- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT07684066
D-TECT: Pretreatment D-dimers and Disease Control in Advanced cSCC Treated With Cemiplimab (D-TECT)
D-TECT: Prospective Multicenter Evaluation of Pretreatment D-dimer Levels as a Predictor of Disease Control in Advanced Cutaneous Squamous Cell Carcinoma Treated With Cemiplimab
D-TECT is a prospective, multicenter, non-interventional observational study investigating whether pretreatment D-dimer levels predict disease control in patients with locally advanced or metastatic cutaneous squamous cell carcinoma treated with cemiplimab in routine clinical care.
D-dimers are routinely available laboratory markers related to activation of the coagulation system. Previous single-center data suggest that elevated pretreatment D-dimer levels may be associated with poorer disease control under cemiplimab. In D-TECT, a single pretreatment D-dimer value and prospectively collected routine clinical follow-up data will be analyzed to validate this association in a multicenter real-world setting. No study-specific treatment decisions, imaging procedures, or additional blood draws are mandated by the study.
Przegląd badań
Status
Warunki
Interwencja / Leczenie
Szczegółowy opis
Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin cancers. While most cases can be treated with curative local therapy, a subgroup of patients develops locally advanced or metastatic disease requiring systemic treatment. Cemiplimab, a PD-1 inhibitor, is an established systemic treatment option for advanced cSCC. However, validated routine biomarkers predicting disease control under cemiplimab are lacking.
D-dimers are fibrin degradation products and sensitive markers of coagulation activation. In a prior single-center retrospective analysis, elevated pretreatment D-dimer levels were associated with lower disease control, lower objective response, and shorter progression-free survival in patients with advanced cSCC treated with cemiplimab. D-TECT is designed to prospectively validate this observation in a multicenter real-world cohort.
Eligible patients are adults with histologically confirmed locally advanced or metastatic cSCC for whom cemiplimab treatment is planned as part of routine clinical care. A D-dimer measurement is documented within 7 days before the first cemiplimab dose up to the day of first administration before infusion. Subsequent clinical data, including tumor response, progression, survival, treatment discontinuation, and thromboembolic events, are collected from routine medical records during follow-up.
The primary endpoint is disease control within the first 6 months after initiation of cemiplimab. The primary confirmatory analysis compares disease control between patients with high versus low pretreatment D-dimer values using the prespecified cutoff of 0.91 mg/L FEU derived from the prior single-center study. If the primary analysis is statistically significant, the same primary endpoint will be tested hierarchically using the local laboratory-defined upper limit of normal. Additional analyses include objective response rate, progression-free survival, overall survival, thromboembolic events, diagnostic performance measures of the predefined cutoffs, sensitivity analyses, and exploratory analyses addressing inter-site assay heterogeneity.
Typ studiów
Zapisy (Szacowany)
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Glenn Geidel, MD, MSc
- Numer telefonu: +49 (0)40 7410 70743
- E-mail: g.geidel@uke.de
Lokalizacje studiów
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Salzburg, Austria, 5020
- University Medical Center Salzburg
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Kontakt:
- Matthias Brandlmaier, MD, PhD, MSc
- Numer telefonu: +43 (0) 57255 24601
- E-mail: m.brandlmaier@salk.at
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Główny śledczy:
- Matthias Brandlmaier, MD, PhD, MSc
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Bielefeld, Niemcy, 33647
- University Medical Center OWL, Campus Klinikum Bielefeld Rosenhöhe
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Kontakt:
- Selma Ugurel, MD
- Numer telefonu: +49 (0)521 9438801
- E-mail: selma.ugurel@klinikumbielefeld.de
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Główny śledczy:
- Selma Ugurel, MD
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Bremerhaven, Niemcy, 27574
- Klinikum Bremerhaven Reinkenheide
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Kontakt:
- Michael M. Sachse, MD
- Numer telefonu: +49 (0)471 2993700
- E-mail: Michael.Sachse@klinikum-bremerhaven.de
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Główny śledczy:
- Michael M. Sachse, MD
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Buxtehude, Niemcy, 21614
- Elbe Klinikum Buxtehude
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Kontakt:
- Kai-Martin Thoms, MD
- Numer telefonu: +49 (0)4161 7036250
- E-mail: kai-martin.thoms@elbekliniken.de
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Główny śledczy:
- Kai-Martin Thoms, MD
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Erlangen, Niemcy, 91054
- University Medical Center Erlangen
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Kontakt:
- Markus V. Heppt, MD, PhD, MHBA
- Numer telefonu: +49 (0)9131 8533165
- E-mail: onkstudienzentrale.DE@uk-erlangen.de
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Główny śledczy:
- Markus V. Heppt, MD, PhD, MHBA
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Göttingen, Niemcy, 37075
- University Medical Center Göttingen
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Kontakt:
- Katharina Amschler, MD
- Numer telefonu: +49 (0)551 3968082
- E-mail: katharina.amschler@med.uni-goettingen.de
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Główny śledczy:
- Katharina Amschler, MD
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Hamburg, Niemcy, 20246
- University Medical Center Hamburg-Eppendorf
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Kontakt:
- Glenn Geidel, MD, MSc
- Numer telefonu: +49 (0)40 741070743
- E-mail: g.geidel@uke.de
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Główny śledczy:
- Glenn Geidel, MD, MSc
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Hanover, Niemcy, 30625
- Hannover Medical School
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Kontakt:
- Imke von Wasielewski, MD
- Numer telefonu: +49 (0)5115320
- E-mail: vonWasielewski.Imke@mh-hannover.de
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Główny śledczy:
- Imke von Wasielewski, MD
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Kiel, Niemcy, 24105
- University Medical Center Schleswig-Holstein, Campus Kiel
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Główny śledczy:
- Katharina Kähler, MD
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Kontakt:
- Katharina Kähler, MD
- Numer telefonu: +49 (0)431 50021131
- E-mail: Katharina.Kaehler@uksh.de
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Lübeck, Niemcy, 23538
- University Medical Center Schleswig-Holstein, Campus Lübeck
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Kontakt:
- Dagmar von Bubnoff, MD
- Numer telefonu: +49 (0)451 50041501
- E-mail: DagmarAngela.vonbubnoff@uksh.de
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Główny śledczy:
- Dagmar von Bubnoff, MD
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Mainz, Niemcy, 55131
- University Medical Center Mainz
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Kontakt:
- Henner Stege, MD
- Numer telefonu: +49 (0)6131 172919
- E-mail: Henner.Stege@unimedizin-mainz.de
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Główny śledczy:
- Henner Stege, MD
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Mannheim, Niemcy, 68167
- University Medical Center Mannheim
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Główny śledczy:
- Jochen Utikal, MD
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Kontakt:
- Jochen Utikal, MD
- Numer telefonu: +49 (0)621 3834461
- E-mail: jochen.utikal@umm.de
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Minden, Niemcy, 32429
- Johannes Wesling Klinikum Minden
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Kontakt:
- Ralf Gutzmer, MD
- Numer telefonu: +49 (0)571 7904501
- E-mail: dermatologie-minden@muehlenkreiskliniken.de
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Główny śledczy:
- Ralf Gutzmer, MD
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Rostock, Niemcy, 18057
- University Medical Center Rostock
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Kontakt:
- Markus Thieme, MD
- Numer telefonu: +49 (0) 381 494 9789
- E-mail: Markus.Thieme@med.uni-rostock.de
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Główny śledczy:
- Markus Thieme, MD
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Tübingen, Niemcy, 72076
- University Medical Center Tübingen
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Główny śledczy:
- Ulrike Leiter, MD
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Kontakt:
- Ulrike Leiter, MD
- Numer telefonu: +49 (0)7071 2984555
- E-mail: ulrike.leiter@med.uni-tuebingen.de
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Metoda próbkowania
Badana populacja
Opis
Inclusion Criteria:
- Histologically confirmed locally advanced or metastatic cutaneous squamous cell carcinoma
- Planned initiation of systemic treatment with cemiplimab as part of routine clinical care
- Pretreatment D-dimer measurement performed within 7 days before initiation of cemiplimab treatment up to the day of first administration before infusion
- Age 18 years or older at the time of consent
- ECOG performance status 0 to 2
- Written informed consent for study participation and pseudonymized collection and analysis of clinical and laboratory data
Exclusion Criteria:
- Prior treatment with immune checkpoint inhibitors in curative or palliative intent for cutaneous squamous cell carcinoma
- Concurrent second malignancy requiring systemic treatment, such as chemotherapy, immunotherapy, or targeted therapy
- Clinically unstable comorbidity, including NYHA class III-IV heart failure or active systemic infection
- Acute symptomatic thrombosis or pulmonary embolism within 4 weeks before the pretreatment D-dimer measurement
- Incidental asymptomatic thromboembolic events detected during clinical diagnostic work-up or following an elevated D-dimer result are not exclusion criteria and will be documented
- Physician-estimated life expectancy of less than 3 months or severe non-tumor-related comorbidity likely to preclude assessment of the clinical course within the first 6 months
- Lack of capacity to consent or legal guardianship without valid legal representation
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
Kohorty i interwencje
Grupa / Kohorta |
Interwencja / Leczenie |
|---|---|
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High pretreatment D-dimer
Patients with locally advanced or metastatic cutaneous squamous cell carcinoma treated with cemiplimab in routine clinical care and a pretreatment D-dimer level above the prespecified cutoff of 0.91 mg/L FEU.
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Pretreatment D-dimer status is defined using a single D-dimer measurement obtained in routine clinical laboratory testing within 7 days before the first cemiplimab dose up to the day of first administration before infusion.
D-dimer status is not used to assign treatment and does not mandate any study-specific diagnostic or therapeutic intervention.
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Low pretreatment D-dimer
Patients with locally advanced or metastatic cutaneous squamous cell carcinoma treated with cemiplimab in routine clinical care and a pretreatment D-dimer level at or below the prespecified cutoff of 0.91 mg/L FEU.
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Pretreatment D-dimer status is defined using a single D-dimer measurement obtained in routine clinical laboratory testing within 7 days before the first cemiplimab dose up to the day of first administration before infusion.
D-dimer status is not used to assign treatment and does not mandate any study-specific diagnostic or therapeutic intervention.
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Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Disease Control Rate Within the First 6 Months of Cemiplimab Treatment
Ramy czasowe: From start of cemiplimab treatment through 6 months
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Disease control rate is defined as the proportion of participants with complete response, partial response, or stable disease according to clinical and/or radiological assessment in routine care within the first 6 months after initiation of cemiplimab.
Participants with documented progression, death, or treatment discontinuation due to clinical progression within the first 6 months are considered not to have disease control.
Participants without documented progression or death but without evaluable clinical or radiological follow-up assessment within the first 6 months are considered not evaluable for the primary analysis.
The primary confirmatory analysis compares disease control between participants with high versus low pretreatment D-dimer levels using the prespecified cutoff of 0.91 mg/L FEU.
If statistically significant, the same primary endpoint will be tested hierarchically using the local laboratory-defined upper limit of normal.
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From start of cemiplimab treatment through 6 months
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Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Objective Response Rate
Ramy czasowe: From start of cemiplimab treatment through 24 months
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Objective response rate is defined as the proportion of participants with complete response or partial response according to clinical and/or radiological assessment in routine care during follow-up.
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From start of cemiplimab treatment through 24 months
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Progression-Free Survival
Ramy czasowe: From start of cemiplimab treatment through 24 months
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Progression-free survival is defined as the time from initiation of cemiplimab treatment to the first documented disease progression or death from any cause, whichever occurs first.
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From start of cemiplimab treatment through 24 months
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Overall Survival
Ramy czasowe: From start of cemiplimab treatment through 24 months
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Overall survival is defined as the time from initiation of cemiplimab treatment to death from any cause.
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From start of cemiplimab treatment through 24 months
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Thromboembolic Events During Follow-up
Ramy czasowe: From start of cemiplimab treatment through 24 months
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Incidence of venous or arterial thromboembolic events documented during follow-up and evaluated in relation to pretreatment D-dimer levels.
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From start of cemiplimab treatment through 24 months
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Diagnostic Performance of Prespecified D-dimer Cutoffs for 6-Month Disease Control
Ramy czasowe: From start of cemiplimab treatment through 6 months
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Sensitivity, specificity, positive predictive value, and negative predictive value of the prespecified D-dimer cutoff of 0.91 mg/L FEU and of the local laboratory-defined upper limit of normal for disease control within the first 6 months after initiation of cemiplimab.
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From start of cemiplimab treatment through 6 months
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Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Cumulative Incidence of Documented Disease Progression Accounting for Death as a Competing Event
Ramy czasowe: From start of cemiplimab treatment through 24 months
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Exploratory competing-risk analysis of the cumulative incidence of documented disease progression, treating death without prior documented progression as a competing event.
Deaths without prior documented progression will additionally be described by cause of death where available from the medical record.
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From start of cemiplimab treatment through 24 months
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Association of Pretreatment D-dimer Levels With Clinical Outcomes in Multivariable Models
Ramy czasowe: From start of cemiplimab treatment through 24 months
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Exploratory multivariable models evaluating the association between pretreatment D-dimer levels and clinical outcomes while accounting for predefined clinical covariates such as performance status, lactate dehydrogenase, comorbidities, and anticoagulation.
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From start of cemiplimab treatment through 24 months
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Exploratory Analysis of Assay-Related Heterogeneity in D-dimer Measurements
Ramy czasowe: Baseline through 24 months
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Exploratory evaluation of inter-site heterogeneity in D-dimer assays, measurement units, and local reference ranges.
Analyses may include ULN-normalized D-dimer values defined as the quotient of the measured value and the local upper limit of normal.
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Baseline through 24 months
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Współpracownicy i badacze
Śledczy
- Główny śledczy: Glenn Geidel, MD, MSc, Universitätsklinikum Hamburg-Eppendorf
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
- D-TECT
- DRKS00040746 (Identyfikator rejestru: German Clinical Trials Register)
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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