Prospektive multizentrische Kohortenstudie zur Validierung von vier Gruppen von Biomarkern zur Beurteilung des Lungenkrebsrisikos bei Patienten mit atheromatöser Herz-Kreislauf-Erkrankung in einem Screening-Pfad (BIOCEPTION)
Interventional study with minimal risks and constraints, with evaluation of the incidence of lung cancers by low-dose thoracic CT scan without injection of contrast medium, of the immunological, inflammatory and metabolic blood profile and of the microbiota; systematic proposal of smoking cessation for active smokers or assistance in maintaining cessation.
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
This study aims to validate candidate biomarkers associated with the risk of lung cancer diagnosis among patients with atheromatous disease associated with smoking.
hese candidate biomarkers were identified from blood and stool samples taken from the PREVALUNG cohort (NCT03976804), comprising 512 patients with at least one smoking-related atheromatous disease who underwent a thoracic CT lung cancer screening pathway (1 single screening round, i.e. one CT scan and one year of follow-up) at the Marie Lannelongue Hospital - Groupe Hospitalier Paris Saint-Joseph (Le Plessis-Robinson). This screening pathway led to the diagnosis of 14 patients (3%) with lung cancer, over 70% of whom were early-stage (I or II) and could be managed curatively by minimally invasive surgery (unpublished results, presented at the World Congress Lung cancer in Singapore on September 10 and 11, 2023). A case-control study nested in the PREVALUNG cohort compared the biological profiles of patients with suspected lung cancers or nodules with those of patients without lung nodules. Around 15,000 biomarkers per case and control were analyzed by standard statistical methods (descriptive and logistic regression), partial least square method and machine learning after reduction of the number of variables.
By analyzing several types of variables linked to inflammation, immunity, blood metabolomics and stool metagenomics, these analyses identified 14 biomarkers divided into 4 groups of candidate biomarkers associated with the diagnosis of lung cancers the second cohort, PREVALUNG ETOILE (NCT05649046), was recruited at Marseille's Hôpital Nord, using the same intervention methods as PREVALUNG, but extending the inclusion criteria to other tobacco-related diseases (atheroma, but also chronic bronchitis and tobacco-related cancers in remission for more than 5 years), to people who would have been eligible in the prospective-randomized studies that have shown that lung cancer screening reduces lung cancer mortality (NLST and NELSON), and to people meeting the criteria of the North American recommendations. The aim of the PREVALUNG ETOILE study is to set up and evaluate a lung cancer screening care pathway at the APHM, using a biological blood and faeces collection identical to that of PREVALUNG. PREVALUNG ETOILE plans to include 160 participants in 2023 (160 have already been included as of September 20, 2023). A 5-month follow-up after the first screening round is planned for each participant. The total number of participants to be included in Europe is 2750. The number of participants to be included in the French BIOCEPTION cohort will therefore be a maximum of 2,750. APHM is coordinating data collection from the various European centers involved in the PREVALUNG BIOCEPTION study. Pr Tatiana Kouznetsova of KU Leuven (Belgium) is in charge of the statistical analysis of the data, in collaboration with APHM.
The PREVALUNG BIOCEPTION cohort was set up to validate biomarkers of risk of incident lung cancer at 2 years, as part of screening. These biomarkers will subsequently serve as therapeutic targets for the primary prevention of lung cancer. As part of the PREVALUNG EU project, a prospective randomized 8-arm study is planned to demonstrate the biological effect of drug interventions on the 4 classes of biomarkers that will have been validated (see PREVALUNG EU appendix).
This protocol is therefore part of a scientifically validated project funded by the European Commission for the validation of biological biomarkers and the primary prevention of lung cancer risk in patients with smoking-related atheromatous disease. External validation of biomarkers from a cohort of participants at risk of lung cancer without atheromatous disease or moderate or severe calcium score (some participants of PREVALUNG ETOILE or newly recruited) will initiate the extension of the validation and application of these biomarkers to non-atheromatous populations.
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: David BOULATE, Pr
- Telefonnummer: +33491966018
- E-Mail: david.boulate@ap-hm.fr
Studienorte
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-
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Marseille, Frankreich
- Rekrutierung
- Assistance Publique Hopitaux de Marseille
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Kontakt:
- David Boulate
- E-Mail: david.boulate@ap-hm.fr
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Beschreibung
Inclusion Criteria:
- 1- All PREVALUNG or PREVALUNG ETOILE participants
- 2- Active or former smokers who have smoked daily for at least 10 years and have either atheromatous disease (coronary, lower limb, supra-aortic trunk, aortic, visceral or upper limb arteries) or a moderate or high coronary calcium score*, **.
Inclusion criteria:
-
Age 45- 75 years and
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Medical follow-up for smoking-related atheromatous pathology and
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daily smoking for at least 10 years prior to disease (for smoking, there are no quantitative criteria or withdrawal times)
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visual coronary calcium score quantified by a radiologist on a chest CT scan.
3- Individuals at risk of lung cancer without atheromatous disease or moderate or high calcium score being managed for a tobacco-related disease (chronic bronchitis or non-progressive cancer > 5 years) or with eligibility criteria for lung cancer screening (inclusion criteria in the NLST or NELSON studies or American recommendations)**.
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Inclusion criteria :
- Age 45- 75 and
- Medical follow-up for a smoking-related pathology:
- chronic obstructive pulmonary disease / emphysema, or
- history of non-progressive cancer > 5 years, including ENT, lung, breast, cervix, excreto-urinary tract, bladder, esophagus, stomach, pancreas, liver, kidney, chronic myeloid leukemia.
and
- daily smoking for at least 10 years prior to the disease (for smoking, there are no quantitative criteria or withdrawal periods).
Or
Inclusion criteria in NLST :
- Age 55 - 74
- Cumulative smoking ≥ 30 pack-years
- active or weaned for less than 15 years Or
NELSON inclusion criteria :
- Age 50-75
- Smoking :
- > 15 cigarettes /D for more than 25 years or
- > 10 cigarettes /D for more than 30 years
- active smoking or cessation < 10 years Or
American recommendations :
- Age 50 - 80
- Smoking ≥20 PA
Exclusion Criteria:
- cancer history < 5 years (except carcinoma in situ of the uterine cervix, basal cell carcinoma of the skin, non-invasive urothelial carcinoma treated for curative purposes without CT lung surveillance, prostate cancer with unmeasurable PSA)
- symptoms of lung cancer (involuntary weight loss > 7 kg in 1 year, hemoptysis)
- known history of pulmonary nodule requiring specialized follow-up
- history of pulmonary fibrosis or pulmonary hypertension
- active pulmonary parenchymal infection
- severe cardiac or respiratory insufficiency (rest dyspnea)
- performance status (WHO) 2, 3 or 4
- patient not affiliated to the social security system (beneficiary or beneficiary's beneficiary)
- patient deprived of liberty
- patients under guardianship or trusteeship
- pregnant or breast-feeding women
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Verhütung
- Zuteilung: N / A
- Interventionsmodell: Einzelgruppenzuweisung
- Maskierung: Keine (Offenes Etikett)
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Sonstiges: alle Patienten
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blood collection stool collection low dose CT scan evaluation |
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
biomarker group validation
Zeitfenster: 51 months
|
Sensitivity and specificity of each biomarker |
51 months
|
Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Describe changes in biomarkers over time
Zeitfenster: 51 months
|
reporting the value of each biomarker at each patient's visit to visit |
51 months
|
|
Describe and compare biomarkers according to clinical characteristics of participants
Zeitfenster: 51 months
|
Value of each biomarker according to the clinical characteristics of participants |
51 months
|
|
Describe changes in quality of life over time
Zeitfenster: 51 months
|
Quality of life (SF-12 score) at each visit. |
51 months
|
|
Describe changes in smoking habits over time
Zeitfenster: 51 months
|
Smoking cessation rate achieved (partial and/or total) among participants active smokers |
51 months
|
|
Describe changes in anxiety over time
Zeitfenster: 51 months
|
anxiety (STAI-YA and STAI-YB) at each visit. |
51 months
|
|
Describe and compare biomarkers according to medical characteristics of participants
Zeitfenster: 51 months
|
Value of each biomarkers according to medical characteristics of participants |
51 months
|
|
Describe and compare biomarkers according to geographic characteristics of participants
Zeitfenster: 51 months
|
Value of each biomarkers according to geographic characteristics of participants |
51 months
|
|
Describe and compare biomarkers according to socioeconomic characteristics of participants
Zeitfenster: 51 months
|
Value of each biomarkers according to socioeconomic characteristics of participants |
51 months
|
Mitarbeiter und Ermittler
Sponsor
Sponsor
Ermittler
Ermittler
- Studienleiter: David BOULATE, Pr, Assistance Publique Hopitaux De Marseille
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Neubildungen nach Standort
- Neubildungen
- Pathologische Zustände, Anatomisch
- Erkrankungen der Atemwege
- Lungenkrankheit
- Neubildungen der Atemwege
- Thoraxneoplasmen
- Pathologische Zustände, Anzeichen und Symptome
- Lungentumoren
- Plaque, Arteriosklerose
- Untersuchungstechniken
- Handhabung von Proben
- Klinische Labortechniken
- Diagnosetechniken und Verfahren
- Diagnose
- Punktionen
- Chirurgische Eingriffe, operativ
- Blutprobensammlung
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- RCAPHM22_0411
Arzneimittel- und Geräteinformationen, Studienunterlagen
Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt
Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt
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