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Oral, Fecal and Intratumoral Microbiome Atlas in Colombian Patients With Advanced Solid Tumors Receiving First-Line Immunotherapy (ATLAS)

3. juli 2026 oppdatert av: Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo

Atlas of the Oral, Fecal and Intratumoral Microbiome of Colombian Patients With Advanced Solid Tumors Candidates for First-Line Immunotherapy - Initial Phase of a Project With Latin American Projection

This is a prospective observational cohort study conducted at Fundación CTIC in Bogotá, Colombia. It characterizes the oral, fecal and intratumoral microbiome of Colombian adults with advanced solid tumors (gastric, colorectal, breast, cervical and head-and-neck cancer) who receive first-line immunotherapy as standard of care, and compares them with healthy volunteers. Using multi-omics (HiFi metagenomics, 16S, tumor RNA-Seq and untargeted metabolomics), the study aims to identify microbial signatures associated with treatment response and survival, building the initial Colombian cohort of a Cancer Microbiome Atlas with Latin American projection.

Studieoversikt

Status

Rekruttering

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

Single-center, prospective, observational cohort study. 120 patients with advanced (stage III unresectable or IV) solid tumors candidates for first-line immunotherapy and 30 healthy controls are enrolled (total N=150). Patients provide saliva, stool and tongue-scraping samples plus archival FFPE tumor tissue at baseline (V0) and at 6 (V1) and 12 (V2) months; controls provide saliva and stool at V0 only. Microbiomes are profiled by PacBio HiFi shotgun metagenomics and full-length 16S; tumor transcriptome by RNA-Seq; and saliva/stool metabolome by GC-MS in a subcohort (n=60). Tumor response is assessed by RECIST 1.1. Microbial, transcriptomic and metabolomic features are integrated with clinical outcomes (objective response, PFS, OS) using multivariable and machine-learning models.

Studietype

Observasjonsmessig

Registrering (Antatt)

150

Kontakter og plasseringer

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

Studiekontakt

Studer Kontakt Backup

  • Navn: Andrés F Cardona, MD, MSc, PhD, MBA
  • Telefonnummer: +573016348173
  • E-post: acardona@fctic.org

Studiesteder

  • Colombia
    • Bogota D.C.
      • Bogotá, Bogota D.C., Colombia, 110131
        • Rekruttering
        • Fundación CTIC - Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo
        • Ta kontakt med:
        • Hovedetterforsker:
          • Andrés F Cardona, MD, MSc, PhD, MBA

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

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Ja

Prøvetakingsmetode

Ikke-sannsynlighetsprøve

Studiepopulasjon

Colombian adults with advanced solid tumors (gastric, colorectal, breast, cervical, head-and-neck) candidates for first-line immunotherapy, plus healthy adult volunteers. Single center: Fundación CTIC, Bogotá.

Beskrivelse

Inclusion Criteria:

  • Age 18 years or older.
  • Histologically confirmed advanced (stage III unresectable or IV) gastric, colorectal, breast, cervical or head-and-neck cancer.
  • Candidate for first-line immunotherapy per current clinical guidelines.
  • Available FFPE tumor block in institutional or reference pathology archive.
  • Able to provide saliva and stool samples at V0 and follow-up.
  • ECOG performance status within protocol limits; life expectancy over 3 months.
  • Cognitive capacity to give informed consent; signed EVA-BIOBANCO and Atlas consents.

Inclusion Criteria (healthy controls)

  • No prior cancer diagnosis.
  • No active autoimmune disease; no inflammatory bowel disease.
  • No antibiotics, invasive dental treatment, immunosuppressants or corticosteroids in the prior 3 months; no severe active periodontal disease.

Exclusion Criteria:

  • Systemic antibiotics within 3 months (except short course under 5 days for uncomplicated infection).
  • Probiotics or prebiotics within 30 days.
  • Chronic proton-pump inhibitors for more than 3 continuous months.
  • Inflammatory bowel disease (Crohn, ulcerative colitis) or extensive bowel resection.
  • Pregnancy or lactation.
  • BMI under 18.5 or over 40 kg/m².
  • Uncontrolled diabetes (HbA1c at or above 9% in prior 3 months).
  • Invasive dental treatment within 3 months.
  • Patients: simultaneous randomized trial of a non-INVIMA-approved experimental immunotherapy; or no evaluable FFPE block meeting quality thresholds.
  • Inability to ensure 12-month clinical follow-up.

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
Intervensjon / Behandling
Patients with advanced solid tumors
120 Colombian adults with advanced (stage III unresectable or IV) gastric, colorectal, breast, cervical or head-and-neck cancer, candidates for first-line immunotherapy (standard of care). Saliva, stool and tongue scraping collected at V0, V1 (6 mo) and V2 (12 mo); archival FFPE tumor block retrieved at V0.
Legemiddel: First-line immunotherapy (immune checkpoint inhibitors), INVIMA-approved, standard of care
Exposure observed: first-line immunotherapy with immune checkpoint inhibitors administered as standard of care (INVIMA-approved); no experimental intervention is assigned by the study. Healthy controls receive no immunotherapy.
Healthy controls
30 healthy adult volunteers without prior cancer, active autoimmune disease or inflammatory bowel disease, and without antibiotics or invasive dental treatment in the prior 3 months. Saliva and stool collected at V0 only; no longitudinal follow-up.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Oral, fecal and intratumoral microbiome signatures associated with objective tumor response (RECIST 1.1) to first-line immunotherapy
Tidsramme: Baseline (V0) and through 12 months
Characterization of oral, fecal and intratumoral microbiomes and identification of taxa and diversity metrics differentiating responders (CR+PR) from non-responders (SD+PD) by RECIST 1.1.
Baseline (V0) and through 12 months
Differences in microbiome composition and diversity between cancer patients and healthy controls
Tidsramme: Baseline (V0)
Comparison of alpha and beta diversity and differential taxonomic and functional abundance between cancer patients and healthy controls.
Baseline (V0)

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Microbial, transcriptomic and metabolomic biomarkers associated with progression-free survival (PFS)
Tidsramme: Association of microbial diversity, key taxa, MAGs and functional pathways with progression-free survival, estimated by Kaplan-Meier and adjusted Cox models.
Up to 36 months
Association of microbial diversity, key taxa, MAGs and functional pathways with progression-free survival, estimated by Kaplan-Meier and adjusted Cox models.
Microbial biomarkers associated with overall survival (OS)
Tidsramme: Up to 36 months
Association of microbiome features with overall survival, estimated by Kaplan-Meier and adjusted Cox models.
Up to 36 months

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Tumor transcriptomic profile and gene-expression pathways modulated by the intratumoral microbiome
Tidsramme: Baseline (V0)
RNA-Seq characterization of tumor gene-expression and identification of pathways correlated with intratumoral microbiome composition.
Baseline (V0)
Untargeted salivary and fecal metabolomic profile (subcohort, n=60)
Tidsramme: Baseline through 12 months
GC-MS untargeted metabolomics of saliva and stool in a stratified subcohort (50 patients, 10 controls) to identify metabolites associated with microbiome composition and immunotherapy response.
Baseline through 12 months

Samarbeidspartnere og etterforskere

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

Sponsor

Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo

Samarbeidspartnere

American Society of Clinical Oncology

Etterforskere

  • Hovedetterforsker: Andrés F Cardona, MD, MSc, PhD, MBA, Fundación CTIC - Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo

Publikasjoner og nyttige lenker

Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.

Generelle publikasjoner

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)

11. juni 2026

Primær fullføring (Antatt)

28. februar 2029

Studiet fullført (Antatt)

30. august 2029

Datoer for studieregistrering

Først innsendt

24. juni 2026

Først innsendt som oppfylte QC-kriteriene

24. juni 2026

Først lagt ut (Faktiske)

30. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

7. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

3. juli 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • ATLAS
  • CEI-232 (Annen identifikator: Comité de Ética de la Investigación Riesgo de Fractura S.A)

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-planbeskrivelse

De-identified genomic sequences (oral, fecal and intratumoral microbiome) will be deposited in public repositories (NCBI SRA / EBI ENA) with minimal metadata (tumor type, age by decade, sex). Analysis pipelines and code will be versioned and shared via GitHub and Zenodo. Raw data and code will be made public at study close.

IPD-delingstidsramme

Available at study close (estimated 2029); retained at least 15 years per ICH-GCP archiving policy.

Tilgangskriterier for IPD-deling

Open access via public repositories (SRA, ENA, Zenodo) for de-identified sequence data and analysis code.

IPD-deling Støtteinformasjonstype

  • STUDY_PROTOCOL
  • SEVJE
  • ANALYTIC_CODE

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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