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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 uppdaterad 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.

Studieöversikt

Status

Rekrytering

Betingelser

Intervention / Behandling

Detaljerad beskrivning

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.

Studietyp

Observationell

Inskrivning (Beräknad)

150

Kontakter och platser

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

Studiekontakt

Studera Kontakt Backup

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

Studieorter

  • Colombia
    • Bogota D.C.
      • Bogotá, Bogota D.C., Colombia, 110131
        • Rekrytering
        • Fundación CTIC - Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo
        • Kontakt:
        • Huvudutredare:
          • Andrés F Cardona, MD, MSc, PhD, MBA

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

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Ja

Testmetod

Icke-sannolikhetsprov

Studera befolkning

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.

Beskrivning

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

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

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Intervention / 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.
Läkemedel: 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.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Oral, fecal and intratumoral microbiome signatures associated with objective tumor response (RECIST 1.1) to first-line immunotherapy
Tidsram: 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
Tidsram: Baseline (V0)
Comparison of alpha and beta diversity and differential taxonomic and functional abundance between cancer patients and healthy controls.
Baseline (V0)

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Microbial, transcriptomic and metabolomic biomarkers associated with progression-free survival (PFS)
Tidsram: 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)
Tidsram: Up to 36 months
Association of microbiome features with overall survival, estimated by Kaplan-Meier and adjusted Cox models.
Up to 36 months

Andra resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Tumor transcriptomic profile and gene-expression pathways modulated by the intratumoral microbiome
Tidsram: 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)
Tidsram: 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

Samarbetspartners och utredare

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

Sponsor

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

Samarbetspartners

American Society of Clinical Oncology

Utredare

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

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

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 (Faktisk)

11 juni 2026

Primärt slutförande (Beräknad)

28 februari 2029

Avslutad studie (Beräknad)

30 augusti 2029

Studieregistreringsdatum

Först inskickad

24 juni 2026

Först inskickad som uppfyllde QC-kriterierna

24 juni 2026

Första postat (Faktisk)

30 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

7 juli 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

3 juli 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

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

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

JA

IPD-planbeskrivning

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.

Tidsram för IPD-delning

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

Kriterier för IPD Sharing Access

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

IPD-delning som stöder informationstyp

  • STUDY_PROTOCOL
  • SAV
  • ANALYTIC_CODE

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Nej

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