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Predicting Response to Immunotherapy for Melanoma With Gut Microbiome and Metabolomics (PRIMM)

25. februar 2020 opdateret af: East and North Hertfordshire NHS Trust
This study will investigate the effects of gut microbiome diversity (richness in terms of many bacterial species in the gut) on responses and side effects of immunotherapy in advanced melanoma patients. Immunotherapy for melanoma is especially damaging for the gut with colitis which can lead to death and significant morbidity with repeated hospital admissions. The richness of the microbiome in the gut may be protective against colitis and other side effects but this needs to be confirmed. There is also some preliminary evidence that the gut microbiome diversity can enhance responses to immunotherapy in cancer but this has been shown in small numbers of melanoma patients.

Studieoversigt

Status

Rekruttering

Betingelser

Detaljeret beskrivelse

This pilot project will assess the gut microbiome with metagenome sequencing before and after starting immunotherapy in stage 3 and 4 melanoma patients. The project will assess the impact of the gut microbiome on treatment response rates and side effects induced by immunotherapy.

200 stage 4 and 250 stage 3 melanoma patients naive to immunotherapy will be recruited from melanoma clinics. Stool samples will be donated pre-treatment and at follow-up visits throughout treatment. An additional sample will also be requested in the event of disease progression or toxicity necessitating treatment delay or discontinuation. An accompanying stool sample questionnaire will be completed at each sampling time point with the optional completion of a 24-hour recall food diary.

Blood samples will also be taken before and after starting immunotherapy treatment, with gastrointestinal, food frequency, quality of life questionnaires administered at baseline. An optional tumour biopsy if safe and accessible, is requested from patients in the stage 4 cohort before and after starting immunotherapy.

Microbiome data from melanoma patients will be compared with the TwinsUK healthy control gut microbiome data on more than 3000 healthy adults. This analysis will help us assess if there are major differences between the microbiome composition in the melanoma cases prior to therapy compared to the control gut microbiome data from TwinsUK.

Undersøgelsestype

Observationel

Tilmelding (Forventet)

450

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Det Forenede Kongerige
      • London, Det Forenede Kongerige
        • Rekruttering
        • Guy's and St. Thomas' NHS Foundation Trust
        • Kontakt:
          • Mark Harries
      • Manchester, Det Forenede Kongerige
        • Rekruttering
        • The Christie NHS Foundation Trust
        • Kontakt:
          • Paul Lorrigan
      • Preston, Det Forenede Kongerige
        • Rekruttering
        • Lancashire Teaching Hospitals NHS Foundation Trust
      • Wirral, Det Forenede Kongerige
        • Rekruttering
        • The Clatterbridge Cancer Centre
        • Kontakt:
          • Joseph Sacco
    • Middlesex
      • Northwood, Middlesex, Det Forenede Kongerige, HA62RN

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Patients with stage 3 or 4 melanoma

Beskrivelse

Inclusion Criteria:

- Patients aged over the age of 18 years with advanced melanoma due to receive first line systemic treatment with immunotherapy with a checkpoint inhibitor alone or in combination.

Exclusion Criteria:

  • Patients who have had systemic anti-cancer treatment for locally advanced or metastatic disease.
  • Patients unable to consent because of language barrier or inability to consent.
  • Patients unable to collect or send the stool samples for geographical, social or psychological reasons.
  • Persons benefitting from protection system of adults (including guardianship and curatorship)
  • Pregnant or breastfeeding women

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Cohort A
Patients with stage 4 melanoma due to commence immunotherapy. Patients should be naïve to immunotherapy.
Cohort B
Patients with stage 3 melanoma who are naïve to immunotherapy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Gut microbiome diversity via measurement of bacterial species in stool samples
Tidsramme: 3-5 years
Gut microbiome diversity and peripheral blood mononuclear cells immunophenotyping in relation to responses to treatment and side effects in patients with stage 3 or stage 4 melanoma receiving immunotherapy
3-5 years
Peripheral blood monocyte measurements to determine the characterisation of peripheral blood mononuclear cells (immunophenotyping) and inflammatory markers before and after starting immunotherapy treatment.
Tidsramme: 3-5 years
Gut microbiome diversity and peripheral blood mononuclear cells immunophenotyping in relation to responses to treatment and side effects in patients with stage 3 or stage 4 melanoma receiving immunotherapy.
3-5 years
Side effects as determined by CTCAE scale Common Toxicity Criteria for Adverse Events v5.03
Tidsramme: 3-5 years
Gut microbiome diversity and peripheral blood mononuclear cells immunophenotyping in relation to responses to treatment and side effects in patients with stage 3 or stage 4 melanoma receiving immunotherapy.
3-5 years

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Analysis of optional punch biopsy samples before and after commencing immunotherapy treatment in patients with stage 4 melanoma
Tidsramme: 3-5 years
Exploratory analysis to examine the association between the gut microbiome and the presence of tumour infiltrates and regulatory environments.
3-5 years

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

East and North Hertfordshire NHS Trust

Samarbejdspartnere

King's College London

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

4. april 2018

Primær færdiggørelse (Forventet)

2. maj 2023

Studieafslutning (Forventet)

2. maj 2023

Datoer for studieregistrering

Først indsendt

10. august 2018

Først indsendt, der opfyldte QC-kriterier

21. august 2018

Først opslået (Faktiske)

22. august 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

27. februar 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

25. februar 2020

Sidst verificeret

1. februar 2020

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • RD2016-56

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

The research results will be published in international journals and presented at scientific meetings.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ingen

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Melanom (hud)

Søg i lignende forsøg

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

CROs by country

CROs in Kazakhstan

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

Abonner