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Predicting Response to Immunotherapy for Melanoma With Gut Microbiome and Metabolomics (PRIMM)

25. februar 2020 oppdatert av: East and North Hertfordshire NHS Trust
This study will investigate the effects of gut microbiome diversity (richness in terms of many bacterial species in the gut) on responses and side effects of immunotherapy in advanced melanoma patients. Immunotherapy for melanoma is especially damaging for the gut with colitis which can lead to death and significant morbidity with repeated hospital admissions. The richness of the microbiome in the gut may be protective against colitis and other side effects but this needs to be confirmed. There is also some preliminary evidence that the gut microbiome diversity can enhance responses to immunotherapy in cancer but this has been shown in small numbers of melanoma patients.

Studieoversikt

Status

Rekruttering

Forhold

Detaljert beskrivelse

This pilot project will assess the gut microbiome with metagenome sequencing before and after starting immunotherapy in stage 3 and 4 melanoma patients. The project will assess the impact of the gut microbiome on treatment response rates and side effects induced by immunotherapy.

200 stage 4 and 250 stage 3 melanoma patients naive to immunotherapy will be recruited from melanoma clinics. Stool samples will be donated pre-treatment and at follow-up visits throughout treatment. An additional sample will also be requested in the event of disease progression or toxicity necessitating treatment delay or discontinuation. An accompanying stool sample questionnaire will be completed at each sampling time point with the optional completion of a 24-hour recall food diary.

Blood samples will also be taken before and after starting immunotherapy treatment, with gastrointestinal, food frequency, quality of life questionnaires administered at baseline. An optional tumour biopsy if safe and accessible, is requested from patients in the stage 4 cohort before and after starting immunotherapy.

Microbiome data from melanoma patients will be compared with the TwinsUK healthy control gut microbiome data on more than 3000 healthy adults. This analysis will help us assess if there are major differences between the microbiome composition in the melanoma cases prior to therapy compared to the control gut microbiome data from TwinsUK.

Studietype

Observasjonsmessig

Registrering (Forventet)

450

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studer Kontakt Backup

Studiesteder

      • London, Storbritannia
        • Rekruttering
        • Guy's and St. Thomas' NHS Foundation Trust
        • Ta kontakt med:
          • Mark Harries
      • Manchester, Storbritannia
        • Rekruttering
        • The Christie NHS Foundation Trust
        • Ta kontakt med:
          • Paul Lorrigan
      • Preston, Storbritannia
        • Rekruttering
        • Lancashire Teaching Hospitals NHS Foundation Trust
      • Wirral, Storbritannia
        • Rekruttering
        • The Clatterbridge Cancer Centre
        • Ta kontakt med:
          • Joseph Sacco
    • Middlesex
      • Northwood, Middlesex, Storbritannia, HA62RN

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

Patients with stage 3 or 4 melanoma

Beskrivelse

Inclusion Criteria:

- Patients aged over the age of 18 years with advanced melanoma due to receive first line systemic treatment with immunotherapy with a checkpoint inhibitor alone or in combination.

Exclusion Criteria:

  • Patients who have had systemic anti-cancer treatment for locally advanced or metastatic disease.
  • Patients unable to consent because of language barrier or inability to consent.
  • Patients unable to collect or send the stool samples for geographical, social or psychological reasons.
  • Persons benefitting from protection system of adults (including guardianship and curatorship)
  • Pregnant or breastfeeding women

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

Kohorter og intervensjoner

Gruppe / Kohort
Cohort A
Patients with stage 4 melanoma due to commence immunotherapy. Patients should be naïve to immunotherapy.
Cohort B
Patients with stage 3 melanoma who are naïve to immunotherapy

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Gut microbiome diversity via measurement of bacterial species in stool samples
Tidsramme: 3-5 years
Gut microbiome diversity and peripheral blood mononuclear cells immunophenotyping in relation to responses to treatment and side effects in patients with stage 3 or stage 4 melanoma receiving immunotherapy
3-5 years
Peripheral blood monocyte measurements to determine the characterisation of peripheral blood mononuclear cells (immunophenotyping) and inflammatory markers before and after starting immunotherapy treatment.
Tidsramme: 3-5 years
Gut microbiome diversity and peripheral blood mononuclear cells immunophenotyping in relation to responses to treatment and side effects in patients with stage 3 or stage 4 melanoma receiving immunotherapy.
3-5 years
Side effects as determined by CTCAE scale Common Toxicity Criteria for Adverse Events v5.03
Tidsramme: 3-5 years
Gut microbiome diversity and peripheral blood mononuclear cells immunophenotyping in relation to responses to treatment and side effects in patients with stage 3 or stage 4 melanoma receiving immunotherapy.
3-5 years

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Analysis of optional punch biopsy samples before and after commencing immunotherapy treatment in patients with stage 4 melanoma
Tidsramme: 3-5 years
Exploratory analysis to examine the association between the gut microbiome and the presence of tumour infiltrates and regulatory environments.
3-5 years

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

4. april 2018

Primær fullføring (Forventet)

2. mai 2023

Studiet fullført (Forventet)

2. mai 2023

Datoer for studieregistrering

Først innsendt

10. august 2018

Først innsendt som oppfylte QC-kriteriene

21. august 2018

Først lagt ut (Faktiske)

22. august 2018

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

27. februar 2020

Siste oppdatering sendt inn som oppfylte QC-kriteriene

25. februar 2020

Sist bekreftet

1. februar 2020

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

NEI

IPD-planbeskrivelse

The research results will be published in international journals and presented at scientific meetings.

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

Denne informasjonen ble hentet direkte fra nettstedet clinicaltrials.gov uten noen endringer. Hvis du har noen forespørsler om å endre, fjerne eller oppdatere studiedetaljene dine, vennligst kontakt register@clinicaltrials.gov. Så snart en endring er implementert på clinicaltrials.gov, vil denne også bli oppdatert automatisk på nettstedet vårt. .

Kliniske studier på Melanom (hud)

Abonnere