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Folate Receptor in Diagnosing Ovarian Cancer Using Serum Samples From Patients With Newly Diagnosed Pelvic Mass or Previously Diagnosed Ovarian Cancer

2019년 8월 12일 업데이트: Ira Winer, Barbara Ann Karmanos Cancer Institute

Study of Serum Measured Folate Receptor and Its Induction as a Biomarker in the Diagnosis and Surveillance of Ovarian Carcinoma

This pilot research trial studies folate receptor in diagnosing ovarian cancer using serum samples from patients with a newly diagnosed pelvic mass or previously diagnosed ovarian cancer. Studying samples of serum from patients with ovarian cancer in the laboratory may help understand the use of folate receptor induction as a clinical tool in initial diagnosis, surveillance, and recurrence.

연구 개요

상세 설명

PRIMARY OBJECTIVES:

I. To evaluate the pre- and post-induction correlation between soluble folate receptor and tumor-based receptor levels as a marker of malignancy in patients with newly diagnosed adnexal masses. (Arm I) II. To evaluate the ability to induce serum folate receptor (FR) with dexamethasone (Dex) and valproic acid (VPA) treatment in patients with newly diagnosed adnexal masses. (Arm I) III. To evaluate the use of the serum soluble FR as a marker for earlier detection of recurrent disease. (Arm II) IV. To evaluate the ability to induce FR with Dex and VPA in the setting of recurrent disease. (Arm II)

SECONDARY OBJECTIVES:

I. To evaluate the expression of FR in primary versus (vs.) metastatic tumor sites in patients with ovarian malignancy undergoing Dex and VPA induction and correlate expression with other markers associated with malignancy (marker of proliferation Ki-67 [Ki67], cancer antigen [CA]-125, etc.).

II. To analyze the correlation between gluco-corticoid receptor (GR) levels and serum FR induction efficacy.

III. To examine global, downstream targets of GR and FR induction in patient samples undergoing treatment with Dex and VPA.

OUTLINE: Patients are assigned to 1 of 2 arms.

ARM I (INDUCTION): Patients receive valproic acid orally (PO) twice daily (BID) on days -7 to -3 and once daily (QD) on day -2 and dexamethasone PO QD on days -5 and -2 and BID on days -4 and -3. Patients undergo collection of serum and tissue samples for analysis via polymerase chain reaction (PCR) and immunohistochemistry (IHC) at baseline, time of surgery, and 7-14 days after surgery.

ARM II (SURVEILLANCE AND RECURRENCE): Patients receive valproic acid PO BID on days -7 to -3 and QD on day -2 and dexamethasone PO QD on days -5 and -2 and BID on days -4 and -3. Patients undergo collection of serum and tissue samples for analysis via PCR and IHC at the time of clinically suspected recurrence, 2 days after completion of induction, and 7-14 days after induction.

연구 유형

중재적

등록 (실제)

50

단계

  • 1단계

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 장소

    • Michigan
      • Bay City, Michigan, 미국, 48706
        • Karmanos Cancer Institute at McLaren Bay Region, Bay City
      • Detroit, Michigan, 미국, 48201
        • Wayne State University/Karmanos Cancer Institute

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

여성

설명

Inclusion Criteria:

  • For study Arm 1, female subjects of childbearing potential or less than 2 years postmenopausal agree to use an acceptable form of contraception from the time of signing informed consent until 30 days after study completion unless total hysterectomy performed at the time of original operation
  • Able to provide informed consent
  • Performance status Eastern Cooperative Oncology Group (ECOG) 0-2
  • Study Arm 1: primary diagnosis of a pelvic or adnexal mass of presumed gynecologic origin who is scheduled for operative resection
  • Study Arm 2: previously diagnosed with a non-mucinous epithelial ovarian carcinoma (including serous, clear cell, and endometrioid histologies as well as borderline ovarian tumors) currently undergoing routine surveillance for recurrence, having been diagnosed with recurrence but prior to initiation of chemotherapy. . Patients from Study Arm 1 will automatically be included in Study Arm 2 as well unless they withdraw consent. Finally, patients who have been diagnosed with an ovarian cancer of acceptable histology but not yet initiated adjuvant chemotherapy are eligible for Study Arm 2.

Exclusion Criteria:

  • Known sarcomatous histologies
  • Current usage of VPA or Dex, if patient has been on these medications in the past but is not currently taking them she is still a candidate for the study. Prior use must be greater than one month for VPA. There is no "wash out" period required for DEX.
  • Any contraindication to dexamethasone or valproic acid such as known allergies or sensitivity
  • Unable to give informed consent
  • Pregnancy
  • Greater than 3 x the upper limit of normal (ULN) for alanine aminotransferase (ALT), aspartate aminotransferase (AST)
  • Greater than 3 x the ULN for total bilirubin (except for known cases of Gilbert's syndrome, where the levels of conjugated bilirubin must be less than 3 x the ULN)
  • Greater than 1.5 x the ULN for blood urea nitrogen (BUN)
  • Greater than 1.5 x the ULN for creatinine
  • Chronic or acute pancreatitis as evidenced by clinical or pathologic diagnosis
  • Significant acute or chronic medical, neurologic, or psychiatric illness in the subject that, in the judgment of the Investigator, could compromise subject safety, limit the subject's ability to complete the study, and/or compromise the objectives of the study
  • For study Arm 2, patients that are currently undergoing chemotherapy for recurrence; maintenance chemotherapy is not considered an exclusion criteria. Additionally, as noted above if a patient has not yet begun chemotherapy for recurrence or adjuvant chemotherapy for initial diagnosis they are still a candidate to be enrolled on this Study arm.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 치료
  • 할당: 무작위화되지 않음
  • 중재 모델: 단일 그룹 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Arm I (induction)
Patients receive valproic acid PO BID on days -7 to -3 and QD on day -2 and dexamethasone PO QD on days -5 and -2 and BID on days -4 and -3. Patients undergo collection of serum and tissue samples for analysis via PCR and IHC at baseline, time of surgery, and 7-14 days after surgery.
주어진 PO
다른 이름들:
  • 데카드론
  • Aacidexam
  • 아덱손
  • 아크니히톨 덱사
  • 알바덱스
  • 알린
  • 알린 디포
  • 알린 오프탈미코
  • 증폭
  • 안물모노
  • 오리쿨라룸
  • 옥실로손
  • 바이큐텐
  • 베이큐튼 N
  • 코르티덱사손
  • 코르티섬만
  • 데카코트
  • 데카드롤
  • 데칼릭스
  • 데카메스
  • 데카손 R.p.
  • 데탄실
  • 델타플루오렌
  • 데로닐
  • 데사메타손
  • 데사메톤
  • 덱사-마말렛
  • 덱사-코뿔소
  • 덱사-스케로손
  • 덱사 사인
  • 덱사피질
  • 덱사코르틴
  • 덱사파마
  • 덱사플루오렌
  • 덱사로컬
  • 덱사메코르틴
  • 덱사메스
  • 덱사메타소눔
  • 덱사모노존
  • 덱사포스
  • 덱시노랄
  • 덱손
  • 다이노르몬
  • 플루오로델타
  • 포르테코틴
  • 감마코르텐
  • 헥사데카드롤
  • 헥사드롤
  • 로컬리슨-F
  • 로베린
  • 메틸플루오르프레드니솔론
  • 밀리코트
  • 마이메타손
  • 오르가드론
  • 스퍼사덱스
  • 비스메타존
주어진 PO
다른 이름들:
  • 밸프로에이트
  • 데파켄
  • 스타브조르
Analysis of serum and tissue samples
실험적: Arm II (surveillance and recurrence)
Patients receive valproic acid PO BID on days -7 to -3 and QD on day -2 and dexamethasone PO QD on days -5 and -2 and BID on days -4 and -3. Patients undergo collection of serum samples for analysis via PCR and IHC at the time of clinically suspected recurrence, 2 days after completion of induction, and 7-14 days after induction.
주어진 PO
다른 이름들:
  • 데카드론
  • Aacidexam
  • 아덱손
  • 아크니히톨 덱사
  • 알바덱스
  • 알린
  • 알린 디포
  • 알린 오프탈미코
  • 증폭
  • 안물모노
  • 오리쿨라룸
  • 옥실로손
  • 바이큐텐
  • 베이큐튼 N
  • 코르티덱사손
  • 코르티섬만
  • 데카코트
  • 데카드롤
  • 데칼릭스
  • 데카메스
  • 데카손 R.p.
  • 데탄실
  • 델타플루오렌
  • 데로닐
  • 데사메타손
  • 데사메톤
  • 덱사-마말렛
  • 덱사-코뿔소
  • 덱사-스케로손
  • 덱사 사인
  • 덱사피질
  • 덱사코르틴
  • 덱사파마
  • 덱사플루오렌
  • 덱사로컬
  • 덱사메코르틴
  • 덱사메스
  • 덱사메타소눔
  • 덱사모노존
  • 덱사포스
  • 덱시노랄
  • 덱손
  • 다이노르몬
  • 플루오로델타
  • 포르테코틴
  • 감마코르텐
  • 헥사데카드롤
  • 헥사드롤
  • 로컬리슨-F
  • 로베린
  • 메틸플루오르프레드니솔론
  • 밀리코트
  • 마이메타손
  • 오르가드론
  • 스퍼사덱스
  • 비스메타존
주어진 PO
다른 이름들:
  • 밸프로에이트
  • 데파켄
  • 스타브조르
Analysis of serum and tissue samples

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Arm I: To evaluate the ability to increase serum Folate Receptor (FR) levels in patients with newly diagnosed adnexal masses or ovarian cancer utilizing Dexamethasone (DEX) and Valproic Acid (VA).
기간: Up to 14 days after induction
FR will be measured in the serum of patients utilizing a standardized tritiated folate/charcoal binding assay pre- and post-drug administration. This will be measured to the femto-molar level. Two sided t-tests will be utilized as a baseline statistical analysis to determine the efficacy of induction in this setting.
Up to 14 days after induction
Arm I: To evaluate the utility of serum FR to distinguish between patients with benign masses or malignancy.
기간: Up to 14 days after surgery
Folate receptor levels in patients with benign and malignant conditions will be compared utilizing receiver operator curves for both pre- and post-induction levels to determine if soluble folate receptor can be utilized as a tumor marker in newly diagnosed adnexal masses and/or ovarian cancer. Both two-sided t tests and ROC curve analysis will be utilized in this portion of the analysis.
Up to 14 days after surgery
Arm II: To evaluate the use of the serum soluble FR as a marker for earlier detection of recurrent disease.
기간: Up to 14 days after induction
Patients are to be followed during surveillance period for a history of know ovarian carcinoma with serum FR in addition to CA-125. FR will again be measured in the serum of patients utilizing a standardized tritiated folate/charcoal binding assay. This will be measured to the femto-molar level. ROC curve analysis will be performed to evaluate the efficacy of baseline Folate Receptor in early detection of relapse and compared to standard tumor markers such as CA-125.
Up to 14 days after induction
Arm II: To evaluate the ability to increase serum FR levels with DEX and VA in the setting of recurrent disease.
기간: Up to 14 days after surgery
If recurrence is suspected, this portion of Arm 2 is meant to determine if serum levels of FR can be artificially increased in the recurrent setting utilizing DEX and VA above baseline recurrent levels. FR will be measured in the serum of patients utilizing a standardized tritiated folate/charcoal binding assay pre- and post-drug administration. This will be measured to the femto-molar level. Two side t-tests will be utilized to determine the efficacy of induction in this setting.
Up to 14 days after surgery

2차 결과 측정

결과 측정
측정값 설명
기간
Arm I: To evaluate expression of FR via immunohistochemistry in primary vs. metastatic tumor sites in patients with ovarian malignancy undergoing DEX & VA induction and determine if this correlates with other known markers associated with malignancy.
기간: Up to day 14
Two sided independent t-tests will be performed to compare the expression of FR in primary vs metastatic tumor sites. Pearson's correlation coefficients will be calculated to evaluate the associations between serum FR and existing markers such as Ki67 and CA-125.
Up to day 14
Arm I: To examine downstream targets of GR and FR induction in patient samples undergoing treatment with DEX and VA via global mRNA analysis and proteomic modalities.
기간: Up to day 14
Achieved by utilizing such techniques (but not limited to) as transcriptome analysis and whole genome Chip analysis.
Up to day 14
Arm I: To analyze the correlation between GR level as noted by immunohistochemistry and serum FR induction efficacy with DEX and VA.
기간: Up to day 14
Pearson's correlation coefficients will be calculated to evaluate the associations between serum Folate receptor levels and tissue based glucocorticoid receptors.
Up to day 14

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Ira Winer, Barbara Ann Karmanos Cancer Institute

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작

2015년 8월 1일

기본 완료 (실제)

2018년 9월 1일

연구 완료 (실제)

2018년 11월 1일

연구 등록 날짜

최초 제출

2015년 7월 30일

QC 기준을 충족하는 최초 제출

2015년 8월 6일

처음 게시됨 (추정)

2015년 8월 11일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2019년 8월 14일

QC 기준을 충족하는 마지막 업데이트 제출

2019년 8월 12일

마지막으로 확인됨

2019년 8월 1일

추가 정보

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .

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