Myeloid Cell Reprogramming in Thyroid Carcinoma
Myeloid Cell Reprogramming in the Context of Radioiodine Therapy in Patients With Non-Medullary Thyroid Carcinoma
Studienübersicht
Status
Bedingungen
Detaillierte Beschreibung
Description of the problem:
Non-medullary thyroid carcinoma (TC) is the most common endocrine malignancy and its incidence is one of the most rapidly increasing among the cancer types. For many patients with advanced and poorly differentiated tumors, treatment options are limited and the prognosis of advanced stage metastatic disease remains poor.
Envisioned solution/research direction:
To improve the patients outcome and identify novel therapeutic targets, one needs a 'systems understanding' of the pathophysiology of tumors, particularly the complex interaction of the malignant cells with other cell types in the tumor en the tumor environment (TME), especially immune cells. Tumor-associated macrophages (TAMs), the most dominant myeloid population in aggressive thyroid tumors, exhibit a distorted phenotype functioning predominantly as tumor enhancer. Despite the progress in understanding the importance of TAMs, the in-depth characterization of different TAMs populations is lacking and the mechanisms governing the functional polarization of TAMs are largely unknown. Understanding the interplay between TAMs and tumor cells represents a crucial step towards development of additional therapeutic strategies in cancer.
Hypothesis:
- We first propose that in advanced TC, not only TAMs, but also circulating monocytes and bone marrow (BM) myeloid progenitors are functionally reprogrammed by tumor-derived factors even before their recruitment in the TME.
- Radioactive iodide (I131)(RAI) is a very effective therapy for patients with TC, but is less effective in patients with advanced, metastatic tumors. We hypothesize that by exposing tumor antigens to the immune system, RAI might induce immunogenic effects at the level of the TME with reprogramming of both TAMs present in the TME and circulating monocytes, towards a tumor suppressive phenotype. This may further potentiate the effects of RAI. In addition this could be explored in the future as a basis for immunotherapy for tumors that are refractory to conventional treatment.
Studientyp
Einschreibung (Tatsächlich)
Kontakte und Standorte
Studienorte
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Nijmegen, Niederlande, 6525GA
- Radboudumc
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Teilnahmekriterien
Zulassungskriterien
Studienberechtigtes Alter
Akzeptiert gesunde Freiwillige
Studienberechtigte Geschlechter
Probenahmeverfahren
Studienpopulation
Beschreibung
Inclusion Criteria:
- Group 1:
Subject is newly diagnosed with TC, therapy-naive and is planned to receive conventional treatment by surgery followed by RAI; no evidence of local or distant metastases
- Group 2:
Subject has TC with evidence of distant metastases (either newly diagnosed or therapy-naive or patients with persistent or recurrent disease); at least 4 months since the previous treatment with RAI if applicable
- Group 3:
Subject is diagnosed with MNG, is euthyroid, and is planned to undergo surgery - Group 4: Subject is diagnosed with MNG, is euthyroid, and is planned to receive RAI treatment
- Group 5: Healthy individuals who are euthyroid and have no evidence of thyroid disease
Exclusion Criteria:
- Mentally incompetent
- Pregnant, trying to become pregnant or breastfeeding
- Known inflammatory or infectious diseases or an immunosuppressive status
- Using medication interfering with the immune system
- Reduced platelet counts or other conditions associated with an increased risk of bleeding
- Severe comorbidities: other active malignancy (except for basal cell carcinoma)
- Serious psychiatric pathology
- A self-reported alcohol consumption of >21 units per week
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
Kohorten und Interventionen
Gruppe / Kohorte |
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Non-metastatic TC
blood withdrawal, bone marrow aspiration
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Metastatic TC
blood withdrawal, bone marrow aspiration
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MNG surgery
blood withdrawal, bone marrow aspiration
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MNG RAI treatment
blood withdrawal
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Healthy volunteers
blood withdrawal
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Was misst die Studie?
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Transcriptional reprogramming of myeloid cells
Zeitfenster: baseline
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RNAseq
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baseline
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Epigenetic reprogramming of myeloid cells
Zeitfenster: baseline
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ATAC-seq
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baseline
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Functional reprogramming of myeloid cells
Zeitfenster: baseline
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Cytokine response
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baseline
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Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Metabolites
Zeitfenster: baseline
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Presence and level metabolites
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baseline
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Change of reprogramming after RAI treatment
Zeitfenster: baseline and 7 days after RAI treatment
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RNAseq
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baseline and 7 days after RAI treatment
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Mitarbeiter und Ermittler
Ermittler
- Hauptermittler: Romana T Netea-Maier, Endocrinologist
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Primärer Abschluss (Tatsächlich)
Studienabschluss (Tatsächlich)
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
Andere Studien-ID-Nummern
- NL62671.091.17
- 2017-3628 (Andere Kennung: CMO Arnhem-Nijmegen)
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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