Pancreatic CancerFlownetNCT04294589
Evaluation of NETs in Patients With Solid Cancers Associated With a High Risk of Venous Thromboembolic Events
An observational study of Pancreatic Cancer and Gastric Cancer, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
Trial summary
Venous Thromboembolic Events (ETVs) are the second leading cause of death (9.2% of causes of death) in cancer patients after tumor progression (1). Indeed, cancer is associated with a 4 to 7-fold risk of ETV during chemotherapy (2). Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Pancreatic Cancer, Gastric Cancer, Colorectal Cancer
- How many people
- 250 participants
- Where
- 1 siteFrance
- Study dates
- 1 Jul 2019to Dec 2020
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Adult, Older adult
Study population: People with pancreatic, gastric or colorectal cancer at high risk of ETV, on the first line of treatment or relapsing after a period of complete remission.
Who may be able to join
- Male or Female over 18 years of age (≥18),
- Patient with pancreatic, gastric or colorectal cancer,
- Patient with a high risk of ETV,
- Patient on the first line of treatment or relapsing after a period of complete remission,
- Patient affiliated to a social security system or CMU.
Who cannot join
- Patient who has had an ETV in the 3 months prior to inclusion,
- Patient with a life expectancy of less than 3 months,
- Patient with an anticoagulation placement,
- Known pregnant or breastfeeding woman,
- Patient under guardianship or curatorship.
Trial locations and contacts
1 site in 1 country.
France1 site, 1 recruiting
- Recruiting
Ambroise Pare Hospital
Boulogne-Billancourt, Haut de Seine, 92100
Valerie Barder, PhD, +33 149095413, valerie.bardet@aphp.fr
About this study
Official title: Evaluation of Neutrophil Extracellular Traps (NETs) by Flow Cytometry in Patients With Solid Cancers Associated With a High Risk of Venous Thromboembolic Events
Venous Thromboembolic Events (ETVs) are the second leading cause of death (9.2% of causes of death) in cancer patients after tumor progression (1). Indeed, cancer is associated with a 4 to 7-fold risk of ETV during chemotherapy (2). This complication is observed in 20% of cancer patients (3), and is sometimes an inaugural manifestation of cancer. This risk is particularly increased during the first 3 months after cancer diagnosis (4).
A biomarker correlated with the occurrence of ETVs would make it possible to target patients at high risk of thrombosis who could benefit from primary thromboprophylaxis, thus avoiding the complications, particularly haemorrhagic, and the additional costs associated with the long-term diagnostic and therapeutic management of ETVs. The investigator has implemented in the laboratory an innovative approach to the detection and quantification of circulating NETs by flow cytometry (FCM) allowing the routine determination of NETs. Therefore the investigator propose to assess NETs by CMF in a cohort of cancer patients with a very high risk of ETVs (pancreatic cancer, gastric cancer and colon cancer).
Read the detailed description
The NETs will be detected and quantified by CMF on the remaining EDTA tube collected to perform the blood count (NFS), using the method in place in the laboratory, adapted from the method initially described by Gavillet et al. The analyses will be carried out on a Fortessa LSR cytometer (Becton Dickinson), the antibodies used are specific to NET components: citrullinated H3 anti-histone in indirect labelling coupled APC, PE myeloperoxidase and Hoescht 34580 as DNA marker. The level will be measured in NETs/µL of whole blood as a function of the white blood cell count (Sysmex XN-3000). In parallel, other parameters associated with ETV risk will be evaluated: NFS on Sysmex-XN PLC, D-dimers, FVIII and MP. The assays of PM, D-dimers and FVIII will be performed specifically as part of the project, the other parameters will be measured as part of routine patient management and will not result in any additional constraints or costs. Biomarker assays will be performed at the time of cancer diagnosis on the EDTA and citrate tubes collected for NFS and TP/TCA respectively as part of routine care.
- Conditions
- Pancreatic Cancer, Gastric Cancer, Colorectal Cancer
- Medical subject headings
- Pancreatic Neoplasms, Stomach Neoplasms, Colorectal Neoplasms
What is being measured
The primary outcome is the main question the study is designed to answer.
Show that the NETs rate is higher at diagnosis in solid cancer patients with ETV within 4 months of diagnosis compared to patients without ETV
At the end of the study, after a minimum clinical follow-up of 4 months, the frequency of ETVs will be correlated to the NET rate measured in univariate and multivariate analysis (including also the following thrombotic risk factors: neutrophil levels, platelet levels, D-dimers, factor VIII, procoagulant activity of PM and body mass index).
Measured: 16 months
Secondary outcomes (2)
Determine a threshold of NETs that optimizes management based on the consequences of classification errors through decision analysis
The choice of an optimal threshold of NETs (sensitivity, specificity, likelihood ratio) will be determined by decision analysis using a decision tree combining probabilities of events and costs associated with fair (true positive, true negative) and erroneous (false positive, false negative) decisions.
Measured: 16 months
Explore the possibility of a prognostic VTE score integrating the NET rate and other clinical and biological parameters measured at the time of cancer diagnosis
The choice of an optimal threshold of NETs (sensitivity, specificity, likelihood ratio) will be determined by decision analysis using a decision tree combining probabilities of events and costs associated with fair (true positive, true negative) and erroneous (false positive, false negative) decisions.
Measured: 16 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Mar 2020
- Study start1 Jul 2019
- Primary completionDec 2020 (estimated)
- Study completionDec 2020 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Pancreatic CancerStudies of the same condition, open and under way.
- More trials run by Assistance Publique - Hôpitaux de ParisThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 250 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Assistance Publique - Hôpitaux de Paris
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Valérie BARDET, PhD, Principal investigator, hematology immunology transfusion Service, Ambroise Pare hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04294589
- Sponsor's protocol ID
- APHP190640
- Acronym
- Flownet
- Status last verified
- Sep 2020
- First submitted
- 2 Mar 2020
- Last updated
- 10 Nov 2020
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost. 2007 Mar;5(3):632-4. doi: 10.1111/j.1538-7836.2007.02374.x. No abstract available.
PubMed 17319909Chew HK, Wun T, Harvey D, Zhou H, White RH. Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med. 2006 Feb 27;166(4):458-64. doi: 10.1001/archinte.166.4.458.
PubMed 16505267
Study at a glance
From the registry record, last updated by the sponsor on 10 Nov 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluation of Neutrophil Extracellular Traps (NETs) by Flow Cytometry in Patients With Solid Cancers Associated With a High Risk of Venous Thromboembolic Events
- ClinicalTrials.gov ID
- NCT04294589
- Acronym / sponsor ID
- Flownet / APHP190640
- Conditions
- Pancreatic Cancer, Gastric Cancer, Colorectal Cancer
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 250 participants (estimated)
- Lead sponsor
- Assistance Publique - Hôpitaux de ParisUniversity, hospital or other
- Study start
- 1 Jul 2019 (actual)
- Primary completion
- Dec 2020 (estimated)
- Study completion
- Dec 2020 (estimated)
- First posted
- 4 Mar 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Venous Thromboembolic Events (ETVs) are the second leading cause of death (9.2% of causes of death) in cancer patients after tumor progression (1). Indeed, cancer is associated with a 4 to 7-fold risk of ETV during chemotherapy (2). This complication is observed in 20% of cancer patients (3), and is sometimes an inaugural manifestation of cancer. This risk is particularly increased during the first 3 months after cancer diagnosis (4).
A biomarker correlated with the occurrence of ETVs would make it possible to target patients at high risk of thrombosis who could benefit from primary thromboprophylaxis, thus avoiding the complications, particularly haemorrhagic, and the additional costs associated with the long-term diagnostic and therapeutic management of ETVs. The investigator has implemented in the laboratory an innovative approach to the detection and quantification of circulating NETs by flow cytometry (FCM) allowing the routine determination of NETs. Therefore the investigator propose to assess NETs by CMF in a cohort of cancer patients with a very high risk of ETVs (pancreatic cancer, gastric cancer and colon cancer).
Detailed description
The NETs will be detected and quantified by CMF on the remaining EDTA tube collected to perform the blood count (NFS), using the method in place in the laboratory, adapted from the method initially described by Gavillet et al. The analyses will be carried out on a Fortessa LSR cytometer (Becton Dickinson), the antibodies used are specific to NET components: citrullinated H3 anti-histone in indirect labelling coupled APC, PE myeloperoxidase and Hoescht 34580 as DNA marker. The level will be measured in NETs/µL of whole blood as a function of the white blood cell count (Sysmex XN-3000). In parallel, other parameters associated with ETV risk will be evaluated: NFS on Sysmex-XN PLC, D-dimers, FVIII and MP. The assays of PM, D-dimers and FVIII will be performed specifically as part of the project, the other parameters will be measured as part of routine patient management and will not result in any additional constraints or costs. Biomarker assays will be performed at the time of cancer diagnosis on the EDTA and citrate tubes collected for NFS and TP/TCA respectively as part of routine care.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Age groups
- Adult, Older adult
- Study population
- People with pancreatic, gastric or colorectal cancer at high risk of ETV, on the first line of treatment or relapsing after a period of complete remission.
Key inclusion criteria (5 listed)
- Male or Female over 18 years of age (≥18),
- Patient with pancreatic, gastric or colorectal cancer,
- Patient with a high risk of ETV,
- Patient on the first line of treatment or relapsing after a period of complete remission,
- Patient affiliated to a social security system or CMU.
Key exclusion criteria (5 listed)
- Patient who has had an ETV in the 3 months prior to inclusion,
- Patient with a life expectancy of less than 3 months,
- Patient with an anticoagulation placement,
- Known pregnant or breastfeeding woman,
- Patient under guardianship or curatorship.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Show that the NETs rate is higher at diagnosis in solid cancer patients with ETV within 4 months of diagnosis compared to patients without ETV
Time frame: 16 months
At the end of the study, after a minimum clinical follow-up of 4 months, the frequency of ETVs will be correlated to the NET rate measured in univariate and multivariate analysis (including also the following thrombotic risk factors: neutrophil levels, platelet levels, D-dimers, factor VIII, procoagulant activity of PM and body mass index).
2 secondary outcomes
Determine a threshold of NETs that optimizes management based on the consequences of classification errors through decision analysis
Time frame: 16 months
Explore the possibility of a prognostic VTE score integrating the NET rate and other clinical and biological parameters measured at the time of cancer diagnosis
Time frame: 16 months
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 10 Nov 2020.
- Background: PubMed 17319909Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost. 2007 Mar;5(3):632-4. doi: 10.1111/j.1538-7836.2007.02374.x. No abstract available.
- Background: PubMed 16505267Chew HK, Wun T, Harvey D, Zhou H, White RH. Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med. 2006 Feb 27;166(4):458-64. doi: 10.1001/archinte.166.4.458.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Valérie BARDET, PhD principal investigator
hematology immunology transfusion Service, Ambroise Pare hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Pancreatic Cancer and Gastric Cancer, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 10 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Valérie BARDET, PhD ((+33) 1.49.09.54.13, valerie.bardet@aphp.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Show that the NETs rate is higher at diagnosis in solid cancer patients with ETV within 4 months of diagnosis compared to patients without ETV (time frame: 16 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04294589, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Nov 2020.