治験レーダーAI | ||
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治験 NCT06073431 (LOTUS-CC)(対象:進行大腸癌、進行肺非小細胞癌、進行性膵腺癌、ステージ IV 大腸がん AJCC v8、ステージIV肺がん AJCC v8、ステージIV膵臓がん AJCC v8、切除不能大腸癌、切除不能肺非小細胞癌、切除不能膵腺癌)は募集中です。詳細は治験レーダーのタイル表示と AI 発見ツールで確認するか、ここで質問してください。 | ||
An Observational Research Study to Uncover Subtypes of Cancer Cachexia (LOTUS-CC)
I. To identify multiple distinct diagnostic subtypes within the syndrome of CC as defined by host characteristics (e.g. cachexia symptoms, physical activity, physical function, blood biomarkers including hemoglobin and albumin, and body composition) at baseline and change in these factors over time in patients with cancer at high risk for CC.
SECONDARY OBJECTIVES:
I. To determine the association of each CC phenotype with overall survival. II. To validate CC diagnostic phenotypes developed in a separate, independent cachexia observational study performed by our collaborators at Kaiser Permanente.
III. To collect human samples of blood, tumor tissue, and medical images and build a large, comprehensive CC database clinically annotated with cancer-related outcomes, cachexia symptoms, and physical function data.
EXPLORATORY OBJECTIVE:
I. To evaluate for tumor-derived factors contributing to CC by determining the association between interleukin-6 (IL-6) expression in tumor and IL-6 and CC chemokine ligand 2 (CCL2) levels in the blood in patients with CC.
OUTLINE: This is an observational study.
Patients complete surveys over 30 minutes, undergo physical function tests over 30 minutes, undergo collection of blood and archived tumor samples, and wear actigraph over 24 hours for 7 days to record daily sleep and exercise activity at baseline and 3-month follow-up. Additionally, patients undergo standard of care positron emission tomography (PET)/computed tomography (CT) scans throughout the study and patients' medical records are also reviewed at baseline, 3-month and 1-year follow-up.
Longitudinal Observational Trial to Uncover Subtypes of Cancer Cachexia
- LOTUS-CC
- URCC-22063
- NCI-2023-04268 (登録識別子) (CTRP (Clinical Trial Reporting Program))
- URCC-22063 (その他の識別子) (University of Rochester NCORP Research Base)
- URCC-22063 (その他の識別子) (DCP)
- URCC-22063 (その他の識別子) (CTEP)
- UG1CA189961 (米国NIHの助成金/契約)
| 参加グループ/群 | 介入/治療法 |
|---|---|
Observational (survey, function tests, biospecimen, actigraph) Patients complete surveys over 30 minutes, undergo physical function tests over 30 minutes, undergo collection of blood and archived tumor samples, and wear actigraph over 24 hours for 7 days to record daily sleep and exercise activity at baseline and 3-month follow-up. Additionally, patients undergo standard of care PET/CT scans throughout the study and patients' medical records are also reviewed at baseline, 3-month and 1-year follow-up. | 生体試料採取 Undergo collection of blood and archived tumor samples コンピュータ断層撮影 Undergo PET/CT scan 電子カルテ Review of medical record 医療機器の使用と評価 Wear actigraph 身体能力検査 Undergo physical function tests 陽電子放出断層撮影 Undergo PET/CT scan 調査管理 Complete surveys |
| 評価指標 | 指標の説明 | 時間枠 |
|---|---|---|
Identification of multiple distinct diagnostic subtypes within the syndrome of cancer cachexia (CC) | Defined by host characteristics (e.g. cachexia symptoms, physical activity, physical function, blood biomarkers including hemoglobin and albumin, and body composition) at baseline and change in these factors over time in patients with cancer at high risk for CC. First, will examine the distributions of each variable and assess the need for using transformations to achieve normality for continuous variables (log transformation, quartiles, or clinically important thresholds), collapsing similar variables into single categories, and excluding g conditions that are too rare (\< 1% of the cohort). Next, will assess statistical correlations using the Jaccard similarity metric for binary variables and the Pearson correlation for continuous variables to determine highly correlated variables that may provide redundant information. | Baseline through study completion, assessed up to 1 year follow up |
| 評価指標 | 指標の説明 | 時間枠 |
|---|---|---|
Association of each CC phenotype (clusters) with overall survival | Will be assessed in the Cox regression model. Will estimate the bivariate association where the only independent variables will be the indicators for the cluster membership. Will report the hazard ratio for the association of each CC phenotype, specifying the lowest-risk cluster as the reference. Will assess the influence of selected factors (e.g., age, performance status, and other known prognostic factors) on the association of the cluster with survival by adding the factor to the model as a covariate and keeping those that resulted in 10% or more change in any regression coefficients for cluster membership. Will assess if the association of clusters with survival varies by specific subgroups (e.g., older versus younger age, gender, and cancer type). Will assess the statistical significance interaction of the subgroup with the cluster membership by maximum likelihood test and evaluate the regression coefficients for clusters in each subgroup comparing the direction and magnitude. | Days from registration (day 0) to death (the event) or the last contact (censored), assessed up to 1 year follow up |
Validation of CC diagnostic phenotypes developed in a separate, independent cachexia observational study performed by collaborators at Kaiser Permanente | Study participants will be categorized into the Kaiser Permanente Medical Care (KPMC)-derived CC phenotype groups. Will use the final latent class analysis model fit in the KPMC data to compute the posterior probabilities of membership in each latent class for each individual National Cancer Institute Community Oncology Research Program (NCORP) participant based on his/her individual data. Will compare cluster prevalence in each cohort as well as the distributions of the variables used to determine each cluster to investigate patterns of commonality and dissimilarity across the contributing variables. Validation will be determined by fitting University of Rochester Cancer Center (URCC) NCORP participants in KPMC-derived clusters and evaluating each cluster's association with survival. If the ranking of survival (best to worst) among each cluster in the URCC NCORP dataset mirrors the prognostic ranking of clusters in the KPMC dataset, the clusters will be deemed validated. | Up to study completion, assessed up to 1 year |
Have a primary diagnosis of unresectable or stage IV 1) non-small cell lung cancer (NSCLC), 2) pancreatic adenocarcinoma, or 3) colorectal cancer
- Note: Patients do not need to have cachexia to be eligible
Plan to start first-line systemic anti-cancer therapy (chemotherapy, immunotherapy, targeted therapy, interventional clinical trial) in the next 6 weeks or has started first-line systemic therapy in the previous 6 weeks.
- NOTE: Patients who received systemic anti-cancer therapy previously as part of adjuvant or neoadjuvant treatment and have since recurred are still eligible if such treatment ended > 6 months prior to enrollment. Patients receiving concurrent radiation with systemic therapy or received local therapy alone (surgery, radiation therapy [RT]) prior to first line therapy remain eligible. Patients receiving maintenance treatment after first line therapy are not eligible
Have an Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
Be able to understand, speak and read English
Be 18 years of age or older
- Have contraindications to physical function assessments (30-second arm curl, Timed-Up-And-Go test, or 30-second chair-stand test) per the treating provider or their designee
- Have any planned major surgeries within the next 3 months
- Have received chemotherapy or surgery for separate primary cancer within the past 3 years other than early local staged non-melanoma skin cancer
- Be pregnant
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