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Dietary Fiber to Induce Gut Microbiota-mediated Response to Immunotherapy in Melanoma. (FIGURE-IM)

24. juli 2026 opdateret af: Radboud University Medical Center
Previous research has shown that a higher fiber intake may have a beneficial effect on the intestinal health and improve the effectiveness of immunotherapy, but this is not certain. The objective of this double-blinded randomized clinical trial is to analyze, whether increased dietary fiber intake by patients with metastatic melanoma will increase the relative amount of Bifidobacterium, which in turn stimulates immune cell activity and improves the response to immunotherapy.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

70

Fase

  • Fase 2

Kontakter og lokationer

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

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

  • Holland
    • Gelderland
      • Nijmegen, Gelderland, Holland, 6525GA
    • Provincie Groningen
      • Groningen, Provincie Groningen, Holland, 9713GZ
        • Ikke rekrutterer endnu
        • Universitair Medisch Centrum Groningen
        • Kontakt:
        • Ledende efterforsker:
          • Kalijn Bol, dr.
        • Underforsker:
          • Isabel Ossekoppele, MS.
        • Kontakt:
        • Ledende efterforsker:
          • Sjoukje Lubberts, dr.

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

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Histologically confirmed cutaneous melanoma classified as irresectable stage III or stage IV disease
  • Measurable disease according to RECIST 1.1 criteria
  • Age ≥ 18 years
  • Starting standard-of-care treatment with ICI in first line
  • Written informed consent must be given
  • Able to read and understand Dutch or English
  • Able to comply with study procedures (e.g. willing to provide fecal samples)

Exclusion Criteria:

  • Symptomatic brain metastases
  • Received prior immunotherapy; previous (neo)adjuvant treatment is allowed if the last administration is at least 6 months ago
  • Use of systemic immunosuppressive medications
  • Use of laxatives up to 1 week prior to start of ICI
  • Use of supplements that alter bowel function or gut microbiota such as fibers/prebiotics, probiotics, synbiotics, or postbiotics up to 1 month prior to start of ICI
  • Use of antibiotics up to 1 months prior to start of ICI
  • Use of proton pumps inhibitors (PPI's) up to 3 months prior to start of ICI
  • Pregnant or lactating
  • Current participation in another clinical trial requiring the use of study medication
  • Has a known allergy to plants such as lettuce, sage, tarragon, chicory, artichoke, chamomile, daisy, or sunflower.
  • Has a medical history of gastrointestinal resection (appendectomy is allowed)
  • Has active inflammatory bowel disease

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Firedobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Fiber intervention arm
Dried chicory roots
Kosttilskud: Dried chicory roots
The dried chicory roots are implemented using a dosage of 22.5 gram/day resulting in 18.5 gram additional fibers a day.
Andre navne:
  • Dietary fibers
  • fiber
  • Vezel
Placebo komparator: Placebo arm
iso-caloric placebo (rice-puffs)
Kosttilskud: Placebo
The control arm will receive 12.4 grams of placebo a day, isocaloric to the intervention.
Andre navne:
  • Styring
  • Placebo kontrol

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
An increase in the relative abundance of Bifidobacterium in fecal samples.
Tidsramme: From baseline (T0) to 3-4 weeks (T1) after start ICI
The primary endpoint of this study is defined as a ≥5% (e.g. from 3% to 8%) increase in the relative abundance of Bifidobacterium in fecal samples between baseline (T0) and follow-up (T1) and significant differences between the experimental arm and the control arm.
From baseline (T0) to 3-4 weeks (T1) after start ICI

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Fecal microbiota composition
Tidsramme: Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
Study the baseline and on-treatment gut microbiota composition of patients with melanoma treated with ICI +/- additional dietary fiber.
Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
Radiological response rate to ICI
Tidsramme: From baseline (T0) to the first date of documented progression or date of death from any cause, wichever came first, assesed up to 5 year.
Evaluate radiological response rates to ICI +/- additional dietary fiber, assessed by CT/PET scan per RECIST 1.1 defined as; the date of randomization to the date of disease progression or death, respectively.
From baseline (T0) to the first date of documented progression or date of death from any cause, wichever came first, assesed up to 5 year.
Progression free survival (PFS)
Tidsramme: From baseline (T0) to the first date of documented progression or date of death from any cause, wichever came first, assesed up to 5 year.
Evaluate progression-free survival defined as; the date of randomization to the date of disease progression or death, respectively.
From baseline (T0) to the first date of documented progression or date of death from any cause, wichever came first, assesed up to 5 year.
Overall survival (OS)
Tidsramme: From baseline (T0) on, survival follow-up will be continued after study completion for a maximal of 5 years in accordance with standard-of-care follow-up.
Evaluate overall survival to ICI +/- additional dietary fiber defined as; the date from randomization to date of death, respectively.
From baseline (T0) on, survival follow-up will be continued after study completion for a maximal of 5 years in accordance with standard-of-care follow-up.
Evaluate the gastro-intestinal side effects of additional dietary fiber intake
Tidsramme: From start intervention at baseline (T0) until the end of wash-out period at 6-7 months (T3) after start ICI.
Evaluate the gastro-intestinal side effects of additional dietary fiber intake, according to CTCAE common criteria v 5.0.
From start intervention at baseline (T0) until the end of wash-out period at 6-7 months (T3) after start ICI.

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Habitual dietary intake (Food Frequency Questionnaire)
Tidsramme: At baseline (T0) and at 3-4 months (T2)
Nutritional intake is measured using a semi-quantitative Food Frequency Questionnaire (FFQ). Scores are calculated using the Dutch National Food Consumption tables. The FFQ will be used to evaluate habitual diet and fiber intake.
At baseline (T0) and at 3-4 months (T2)
Physical activity level (Short QUestionnaire to ASsess Health-enhancing physical activity)
Tidsramme: At baseline (T0) and at 3-4 months (T2)
Physical activity is measured using the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH). The questions in the SQUASH are pre-structured in commuting, leisure time, household and work/school activities. Scores will be assigned to the different reported activities base on intensities in MET and translated to minutes of physical activity.
At baseline (T0) and at 3-4 months (T2)
Sleep quality and duration (Pittsburgh Sleep Quality Index)
Tidsramme: At baseline (T0) and at 3-4 months (T2)
Sleep quality is measured with the Pittsburgh Sleep Quality Index (PSQI), a 19-item questionnaire with scores ranging from 0-21. A score above 5 indicates bad sleep quality.
At baseline (T0) and at 3-4 months (T2)
Bristol Stool Scale (BSS)
Tidsramme: Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
Stool consistency is measured using the Bristol Stool Scale (BSS)
Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
Circulating tumor DNA (ctDNA)
Tidsramme: Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
ctDNA levels will be analysed to evaluate circulating tumor DNA.
Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
Short-Chain Fatty Acids
Tidsramme: Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
Fecal and Plasma SCFA's levels will be evaluated.
Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
Sequencing mRNA in circulating immune cells
Tidsramme: Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
(m)RNA will be sequenced to evaluate the transcription/gene expression in circulating immune cells.
Measurement at baseline (T0), 3-4 weeks (T1), 3-4 months (T2), and 6-7 months (T3) after start ICI
Tumor infiltration
Tidsramme: Pretreatment

Archived tumor tissue, previous to baseline (T0):

Pre-interventional tumor tissue will be requested for immune cell analyses using multiplex immunohistochemistry.
Pretreatment

Samarbejdspartnere og efterforskere

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

Sponsor

Radboud University Medical Center

Samarbejdspartnere

Wageningen University and Research

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 (Anslået)

31. juli 2026

Primær færdiggørelse (Anslået)

1. maj 2028

Studieafslutning (Anslået)

30. april 2029

Datoer for studieregistrering

Først indsendt

4. juni 2026

Først indsendt, der opfyldte QC-kriterier

29. juni 2026

Først opslået (Faktiske)

7. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

27. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

24. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • R0007807A

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