum specimen requirements
  • Encouraged: normal tissue sample: (optional): blood or other specimen source for germline sequencing

  • The tumor samples and clinical data submitted to the Exceptional Responders Database in database in Genotypes and Phenotypes (dbGaP) will need to have appropriate agreements in place to allow for the submission; the Exceptional Responders Database can accept clinical data and samples from cases enrolled on a Cancer Therapy Evaluation Program (CTEP) sponsored clinical trial and cases that were not enrolled on any clinical trial; if the response occurred on a trial that was not CTEP-sponsored, there are existing agreements between the submitting site and the pharmaceutical company; if existing agreements do not allow for the submission of sample and clinical data, the NCI will provide the investigators with a letter that allows the tissue to be used for the exceptional responders study if signed by the appropriate collaborator; the letter modifies the existing agreement to include the CTEP Intellectual Property (IP) Option language that would allow the case to be submitted to the Exceptional Responders Database; if the existing agreement cannot be modified and the letter cannot be signed, the proposed case will not be accepted; Note: as stated above, the patient does not need to have been enrolled on a clinical trial to be eligible for the exceptional responders study

Exclusion Criteria:

  • Patient's response did not meet criteria for an exceptional response
  • Patient's treatment regimen is expected to lead to CR or durable PR in > 10% of patients
  • Patient's duration of response is not > 3 x expected median length of response
  • Response not evaluable or not able to be attributed to systemic treatment (e.g. adjuvant treatment)
  • Patient refused consent for use of tissue for research activities included in the exceptional responders study
  • Tumor sample from prior to the exceptional response is not available, or does not meet quality metrics

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Observační modely: CASE_CONTROL
  • Časové perspektivy: RETROSPECTIVE

Kohorty a intervence

Skupina / kohorta
Intervence / Léčba
Ancillary-Correlative (molecular profiling)

Previously collected tissue samples are analyzed via whole exome sequencing and/or targeted NGS assay deep sequencing. Cases for which sufficient nucleic acid amounts are available will undergo additional analyses including whole genome sequencing, mRNA-sequencing, miRNA sequencing, promoter methylation analysis, and SNP analysis.

Undergo sequencing and SNP analysis

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Molecular features in tissue samples from patients who were exceptional responders
Časové okno: Baseline

The molecular features of the tumors in the patients will be discernible as distinct to the tumor by comparison to (i) samples from normal tissue in the same patient and (ii) databases of similar data for normal and other tumor types.

Baseline
Putative mechanisms of action of the treatments that the patients received when they experienced their exceptional responses
Časové okno: Baseline

The associations between identified molecular features and the putative mechanisms of action of the treatments that the patients received when they experienced their exceptional responses will be explored. Statistical analyses will be primarily descriptive.

Baseline
Number of cases identified as potential exceptional responders
Časové okno: Baseline

Statistical analyses will be primarily descriptive.

Baseline
Percentage of identified potential cases confirmed to be exceptional responders
Časové okno: Baseline

Statistical analyses will be primarily descriptive.

Baseline
Percentage of confirmed exceptional responders for which adequate tissue with appropriate informed consent is acquired
Časové okno: Baseline

Statistical analyses will be primarily descriptive.

Baseline
Percentage of acquired cases with tissue for which at least the minimum molecular characterization is successfully obtained
Časové okno: Baseline

Statistical analyses will be primarily descriptive.

Baseline
Percentage of molecularly characterized cases for which a Molecular Characterization report identified (without reference to the drug received by the patient) at least one feature judged to have potential therapeutic relevance
Časové okno: Baseline

Promising discoveries will be summarized for the group of cases for which the minimum molecular characterization was successfully obtained. For each such case, molecular data will be reviewed by an expert panel ("Panel") to identify interesting features. All estimated proportions will be accompanied by exact 95% confidence intervals.

Baseline
Percentage of cases with >= 1 feature on Molecular Characterization report that was judged to have potential therapeutic relevance to the specific class of drug the patient actually received when the exceptional response was experienced
Časové okno: Baseline

Promising discoveries will be summarized for the group of cases for which the minimum molecular characterization was successfully obtained. For each such case, molecular data will be reviewed by the Panel to identify interesting features. All estimated proportions will be accompanied by exact 95% confidence intervals.

Baseline
Percentage of cases with >= 1 feature that correlates with the mechanism of action of the specific grant to which the exceptional response occurred that was found after further analyzing the molecular profile data for relevant molecular abnormalities
Časové okno: Baseline

Promising discoveries will be summarized for the group of cases for which the minimum molecular characterization was successfully obtained. For each such case, molecular data will be reviewed by the Panel to identify interesting features. All estimated proportions will be accompanied by exact 95% confidence intervals.

Baseline

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Vyšetřovatelé

  • Vrchní vyšetřovatel: S. P Ivy, National Cancer Institute (NCI)

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

24. září 2014

Primární dokončení (Aktuální)

4. března 2021

Dokončení studie (Odhadovaný)

30. dubna 2027

Termíny zápisu do studia

První předloženo

16. září 2014

První předloženo, které splnilo kritéria kontroly kvality

16. září 2014

První zveřejněno (Odhadovaný)

18. září 2014

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

12. listopadu 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

10. listopadu 2026

Naposledy ověřeno

1. září 2026

Více informací

Termíny související s touto studií

Další relevantní podmínky MeSH

Další identifikační čísla studie

  • NCI-2014-01585
  • UM1CA186704 (Grant/smlouva NIH USA)
  • 9671 (Jiný identifikátor: CTEP)
  • NCI-2014-01585 (Identifikátor registru: CTRP (Clinical Trial Reporting Program))
  • 9671 (Jiný identifikátor: National Cancer Institute)

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .