Towards Effective, Patient-tailored Anti-plasma Cell Therapies in AL Amyloidosis: Predicting Drug Response and Overcoming Drug Resistance
Studieoversigt
Status
Status
Betingelser
Betingelser
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Kontakter og lokationer
Studiesteder
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Lombardy
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Pavia, Lombardy, Italien, 27100
- Fondazione IRCCS Policlinico San Matteo
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Prøveudtagningsmetode
Studiebefolkning
Beskrivelse
Inclusion Criteria:
- Biopsy-proven systemic AL amyloidosis
- No IgM clone
- No history of anti-plasma cell therapy
- Diagnostic bone marrow aspiration at ARTC
- Age > 18 years
- Willingness to allow use of clinical data and diagnostic leftovers of clinical specimens for research purposes through signing a written informed consent.
Exclusion Criteria:
- Non-AL amyloidosis
- IgM clone
- Previous anti-plasma cell therapy
- Age <18 years
- Failure to show willingness to allow use of clinical data and diagnostic leftovers of clinical specimens for research purposes.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Identification of predictive biomarkers of response to proteasome inhibitor-based first-line therapy in AL amyloidosis
Tidsramme: From baseline (diagnosis) to 6 months after initiation of first-line therapy
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To identify and validate biological, genetic, and proteomic biomarkers predictive of in vivo response to proteasome inhibitor-based first-line therapies in patients with AL amyloidosis.
This will be achieved through the integration of ex vivo drug sensitivity assays performed on patient-derived CD138+ plasma cells, characterization of plasma cell and mesenchymal stromal cell biological features, and retrospective and prospective molecular analyses.
Biomarker profiles will be correlated with hematologic response at 6 months and used to develop a predictive statistical model of treatment response.
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From baseline (diagnosis) to 6 months after initiation of first-line therapy
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Molecular characterization of mechanisms of resistance to proteasome inhibitors
Tidsramme: From baseline (diagnosis) to MRD assessment after achievement of complete hematologic response (approximately up to 12-24 months)
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To investigate the mutational, transcriptional, and proteomic profiles associated with in vivo resistance to proteasome inhibitors by comparing plasma cell clones at diagnosis and minimal residual disease (MRD).
Analyses will include next-generation sequencing, targeted DNA sequencing of genes involved in proteostasis, and quantitative proteomics to identify molecular determinants of drug resistance.
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From baseline (diagnosis) to MRD assessment after achievement of complete hematologic response (approximately up to 12-24 months)
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Evaluation of the therapeutic potential of deubiquitinating enzyme (DUB) inhibitors
Tidsramme: At baseline (sample collection at diagnosis) and during ex vivo experimental analyses
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To assess the ex vivo sensitivity of patient-derived amyloidogenic plasma cells to DUB inhibitors and to characterize the expression of DUB family members at RNA and protein level.
The study will evaluate whether DUB inhibition can overcome resistance to proteasome inhibitors and identify candidate DUB inhibitors for therapeutic development.
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At baseline (sample collection at diagnosis) and during ex vivo experimental analyses
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Role of mesenchymal stromal cells in modulating drug response
Tidsramme: At baseline (sample collection at diagnosis) and during ex vivo experimental analyses
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To evaluate the contribution of patient-derived mesenchymal stromal cells to resistance against proteasome inhibitors by assessing their protective effect in co-culture systems with amyloidogenic plasma cells or cell lines.
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At baseline (sample collection at diagnosis) and during ex vivo experimental analyses
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- P_52345_2019
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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Kliniske forsøg med AL Amyloidose
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-
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-
NCT04604236AfsluttetMapping Enhanced Counseling (MEC) | Active Linkage (AL)
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NCT06097832RekrutteringLet kæde (AL) amyloidose
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NCT02524392AfsluttetAl international klassifikation af primære pleje 2 diagnoser
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NCT07103863Tilmelding efter invitationHjerte amyloidose | Al amyloidose (AL)
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NCT04847453Aktiv, ikke rekrutterendeTilbagevendende AL-amyloidose | Refraktær AL Amyloidose
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NCT07335887Ikke rekrutterer endnut(11;14) Positiv | Al amyloidose (AL)
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NCT00804869Trukket tilbageAksial længde (AL) | Anterior Chamber Deep (ACD) | Linsetykkelse (LT)