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Serial Tumour Biopsies and Blood Biomarkers in Melanoma

2020年7月29日 更新者:The Christie NHS Foundation Trust

Molecular Characterisation of Serial Tumour Samples and Their Correlation With Circulating Biomarkers and Other Biospecimens Taken During the Clinical Course of Patients Receiving Treatment for Malignant Melanoma.

Recent advances in understanding how cancer develops and spreads have led to effective new treatments and improved outcomes for patients with melanoma. However, we know that these new treatments do not work for all patients: some do not respond to them and some initially respond but then develop resistance. The overall aim of this study will be to collect tumour biopsies, biomarkers present in the blood, and other biological specimens which can be used to try to understand why resistance to anti-cancer treatment occurs, and to develop predictive biomarkers of this resistance in patients with locally advanced and metastatic malignant melanoma.

The study will be open to NHS patients aged 16 and over, who have been diagnosed with advanced melanoma, and who will be receiving treatment for their disease as part of their routine care. Patients will be asked to provide samples from tumour biopsies before, during and after treatment. We will also ask for blood samples to look at biomarkers in the blood and see how these correspond with tumour samples, which will further help us to understand treatment response. Biomarkers are substances in the body that can be measured and help indicate how a disease is developing. It is hoped that soon we will be able to monitor cancer by analysing a patient's blood samples, thus reducing the need for biopsies. As blood tests could be taken more frequently, signs that patients are becoming resistant to treatments could be picked up sooner.

As well as monitoring biomarkers, we would also like to understand what happens to the healthy cells surrounding the tumour during treatment. This will improve our understanding of how cells adapt and respond to treatments, and may eventually lead to the discovery of new biomarkers to help predict which patients will develop resistance to certain treatments.

調査の概要

詳細な説明

This will be a prospective study recruiting patients who have been diagnosed wth advanced melanoma.

Participants will be asked to give informed consent before any samples are collected.

Participants will be asked to donate tissue and other biospecimens (see list below) that are surplus to clinical requirements if a participant is undergoing any of the following as part of their routine care:

  • lymph node dissection
  • sentinel lymph node biopsy as part of their normal care
  • resection of metastatic skin lesions or visceral disease
  • medical treatment for Stage IV disease Biospecimens include urine, stool, saliva, hair follicles, ascitic, pleural, pericardial or cerebrospinal fluid Collection of archival tumour tissue from previous biopsy/surgery that is surplus to clinical requirements will also be requested, where available.

Participants will be asked to consent to having easily accessible lesions biopsied or resected, which are not required for clinical reasons, but are for research purposes only. Participants can still be part of the study even if they do not agree to these extra, optional biopsies. Tissue samples from the surgical specimens and the original primaries will be examined to look for molecular markers to correlate with circulating tumour molecular markers.

Consent will be requested to grow cell lines from the donated tumour tissue and implant tumour tissue into mice to characterise the genetic changes seen in both CTCs and biopsies, in terms of resistance to targeted agents, in the lab setting. Consent to this part of the study will be optional.

A maximum of 50mls blood sample will be requested from participants before any intervention. Further blood samples (maximum of 50mls each time) will also be requested as follows:

  • after surgery, on subsequent routine follow up at 3 months, and then 3 monthly thereafter (i.e. approximately 4 times in a year after the initial pre and post surgical specimens)
  • at the time of disease recurrence
  • If on treatment, then usually approximately 3 weeks after starting treatment, and then every 2 cycles of treatment
  • at disease progression The samples will be tested for various circulating tumour biomarkers.

We will be asking a small group of patients, approx 20, to consent to weekly blood samples, for up to 8 weeks, for specific biomarker analyses.

Clinical data will be collected for each patient, looking at demographics, baseline haematology and biochemistry blood results, radiological extent of disease, time to disease progression, clinical and histological features of the primary. Patients will be followed up for approximately 10 years to assess their outcome.

研究の種類

観察的

入学 (予想される)

300

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究連絡先のバックアップ

研究場所

      • Manchester、イギリス、M20 4BX
        • 募集
        • The Christie
        • コンタクト:
          • Dr Gupta
          • 電話番号:0161 446 3472

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

16年歳以上 (子、大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

Patients with stage III or IV melanoma undergoing systemic therapy at The Christie hospital

説明

Inclusion Criteria:

  1. Age of 16 years or more.
  2. Patients must have given written informed consent.
  3. Evidence of locally advanced or metastatic melanoma, i.e. stage III or IV disease.
  4. Accessible tumour that can be safely biopsied using radiological or surgical techniques (if consenting to part A).
  5. Full blood count and coagulation tests within acceptable parameters (if consenting to part A).

Exclusion Criteria:

  1. Inability to provide informed consent.
  2. History of significant bleeding disorder (patients on anticoagulation are eligible if the anticoagulation can be safely managed to allow fresh tumour biopsies and blood sampling).
  3. History of HIV, Hepatitis B/C or other transmissible human disease.
  4. Any conditions where research biopsies or blood sampling may increase risk of complications for the patient and/or investigator, including high risk groups such as intravenous drug users.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

コホートと介入

グループ/コホート
介入・治療
参加者全員
資格のある同意されたすべての参加者は、研究目的で血液、組織、その他の生体試料を提供するよう求められます。
To collect tumour tissue
他の名前:
  • 生検
To collect blood samples

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
The number of patients who consent to have additional samples taken for research purposes and the number of research samples collected.
時間枠:Duration of study, 300 participants over 16 years
This is primarily a sample collection study, where tissue will be used in future experiments to further understand mechanisms of disease resistance. This study will however assess patients acceptability to enrol in a study, where biological samples are taken purely for research, and not part of routine care.
Duration of study, 300 participants over 16 years

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

捜査官

  • 主任研究者:Lorigan, Prof、University of Manchester

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2018年11月14日

一次修了 (予想される)

2034年7月1日

研究の完了 (予想される)

2034年7月1日

試験登録日

最初に提出

2020年7月21日

QC基準を満たした最初の提出物

2020年7月29日

最初の投稿 (実際)

2020年7月30日

学習記録の更新

投稿された最後の更新 (実際)

2020年7月30日

QC基準を満たした最後の更新が送信されました

2020年7月29日

最終確認日

2020年7月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • CFTSp157
  • 18/NW/0515 (その他の識別子:Preston NW REC)
  • 132792 (その他の識別子:IRAS)

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

No plans to share IPD

医薬品およびデバイス情報、研究文書

米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。

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