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Biomarker Development for Response Prediction by DNA Mutational Analysis (CPCT-01)

7 de marzo de 2018 actualizado por: P.O. Witteveen

Feasibility Study of Biomarker Development for Response Prediction by Large Scale DNA Mutational Analysis of Metastatic Lesions

The purpose of this study is to determine whether it is possible to predict response to chemotherapy in patients with metastatic cancer who are treated with irinotecan by determining the mutational profile of the tumor.

Descripción general del estudio

Estado

Terminado

Condiciones

Intervención / Tratamiento

Tipo de estudio

De observación

Inscripción (Actual)

79

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

  • Países Bajos
      • Utrecht, Países Bajos, 3584 CX
        • University Medical Center Utrecht
    • North Holland
      • Amsterdam, North Holland, Países Bajos, 1066 CX
        • Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
    • South Holland
      • Rotterdam, South Holland, Países Bajos, 3075 EA
        • Erasmsus Medical Center - Daniël den Hoed clinic

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Método de muestreo

Muestra de probabilidad

Población de estudio

Patients with a metastatic solid tumor who are eligible for (standard of care) treatment with irinotecan.

Descripción

Inclusion Criteria:

  1. Patients with a metastatic solid tumor who have failed at least one line of palliative chemotherapy and are irinotecan naïve.
  2. Patients who are, as per local protocol, eligible for palliative treatment with (standard of care) irinotecan.
  3. Measurable metastatic lesion(s), according to RECIST 1.1 criteria.

  4. Radiological measurable metastatic lesion(s) of which a histological biopsy can safely be obtained:

    1. Patients with safely accessible metastases.
    2. Patients not known with bleeding disorders (such as hemophilia) or bleeding complications from biopsies, dental procedures or surgeries.
    3. Patients not using any anti-coagulant medication at the time of biopsy: all aspirin derivatives, NSAID's, coumarines, platelet function inhibitors, heparins (including LMWHs) and oral factor Xa inhibitors are not allowed, unless medication can either be safely stopped or counteracted.

    4. Adequate coagulation status on the day of biopsy as measured by:

      • PTT < 1.5 x ULN
      • APTT < 1.5 x ULN
      • Platelet count 100 x 10*9 / L or higher
      • PT-INR < 1.6
      • HB > 6
    5. Biopsies should be performed at least four weeks after last bevacizumab administration.
  5. Patients age 18 years or up, willing and able to comply with the protocol as judged by the investigator with a signed informed consent.

Exclusion Criteria:

Patients not meeting all of the above inclusion criteria.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

Cohortes e Intervenciones

Grupo / Cohorte
Intervención / Tratamiento
Irinotecan

Patients will be subjected to a their metastatic solid tumor. Radiological response will be evaluated after each 2 cycles: 1. percentage change in radiological volume of the "index lesion" (radiological measurable lesion that underwent biopsy) after the first two cycles of irinotecan; 2. radiological response according to RECIST 1.1 after each 2 cycles. Patients are intended to receive irinotecan until progressive disease or unacceptable toxicity. Patients will be subjected to another biopsy of the index lesion at definitive discontinuation of irinotecan. Patients will also be subjected to blood draws for determining patient's genetic background variation.

Side studies include:

  • pharmacogenetics
  • pharmacokinetics of SN-38
  • carboxylesterase activity in the index lesion
  • midazolam clearance test (only in Rotterdam patients)
Procedimiento: Biopsy
Histological biopsy of the "index lesion" (a radiological measurable lesion on which biopsy is performed) at baseline, as well as when showing progressive disease. Histological biopsies will be subjected to DNA sequencing to assess the mutational profile, as well as to analysis of carboxylesterase activity.
Otros nombres:
  • Histological biopsy
Procedimiento: Blood samples
Blood samples will be taken at baseline to determine patient's genetic background variation (germline DNA).
Otros nombres:
  • Muestra de sangre
Procedimiento: Pharmacokinetics
Blood samples will be taken for pharmacokinetic analysis of the active irinotecan metabolite (SN-38).
Otros nombres:
  • PAQUETE
  • Pharmacokinetic analysis
  • Pharmacokinetic analyses
Procedimiento: Midazolam clearance test
Patients who are being treated in Rotterdam will be subjected to blood draws for validation of the earlier developed midazolam phenotyping test (midazolam clearance test), which may be an indicator for pharmacokinetics of irinotecan.
Otros nombres:
  • MCT

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Periodo de tiempo
Exploration of the correlation between the mutational profile and the percentage change in volumetric measurement of the index lesion after the first two cycles of chemotherapy.
Periodo de tiempo: Change in radiological volume of the index lesion after the first 2 cycles of irinotecan. Radiological response (according to RECIST 1.1) after the first 2 cycles of irinotecan (i.e. after 2 x 3 weeks = 6 weeks)
Change in radiological volume of the index lesion after the first 2 cycles of irinotecan. Radiological response (according to RECIST 1.1) after the first 2 cycles of irinotecan (i.e. after 2 x 3 weeks = 6 weeks)

Medidas de resultado secundarias

Medida de resultado
Periodo de tiempo
Exploration of the correlation between the mutational profile and radiological response according to RECIST-criteria after the first two cycles of chemotherapy.
Periodo de tiempo: Analysis 6 weeks after initiation of treatment
Analysis 6 weeks after initiation of treatment
Exploration of the correlation between the mutational profile and progression free survival and overall survival.
Periodo de tiempo: Overall survival approximately after 2 years of first cycle of irinotecan. Progression free survival approximately 3 months after first irinotecan
Overall survival approximately after 2 years of first cycle of irinotecan. Progression free survival approximately 3 months after first irinotecan
Exploration of the correlation between the mutational profile of the index lesion and patient's germline DNA background variation.
Periodo de tiempo: Analysis after progressive disease, on average after 3 months.
Analysis after progressive disease, on average after 3 months.
Differences in mutational profile of metastasis prior to and after exposure to treatment.
Periodo de tiempo: Analysis after progressive disease and subsequent post-treatment biopsy, on average after 3 months of treatment
Analysis after progressive disease and subsequent post-treatment biopsy, on average after 3 months of treatment
Determine reliable and valid strategies for statistical analysis for biomarker discovery
Periodo de tiempo: 2 years
2 years
Correlate response to pharmacokinetics of SN-38
Periodo de tiempo: After progressive disease and subsequent post-treatment biopsy, in general after 3 months of treatment
After progressive disease and subsequent post-treatment biopsy, in general after 3 months of treatment
Determine carboxylesterase activity in metastatic tumor material (pre- and posttreatment) and correlate intra-tumoral carboxylesterase activity to systemic SN-38 pharmacokinetics and to irinotecan response
Periodo de tiempo: After progressive disease and subsequent post-treatment biopsy, in general after 3 months of treatment
After progressive disease and subsequent post-treatment biopsy, in general after 3 months of treatment
Determine clinical applicability of the midazolam phenotyping probe
Periodo de tiempo: After first cycle of irinotecan, at three weeks
After first cycle of irinotecan, at three weeks
Number and nature of all (serious) adverse events of study related procedures
Periodo de tiempo: 14 days after baseline biopsy and 14 days after post-treatment biopsy (approximately after 3 months of treatment)
14 days after baseline biopsy and 14 days after post-treatment biopsy (approximately after 3 months of treatment)

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

P.O. Witteveen

Colaboradores

Erasmus Medical Center
The Netherlands Cancer Institute

Investigadores

  • Investigador principal: Marlies Langenberg, MD/PhD, UMC Utrecht
  • Investigador principal: Neeltje Steeghs, MD/PhD, Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam
  • Investigador principal: Ron Mathijssen, MD/PhD, Erasmus Medical Center - Daniël den Hoed clinic, Rotterdam

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de mayo de 2011

Finalización primaria (Actual)

1 de noviembre de 2015

Finalización del estudio (Actual)

1 de agosto de 2016

Fechas de registro del estudio

Enviado por primera vez

1 de agosto de 2011

Primero enviado que cumplió con los criterios de control de calidad

13 de mayo de 2013

Publicado por primera vez (Estimar)

16 de mayo de 2013

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

9 de marzo de 2018

Última actualización enviada que cumplió con los criterios de control de calidad

7 de marzo de 2018

Última verificación

1 de marzo de 2018

Más información

Términos relacionados con este estudio

Palabras clave

Términos MeSH relevantes adicionales

Otros números de identificación del estudio

  • NL35198.041.11

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

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