- ICH GCP
- 미국 임상 시험 레지스트리
- 임상시험 NCT05132244
췌장암 환자의 포도당 수치 모니터링 및 관리 (PEGASUS)
췌장암 포도당 평가 및 조절 연구
이 연구는 췌장암 환자의 포도당 수치를 면밀히 모니터링하고 관리하는 것이 가능한지 여부를 조사할 것입니다. 또한 포도당 관리가 췌장암에 어떤 영향을 미칠 수 있는지 조사할 것입니다.
이것은 췌장암을 앓고 있는 약 50명의 참가자의 포도당 수준을 모니터링하기 위해 연속 포도당 모니터(CGM)를 사용하는 파일럿 연구입니다. 참가자들은 췌장암을 치료하기 위해 옥살리플라틴, 이리노테칸, 5-플루오로우라실 및 류코보린(FOLFIRINOX)과 같은 최대 4가지 약물의 조합으로 표준 화학 요법을 받게 됩니다. 높은 포도당 수치를 치료하기 위해 참가자는 두 그룹 중 하나에 무작위로 배정됩니다. 그룹 1은 포도당 수치를 4~10mmol/L 사이로 유지하기 위해 내분비학자의 안내에 따라 항고혈당 치료를 받습니다. 그룹 2는 혈당 수치가 표준 치료인 15mmol/L 이상인 경우 항고혈당 치료를 받게 됩니다. 그룹 1과 2 모두의 참가자는 메트포르민, 인슐린, 글루카곤 유사 펩티드-1(GLP-1) 수용체 작용제, SGLT2(나트륨 포도당 공동수송체) 억제제, 디펩티딜 펩티다제 4(DPP- 4) 억제제.
FOLFIRINOX의 4주기 후 CGM은 제거되지만 항고혈당 치료는 필요에 따라 계속됩니다. 참가자가 FOLFIRINOX로 치료를 중단하는 경우 생존 및 후속 항암 요법에 대해 계속해서 추적될 것이며 내분비학자 및/또는 의학 종양학자의 재량에 따라 포도당 관련 문제에 대한 후속 조치를 계속할 것입니다.
연구 개요
연구 유형
등록 (추정된)
단계
- 해당 없음
연락처 및 위치
연구 연락처
- 이름: Daniel Renouf, MD, MPH
- 전화번호: 800-663-3333
- 이메일: drenouf@bccancer.bc.ca
연구 장소
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British Columbia
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Vancouver, British Columbia, 캐나다, V5Z 4E6
- 모병
- British Columbia Cancer
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수석 연구원:
- Daniel Renouf, MD, MPH
-
연락하다:
- Daniel Renouf, MD, MPH
- 전화번호: 800-663-3333
- 이메일: drenouf@bccancer.bc.ca
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Ontario
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Toronto, Ontario, 캐나다, M5G 2M9
- 모병
- Princess Margaret Cancer Centre
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연락하다:
- Erica Tsang, MD, MPH
- 전화번호: 416-946-2000
- 이메일: erica.tsang@uhn.ca
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연락하다:
- Robert Grant, MD
- 전화번호: 416-946-2000
- 이메일: robert.grant@uhn.ca
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
설명
포함 기준:
- 췌관 선암종(PDAC)의 조직학적/세포학적 진단.
- FOLFIRINOX로 1차 전신 요법을 받을 계획입니다.
- 18세 이상의 연령.
- 동부 협력 종양학 그룹(ECOG) 수행 상태 0-1.
다음 실험실 값으로 정의된 적절한 골수 및 장기 기능:
- 1.5 x 10^9/L보다 크거나 같은 절대 호중구 수(ANC).
- 혈소판 수는 75 x 10^9/L 이상입니다.
- 9.0g/dL 이상의 헤모글로빈.
- Cockroft-Gault 방정식에 의한 예상 사구체 여과율(GFR) 또는 40ml/min 이상의 24시간 소변 수집.
- Cockcroft-Gault 공식을 사용하여 40mL/분 이상의 크레아티닌 청소율.
- 칼륨은 정상 범위 이내이거나 보충제로 교정됩니다.
- 국제 표준화 비율(INR)이 1.5 이하입니다.
- 총 혈청 빌리루빈이 정상 상한치(ULN)의 2배 이하(모든 상승된 빌리루빈은 등록 시 무증상이어야 함) ULN 또는 1.5 x ULN 이하의 직접 빌리루빈).
- ALT(Alanine aminotransferase) 및 AST(aspartate aminotransferase)는 2.5 x ULN 이하(또는 간 전이가 있는 경우 5 x ULN 이하)입니다.
- 정보에 입각한 동의서를 이해하고 자발적으로 서명할 수 있습니다.
- 연구 방문 일정 및 기타 프로토콜 요구 사항을 준수할 수 있습니다.
- 경구 약물을 삼킬 수 있으며 피하 인슐린 주사에 대한 금기 사항이 없습니다.
- 베이스라인에서 RECIST(Response Evaluation Criteria in Solid Tumors) 1.1에 의해 측정 가능하거나 평가 가능한 질병.
- 연구 의사가 판단한 90일 이상의 기대 수명.
제외 기준:
- 원격 또는 림프절 전이의 부재. 경계선 절제 가능 PDAC 또는 국소적으로 진행된 PDAC를 가진 참가자는 자격이 없습니다.
- 전이성 PDAC 치료를 위해 이전에 전신 요법(화학요법 또는 기타 항암제)을 받은 경우. 초기 질병의 외과적 절제 후 보조 화학 요법을 받은 참가자가 자격이 있습니다.
- 현재 항암 요법(화학 요법 또는 기타 항암제)을 받고 있습니다.
- 연구 의사가 판단한 병용 화학 요법에 적합하지 않습니다.
- 뇌 전이의 존재.
- 엄격한 포도당 조절 및 면밀한 내분비학 후속 조치가 이미 지시된 유형 I 당뇨병의 알려진 진단.
- 유형 II 당뇨병의 알려진 진단 및 이미 Endocrinologist에 의해 추적.
- 양성 임신 테스트를 받은 여성 참가자.
- 의학적 또는 비의학적 이유로 연구 의사가 판단한 연구에 포함하기에 안전하지 않은 참가자.
- 연구 평가 및 후속 조치를 준수할 수 없습니다.
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 해당 없음
- 중재 모델: 단일 그룹 할당
- 마스킹: 없음(오픈 라벨)
무기와 개입
참가자 그룹 / 팔 |
개입 / 치료 |
|---|---|
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실험적: Glucose Measurements via Blood Draws
Participants will have glucose levels measured using blood drawn prior to each cycle of systemic therapy.
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Blood glucose levels will be measured using blood drawn prior to each cycle of systemic therapy.
Anti-cancer treatment can follow standard care protocols or be given within another clinical trial.
Anti-hyperglycemic treatment will be administered when indicated by and following standard care protocols.
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연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Proportion of participants who experience at least one episode of hyperglycemia
기간: From baseline (up to 2 weeks prior to first dose) until progression of disease, assessed up to 24 months.
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The proportion of participants who experience at least one episode of hyperglycemia.
Hyperglycemia is defined by standard non-fasting criteria: random plasma glucose greater than or equal to 11.1 mmol/L or hemoglobin A1c greater than or equal to 6.5%.
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From baseline (up to 2 weeks prior to first dose) until progression of disease, assessed up to 24 months.
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Percentage of glucose measurements above the target range
기간: From baseline (up to 2 weeks prior to first dose) until progression of disease, assessed up to 24 months.
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The percentage of random plasma glucose measurements that are greater than or equal to 11.1 mmol/L or hemoglobin A1c measurements that are greater than or equal to 6.5%.
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From baseline (up to 2 weeks prior to first dose) until progression of disease, assessed up to 24 months.
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2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Overall response rate (ORR) of the cohort, as defined by RECIST 1.1
기간: From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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The proportion of participants who have a complete response (CR) or partial response (PR) to first-line systemic therapy, as defined by RECIST 1.1.
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From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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Progression-free survival (PFS) of the cohort from the initiation of first-line systemic therapy
기간: From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
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The length of time from the first dose of first-line systemic therapy until the date of progressive disease (PD), as defined by RECIST 1.1.
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From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
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Overall survival (OS) of the cohort from the initiation of first-line systemic therapy
기간: From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
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The length of time from the initiation of first-line systemic therapy that participants survive.
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From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
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기타 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
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Overall response rate (ORR) of the cohort, as defined by RECIST 1.1 and stratified by prognostic and metabolic gene expression subtypes of PDAC
기간: From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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The proportion of participants stratified by prognostic and metabolic gene expression subtypes of PDAC who have a complete response (CR) or partial response (PR) to first-line systemic therapy, as defined by RECIST 1.1.
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From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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Progression-free survival (PFS) of the cohort stratified by prognostic and metabolic gene expression subtypes of PDAC from the initiation of first-line systemic therapy
기간: From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
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The length of time from the first dose of first-line systemic therapy until the date of progressive disease (PD), as defined by RECIST 1.1, for participants stratified by prognostic and metabolic gene expression subtypes of PDAC.
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From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
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Overall survival (OS) of the cohort stratified by prognostic and metabolic gene expression subtypes of PDAC from the initiation of first-line systemic therapy
기간: From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
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The length of time from the initiation of first-line systemic therapy that participants survive stratified by prognostic and metabolic gene expression subtypes of PDAC.
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From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
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Overall response rate (ORR) of the cohort, as defined by RECIST 1.1 and stratified by clinical features (i.e. type 2 diabetes), pathological profiles, and genomic profiles
기간: From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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The proportion of participants stratified by clinical features (i.e.
type 2 diabetes), pathological profiles, and genomic profiles who have a complete response (CR) or partial response (PR) to first-line systemic therapy, as defined by RECIST 1.1.
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From the date of the screening scan (within 28 days of first dose) until the date of confirmed progression, assessed up to 24 months.
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Progression-free survival (PFS) of the cohort, stratified by clinical features (i.e. type 2 diabetes), pathological profiles, and genomic profiles from the initiation of first-line systemic therapy
기간: From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
|
The length of time from the first dose of first-line systemic therapy until the date of progressive disease (PD), as defined by RECIST 1.1, for participants stratified by clinical features (i.e.
type 2 diabetes), pathological profiles, and genomic profiles.
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From the date of first dose of first-line systemic therapy until the date of confirmed progression, assessed up to 24 months.
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Overall survival (OS) of the cohort stratified by clinical features (i.e. type 2 diabetes), pathological profiles, and genomic profiles from the initiation of first-line systemic therapy
기간: From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
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The length of time from the initiation of first-line systemic therapy that participants survive stratified by clinical features (i.e.
type 2 diabetes), pathological profiles, and genomic profiles.
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From the date of first dose of first-line systemic therapy until the date of death or end of study, assessed up to 24 months.
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Amount of insulin, measured in molar, for participants from screening until the end of study visit
기간: From the date of screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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The quantity of insulin, measured in molar from immunoassays, from blood samples collected throughout the study.
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From the date of screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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Amount of proinsulin, measured in molar, for participants from screening until the end of study visit
기간: From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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The quantity of proinsulin, measured in molar from immunoassays, from blood samples collected throughout the study.
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From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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Amount of C-peptide, measured in molar, for participants from screening until the end of study visit
기간: From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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The quantity of C-peptide, measured in molar from immunoassays, from blood samples collected throughout the study.
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From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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Amount of circulating biomarkers, measured in molar, for participants from screening until the end of study visit
기간: From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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The quantity of circulating biomarkers, measured in molar from immunoassays, from blood samples collected throughout the study.
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From the date of the screening blood sample collection until the date of the end of study blood sample collection (an average of 6 months).
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공동 작업자 및 조사자
수사관
- 수석 연구원: Daniel Renouf, MD, MPH, BC Cancer
간행물 및 유용한 링크
일반 간행물
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- Harris D, Barts A, Connors J, Dahl M, Elliott T, Kong J, Keane T, Thompson D, Stafford S, Ur E, Sirrs S. Glucocorticoid-induced hyperglycemia is prevalent and unpredictable for patients undergoing cancer therapy: an observational cohort study. Curr Oncol. 2013 Dec;20(6):e532-8. doi: 10.3747/co.20.1499.
- Huxley R, Ansary-Moghaddam A, Berrington de Gonzalez A, Barzi F, Woodward M. Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer. 2005 Jun 6;92(11):2076-83. doi: 10.1038/sj.bjc.6602619.
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- Kawada K, Toda K, Sakai Y. Targeting metabolic reprogramming in KRAS-driven cancers. Int J Clin Oncol. 2017 Aug;22(4):651-659. doi: 10.1007/s10147-017-1156-4. Epub 2017 Jun 24.
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연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (추정된)
연구 완료 (추정된)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
추가 관련 MeSH 약관
기타 연구 ID 번호
- H21-03061
약물 및 장치 정보, 연구 문서
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