- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07684066
D-TECT: Pretreatment D-dimers and Disease Control in Advanced cSCC Treated With Cemiplimab (D-TECT)
D-TECT: Prospective Multicenter Evaluation of Pretreatment D-dimer Levels as a Predictor of Disease Control in Advanced Cutaneous Squamous Cell Carcinoma Treated With Cemiplimab
D-TECT is a prospective, multicenter, non-interventional observational study investigating whether pretreatment D-dimer levels predict disease control in patients with locally advanced or metastatic cutaneous squamous cell carcinoma treated with cemiplimab in routine clinical care.
D-dimers are routinely available laboratory markers related to activation of the coagulation system. Previous single-center data suggest that elevated pretreatment D-dimer levels may be associated with poorer disease control under cemiplimab. In D-TECT, a single pretreatment D-dimer value and prospectively collected routine clinical follow-up data will be analyzed to validate this association in a multicenter real-world setting. No study-specific treatment decisions, imaging procedures, or additional blood draws are mandated by the study.
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers. While most cases can be treated with curative local therapy, a subgroup of patients develops locally advanced or metastatic disease requiring systemic treatment. Cemiplimab, a PD-1 inhibitor, is an established systemic treatment option for advanced cSCC. However, validated routine biomarkers predicting disease control under cemiplimab are lacking.
D-dimers are fibrin degradation products and sensitive markers of coagulation activation. In a prior single-center retrospective analysis, elevated pretreatment D-dimer levels were associated with lower disease control, lower objective response, and shorter progression-free survival in patients with advanced cSCC treated with cemiplimab. D-TECT is designed to prospectively validate this observation in a multicenter real-world cohort.
Eligible patients are adults with histologically confirmed locally advanced or metastatic cSCC for whom cemiplimab treatment is planned as part of routine clinical care. A D-dimer measurement is documented within 7 days before the first cemiplimab dose up to the day of first administration before infusion. Subsequent clinical data, including tumor response, progression, survival, treatment discontinuation, and thromboembolic events, are collected from routine medical records during follow-up.
The primary endpoint is disease control within the first 6 months after initiation of cemiplimab. The primary confirmatory analysis compares disease control between patients with high versus low pretreatment D-dimer values using the prespecified cutoff of 0.91 mg/L FEU derived from the prior single-center study. If the primary analysis is statistically significant, the same primary endpoint will be tested hierarchically using the local laboratory-defined upper limit of normal. Additional analyses include objective response rate, progression-free survival, overall survival, thromboembolic events, diagnostic performance measures of the predefined cutoffs, sensitivity analyses, and exploratory analyses addressing inter-site assay heterogeneity.
Typ studie
Zápis (Odhadovaný)
Kontakty a umístění
Studijní kontakt
- Jméno: Glenn Geidel, MD, MSc
- Telefonní číslo: +49 (0)40 7410 70743
- E-mail: g.geidel@uke.de
Studijní místa
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Bielefeld, Německo, 33647
- University Medical Center OWL, Campus Klinikum Bielefeld Rosenhöhe
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Kontakt:
- Selma Ugurel, MD
- Telefonní číslo: +49 (0)521 9438801
- E-mail: selma.ugurel@klinikumbielefeld.de
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Vrchní vyšetřovatel:
- Selma Ugurel, MD
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Bremerhaven, Německo, 27574
- Klinikum Bremerhaven Reinkenheide
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Kontakt:
- Michael M. Sachse, MD
- Telefonní číslo: +49 (0)471 2993700
- E-mail: Michael.Sachse@klinikum-bremerhaven.de
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Vrchní vyšetřovatel:
- Michael M. Sachse, MD
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Buxtehude, Německo, 21614
- Elbe Klinikum Buxtehude
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Kontakt:
- Kai-Martin Thoms, MD
- Telefonní číslo: +49 (0)4161 7036250
- E-mail: kai-martin.thoms@elbekliniken.de
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Vrchní vyšetřovatel:
- Kai-Martin Thoms, MD
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Erlangen, Německo, 91054
- University Medical Center Erlangen
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Kontakt:
- Markus V. Heppt, MD, PhD, MHBA
- Telefonní číslo: +49 (0)9131 8533165
- E-mail: onkstudienzentrale.DE@uk-erlangen.de
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Vrchní vyšetřovatel:
- Markus V. Heppt, MD, PhD, MHBA
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Göttingen, Německo, 37075
- University Medical Center Göttingen
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Kontakt:
- Katharina Amschler, MD
- Telefonní číslo: +49 (0)551 3968082
- E-mail: katharina.amschler@med.uni-goettingen.de
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Vrchní vyšetřovatel:
- Katharina Amschler, MD
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Hamburg, Německo, 20246
- University Medical Center Hamburg-Eppendorf
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Kontakt:
- Glenn Geidel, MD, MSc
- Telefonní číslo: +49 (0)40 741070743
- E-mail: g.geidel@uke.de
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Vrchní vyšetřovatel:
- Glenn Geidel, MD, MSc
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Hanover, Německo, 30625
- Hannover Medical School
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Kontakt:
- Imke von Wasielewski, MD
- Telefonní číslo: +49 (0)5115320
- E-mail: vonWasielewski.Imke@mh-hannover.de
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Vrchní vyšetřovatel:
- Imke von Wasielewski, MD
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Lübeck, Německo, 23538
- University Medical Center Schleswig-Holstein, Campus Lübeck
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Kontakt:
- Dagmar von Bubnoff, MD
- Telefonní číslo: +49 (0)451 50041501
- E-mail: DagmarAngela.vonbubnoff@uksh.de
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Vrchní vyšetřovatel:
- Dagmar von Bubnoff, MD
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Mainz, Německo, 55131
- University Medical Center Mainz
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Kontakt:
- Henner Stege, MD
- Telefonní číslo: +49 (0)6131 172919
- E-mail: Henner.Stege@unimedizin-mainz.de
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Vrchní vyšetřovatel:
- Henner Stege, MD
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Mannheim, Německo, 68167
- University Medical Center Mannheim
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Vrchní vyšetřovatel:
- Jochen Utikal, MD
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Kontakt:
- Jochen Utikal, MD
- Telefonní číslo: +49 (0)621 3834461
- E-mail: jochen.utikal@umm.de
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Minden, Německo, 32429
- Johannes Wesling Klinikum Minden
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Kontakt:
- Ralf Gutzmer, MD
- Telefonní číslo: +49 (0)571 7904501
- E-mail: dermatologie-minden@muehlenkreiskliniken.de
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Vrchní vyšetřovatel:
- Ralf Gutzmer, MD
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Rostock, Německo, 18057
- University Medical Center Rostock
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Kontakt:
- Markus Thieme, MD
- Telefonní číslo: +49 (0) 381 494 9789
- E-mail: Markus.Thieme@med.uni-rostock.de
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Vrchní vyšetřovatel:
- Markus Thieme, MD
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Tübingen, Německo, 72076
- University Medical Center Tübingen
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Vrchní vyšetřovatel:
- Ulrike Leiter, MD
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Kontakt:
- Ulrike Leiter, MD
- Telefonní číslo: +49 (0)7071 2984555
- E-mail: ulrike.leiter@med.uni-tuebingen.de
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Salzburg, Rakousko, 5020
- University Medical Center Salzburg
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Kontakt:
- Matthias Brandlmaier, MD, PhD, MSc
- Telefonní číslo: +43 (0) 57255 24601
- E-mail: m.brandlmaier@salk.at
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Vrchní vyšetřovatel:
- Matthias Brandlmaier, MD, PhD, MSc
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Metoda odběru vzorků
Studijní populace
Popis
Inclusion Criteria:
- Histologically confirmed locally advanced or metastatic cutaneous squamous cell carcinoma
- Planned initiation of systemic treatment with cemiplimab as part of routine clinical care
- Pretreatment D-dimer measurement performed within 7 days before initiation of cemiplimab treatment up to the day of first administration before infusion
- Age 18 years or older at the time of consent
- ECOG performance status 0 to 2
- Written informed consent for study participation and pseudonymized collection and analysis of clinical and laboratory data
Exclusion Criteria:
- Prior treatment with immune checkpoint inhibitors in curative or palliative intent for cutaneous squamous cell carcinoma
- Concurrent second malignancy requiring systemic treatment, such as chemotherapy, immunotherapy, or targeted therapy
- Clinically unstable comorbidity, including NYHA class III-IV heart failure or active systemic infection
- Acute symptomatic thrombosis or pulmonary embolism within 4 weeks before the pretreatment D-dimer measurement
- Incidental asymptomatic thromboembolic events detected during clinical diagnostic work-up or following an elevated D-dimer result are not exclusion criteria and will be documented
- Physician-estimated life expectancy of less than 3 months or severe non-tumor-related comorbidity likely to preclude assessment of the clinical course within the first 6 months
- Lack of capacity to consent or legal guardianship without valid legal representation
Studijní plán
Jak je studie koncipována?
Detaily designu
Kohorty a intervence
Skupina / kohorta |
Intervence / Léčba |
|---|---|
|
High pretreatment D-dimer
Patients with locally advanced or metastatic cutaneous squamous cell carcinoma treated with cemiplimab in routine clinical care and a pretreatment D-dimer level above the prespecified cutoff of 0.91 mg/L FEU.
|
Pretreatment D-dimer status is defined using a single D-dimer measurement obtained in routine clinical laboratory testing within 7 days before the first cemiplimab dose up to the day of first administration before infusion.
D-dimer status is not used to assign treatment and does not mandate any study-specific diagnostic or therapeutic intervention.
|
|
Low pretreatment D-dimer
Patients with locally advanced or metastatic cutaneous squamous cell carcinoma treated with cemiplimab in routine clinical care and a pretreatment D-dimer level at or below the prespecified cutoff of 0.91 mg/L FEU.
|
Pretreatment D-dimer status is defined using a single D-dimer measurement obtained in routine clinical laboratory testing within 7 days before the first cemiplimab dose up to the day of first administration before infusion.
D-dimer status is not used to assign treatment and does not mandate any study-specific diagnostic or therapeutic intervention.
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Disease Control Rate Within the First 6 Months of Cemiplimab Treatment
Časové okno: From start of cemiplimab treatment through 6 months
|
Disease control rate is defined as the proportion of participants with complete response, partial response, or stable disease according to clinical and/or radiological assessment in routine care within the first 6 months after initiation of cemiplimab.
Participants with documented progression, death, or treatment discontinuation due to clinical progression within the first 6 months are considered not to have disease control.
Participants without documented progression or death but without evaluable clinical or radiological follow-up assessment within the first 6 months are considered not evaluable for the primary analysis.
The primary confirmatory analysis compares disease control between participants with high versus low pretreatment D-dimer levels using the prespecified cutoff of 0.91 mg/L FEU.
If statistically significant, the same primary endpoint will be tested hierarchically using the local laboratory-defined upper limit of normal.
|
From start of cemiplimab treatment through 6 months
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Objective Response Rate
Časové okno: From start of cemiplimab treatment through 24 months
|
Objective response rate is defined as the proportion of participants with complete response or partial response according to clinical and/or radiological assessment in routine care during follow-up.
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From start of cemiplimab treatment through 24 months
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Progression-Free Survival
Časové okno: From start of cemiplimab treatment through 24 months
|
Progression-free survival is defined as the time from initiation of cemiplimab treatment to the first documented disease progression or death from any cause, whichever occurs first.
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From start of cemiplimab treatment through 24 months
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Overall Survival
Časové okno: From start of cemiplimab treatment through 24 months
|
Overall survival is defined as the time from initiation of cemiplimab treatment to death from any cause.
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From start of cemiplimab treatment through 24 months
|
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Thromboembolic Events During Follow-up
Časové okno: From start of cemiplimab treatment through 24 months
|
Incidence of venous or arterial thromboembolic events documented during follow-up and evaluated in relation to pretreatment D-dimer levels.
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From start of cemiplimab treatment through 24 months
|
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Diagnostic Performance of Prespecified D-dimer Cutoffs for 6-Month Disease Control
Časové okno: From start of cemiplimab treatment through 6 months
|
Sensitivity, specificity, positive predictive value, and negative predictive value of the prespecified D-dimer cutoff of 0.91 mg/L FEU and of the local laboratory-defined upper limit of normal for disease control within the first 6 months after initiation of cemiplimab.
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From start of cemiplimab treatment through 6 months
|
Další výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Cumulative Incidence of Documented Disease Progression Accounting for Death as a Competing Event
Časové okno: From start of cemiplimab treatment through 24 months
|
Exploratory competing-risk analysis of the cumulative incidence of documented disease progression, treating death without prior documented progression as a competing event.
Deaths without prior documented progression will additionally be described by cause of death where available from the medical record.
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From start of cemiplimab treatment through 24 months
|
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Association of Pretreatment D-dimer Levels With Clinical Outcomes in Multivariable Models
Časové okno: From start of cemiplimab treatment through 24 months
|
Exploratory multivariable models evaluating the association between pretreatment D-dimer levels and clinical outcomes while accounting for predefined clinical covariates such as performance status, lactate dehydrogenase, comorbidities, and anticoagulation.
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From start of cemiplimab treatment through 24 months
|
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Exploratory Analysis of Assay-Related Heterogeneity in D-dimer Measurements
Časové okno: Baseline through 24 months
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Exploratory evaluation of inter-site heterogeneity in D-dimer assays, measurement units, and local reference ranges.
Analyses may include ULN-normalized D-dimer values defined as the quotient of the measured value and the local upper limit of normal.
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Baseline through 24 months
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Spolupracovníci a vyšetřovatelé
Vyšetřovatelé
- Vrchní vyšetřovatel: Glenn Geidel, MD, MSc, Universitätsklinikum Hamburg-Eppendorf
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Odhadovaný)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
Další identifikační čísla studie
- D-TECT
- DRKS00040746 (Identifikátor registru: German Clinical Trials Register)
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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