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Investigating Chemotherapy Treatments, Response and Subsets of HIV-associated Kaposi Sarcoma in Malawi

15 december 2020 uppdaterad av: UNC Lineberger Comprehensive Cancer Center
The purpose of this study is to identify important associations between complete and comprehensive clinical, laboratory, and genomic data derived from patients and tumor specimens, with prospectively recorded clinical outcomes. The investigators also hope to move beyond simple risk factor associations as previously described, to develop a composite score specifically for KS recurrence or progression, analogous to widely used risk scores that are used to direct up-front treatment of other cancers. In so doing, the investigators will draw on extremely granular data to prospectively identify patients who are most likely to benefit from new treatments.

Studieöversikt

Status

Avslutad

Betingelser

Detaljerad beskrivning

This is a prospective, nonrandomized, open-label, single arm, cohort study of pathologically confirmed HIV-associated KS patients initiating chemotherapy in Malawi. The primary objective of this study is to estimate the complete response rate (CR by ACTG criteria) at 48 weeks. This will be done both overall and by chemotherapy (BV or not BV) treatment group. Secondary objectives are to estimate PFS and OS for both overall and by chemotherapy treatment group. Exploratory objectives include the investigation of: select clinical variables and laboratory biomarkers among HIV-associated KS patients and their possible association with response, PFS, and OS; the histopathology of KSHV-associated lymphoproliferative diseases among HIV-associated KS patients; KSHV strains in tumor biopsies, PBMC and plasma, and KSHV gene expression characteristics between KS that develops on and off ART.

The investigators plan to accrue 200 HIV-associated KS patients at a rate of approximately 50 patients per year. Approximately half of the patients will receive BV chemotherapy treatment. An important factor for this study's size is that it will be comparable to or exceed the size of other important KS cohort studies, which have demonstrated significant differences in outcomes based on gender or baseline KSHV DNA levels.

The investigators want to show that there are definable biologic and clinical subsets within the HIV-associated KS population, and that identifying these subsets will have direct relevance to more effective treatment strategies for these patients.

Studietyp

Observationell

Inskrivning (Faktisk)

157

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Malawi
      • Lilongwe, Malawi
        • UNC Project
      • Lilongwe, Malawi
        • UNC Project, Lighthouse Trust

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 99 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Testmetod

Sannolikhetsprov

Studera befolkning

HIV-infected adults ≥18 years of age with pathologically confirmed KS who are initiating chemotherapy at Lighthouse Trust or the KCH Cancer Clinic.

Beskrivning

Inclusion Criteria:

  • Histologically confirmed KS initiating chemotherapy at Lighthouse Trust or the Kamuzu Central Hospital (KCH) Cancer Clinic
  • HIV positive (confirmed at any time point prior by local standard of care assay) on or off ART
  • Age ≥18 years
  • Residence <200 kilometers from KCH
  • Able to understand and comply with study procedures for the entire length of the study
  • Subject able to understand and provide written consent in English or Chichewa Informed consent reviewed and signed by patient

Exclusion Criteria:

  • Failure to meet inclusion criteria listed above.
  • Specifically, pregnancy and breastfeeding are not exclusion criteria given the observational nature of the study with diagnostic and treatment interventions administered according to local standards of care.
  • KS relapse disease as defined by a prior KS diagnosis within 1 year prior to enrollment.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Estimate the complete response rate (CR) at 48 weeks of HIV-associated KS patients overall and by BV treatment group.
Tidsram: 48 weeks
the assessment of a patient's response (CR) to chemotherapy at 48 weeks by ACTG criteria
48 weeks

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Estimate the Progression Free Survival (PFS) in HIV-associated KS patients overall and by bleomycin-vincristine (BV) treatment group
Tidsram: 48 weeks
PFS which will be defined as the time from treatment initiation until disease progression or death
48 weeks
Estimate OS in HIV-associated KS patients overall and by BV treatment group
Tidsram: 48 weeks
To estimate OS in HIV-associated KS patients overall and by BV treatment group
48 weeks

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
The clinical variables and laboratory biomarkers among HIV-associated KS patients and their possible association with response, PFS, and OS
Tidsram: 48 weeks
The prevalence and nature of lymphoproliferative diseases among HIV-associated KS patients
48 weeks
The histopathology of KSHV-associated lymphoproliferative diseases among HIV-associated KS patients
Tidsram: 48 weeks
KSHV gene expression characteristics for HIV-associated KS that develops on and off antiretroviral therapy (ART)
48 weeks
The kind of KSHV strains in tumor biopsies, PBMC and plasma
Tidsram: 48 weeks
Viral genome features of HIV-associated KS
48 weeks
The KSHV gene expression characteristics between KS that develops on and off ART
Tidsram: 48 weeks
To describe KSHV gene expression characteristics between KS that develops on and off ART
48 weeks

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

UNC Lineberger Comprehensive Cancer Center

Samarbetspartners

National Cancer Institute (NCI)

Utredare

  • Huvudutredare: Dirk Dittmer, UNC-CH

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 september 2016

Primärt slutförande (Faktisk)

1 oktober 2020

Avslutad studie (Faktisk)

1 oktober 2020

Studieregistreringsdatum

Först inskickad

2 maj 2017

Först inskickad som uppfyllde QC-kriterierna

17 maj 2017

Första postat (Faktisk)

19 maj 2017

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

17 december 2020

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

15 december 2020

Senast verifierad

1 december 2020

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • LCCC 1424

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

OBESLUTSAM

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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