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Colon AdenocarcinomaPhase 2NCT06017141

Inhalational or Intravenous Anesthesia During Surgery for Patients With Colon Cancer, VIVA Study

A Phase 2 study testing Biospecimen Collection, Electronic Health Record Review and Fentanyl Citrate in people with Colon Adenocarcinoma, run by University of Kansas Medical Center at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This trial evaluates how inhalational anesthesia (drawn in through the lungs) and total intravenous anesthesia (TIVA) (through a needle in a vein in the arm) change the body's ability to recover from surgery or whether they impact the immune system immediately after surgery in patients with colon cancer. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Colon Adenocarcinoma
What is being tested?
Biospecimen Collection, Electronic Health Record Review and Fentanyl Citrate
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteUnited States
Study dates
22 May 2023to 22 May 2026
Phase
Phase 2
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
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Ability of participant OR Legally Authorized Representative (LAR) to understand this study, and participant or LAR willingness to sign a written informed consent
  • Males and females age >= 18 years on day of consent
  • Eastern Cooperative Oncology Group (ECOG) performance status 0 - 2
  • Patients undergoing resection for biopsy proven colon adenocarcinoma
  • Medically fit for colon resection
  • Ability to complete required study questionnaires
  • Stated willingness to comply with all study procedures and availability for the duration of the study

Who cannot join

  • Diagnosis of rectal adenocarcinoma
  • Simultaneously enrolled in any therapeutic clinical trial. Subsequent enrollment in an adjuvant therapy clinical trial is not automatically prohibited by this trial. Trial eligibility for subsequent studies will be determined by the VIVA principal investigator (PI) and the PI of the other clinical trial in question
  • Diagnosed with a psychiatric illness or is in a social situation that would limit compliance with study requirements
  • Active grade 3 (per the National Cancer Institute Common Terminology Criteria for Adverse Events [NCI CTCAE] version 5.0) or higher viral, bacterial, or fungal infection within 2 weeks prior to the first dose of study treatment
  • Prisoner status
  • Allergies to eggs, egg products, soybeans, or soy products (relative or absolute contraindication to propofol)
Show all 10Show fewer
  • Personal or first degree relative with a history of malignant hyperthermia (absolute contraindication to inhaled volatile anesthetics)
  • Diagnosis of inflammatory bowel disease
  • Planned multi-visceral resection (examples include: pelvic exenteration, combined liver and colon resection)
  • Patients undergoing resection for unresectable polyps, or incomplete polypectomies without biopsy proven adenocarcinoma are excluded

Trial locations and contacts

1 site in 1 country.

United States1 site, 1 recruiting
  • University of Kansas Cancer Center

    Kansas City, Kansas, 66160

    Luke V. Selby, 913-588-7750, lselby@kumc.edu

    Luke V. Selby

    Recruiting

Other trials in United States

About this study

Official title: VIVA: Volatile or IV Anesthesia for Cancer

This trial evaluates how inhalational anesthesia (drawn in through the lungs) and total intravenous anesthesia (TIVA) (through a needle in a vein in the arm) change the body's ability to recover from surgery or whether they impact the immune system immediately after surgery in patients with colon cancer. It is unknown whether these types of anesthesia change recovery from surgery or change the chances cancer comes back following surgery. This study may help researchers learn how different types of anesthesia affect recovery from colon cancer surgery.

Read the detailed description

PRIMARY OBJECTIVE:

  1. To evaluate the differential impact of TIVA versus inhaled anesthesia on neutrophil extracellular traps (NET) inflammation and immunosuppression among patients undergoing cancer surgery.

SECONDARY OBJECTIVES:

  1. To evaluate the differential impact of TIVA versus inhaled total anesthesia choice on patient reported post-operative recovery:

Ia. Overall, and domain-specific post-operative recovery (as measured by the Quality of Recovery Score [QoR]-40) on the day of discharge and other post-operative timepoints; Ib. Changes in overall and domain-specific post-operative recovery over time.

II. To evaluate the differential impact of TIVA versus inhaled total anesthesia choice on peri-operative clinical and anesthetic outcomes, as recorded in the electronic medical record (EMR), including:

IIa. Post-operative nausea and vomiting (from medical record); IIb. Post-operative pain (measured on a 1-10 scale) (from medical record); IIc. Return of gastrointestinal (GI) function (from medical record); IId. Post-operative cognitive impairment (from medical record); IIe. 30 and 90 days post-operative complications; IIf. Disease-free survival (from medical record); IIg. Overall survival (from medical record). III. To evaluate the differential impact of TIVA versus inhaled total anesthesia choice on circulating levels of inflammatory cytokines, immune cell populations, global inflammatory markers.

IV. To evaluate the differential impact of TIVA versus inhaled total anesthesia choice on levels of circulating tumor DNA (ctDNA) at multiple post-operative timepoints according to standard of care practices of the University of Kansas Medical Center (KUMC) Division of Medical Oncology GI oncology practice.

  1. Correlation of peri-operative clinical and anesthetic outcomes to neutrophil extracellular traps (NET) levels, measures of immune suppression, ctDNA.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive standard of care (SOC) sedation with sevoflurane via inhalation and fentanyl intravenously (IV) on study prior to SOC surgery. Some patients may also receive sedation with propofol IV prior to surgery. All patients also undergo blood sample collection throughout the study and collection of tissue sample during surgery.

ARM II: Patients receive SOC sedation with fentanyl IV and propofol IV on study prior to SOC surgery. Patients also undergo blood sample collection throughout the study and collection of tissue sample during surgery.

After completion of study treatment, patients are followed up at 1 and 3 days, 3 and 6 weeks, 3 and 6 months, and then yearly for 5 years from SOC surgery.

Being tested
Biospecimen Collection, Electronic Health Record Review, Fentanyl Citrate, Propofol, Questionnaire Administration
Medical subject headings
Colonic Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Biospecimen CollectionProcedure or surgery

    Also called Biological Sample Collection, Biospecimen Collected, Specimen Collection

    Undergo blood and tissue sample collection

  • Electronic Health Record ReviewOther

    Ancillary studies

  • Fentanyl CitrateDrug

    Also called Actiq, Fentanyl, Fentyl, Oralet

    Given via injection

  • PropofolDrug

    Also called Diprivan

    Given IV

  • Questionnaire AdministrationOther

    Ancillary studies

  • SevofluraneDrug

    Also called Ultane

    Given via inhalation

  • Surgical ProcedureProcedure or surgery

    Also called Operation, Surgery, Surgery Type, Surgery, NOS

    Undergo SOC surgery

Study groups in NCT06017141
Study groupRoleWhat they receive
Arm I (sevoflurane, fentanyl citrate, propofol)Active comparatorPatients receive SOC sedation with sevoflurane via inhalation and fentanyl IV on study during to SOC surgery. All patients also undergo blood sample collection throughout the study and collection of tissue sample during surgery.
Receives: Procedure: Biospecimen Collection; Other: Electronic Health Record Review; Drug: Fentanyl Citrate; Drug: Propofol; Other: Questionnaire Administration; Drug: Sevoflurane; Procedure: Surgical Procedure
Arm II (fentanyl citrate, propofol)ExperimentalPatients receive SOC sedation with fentanyl IV and propofol IV on study during to SOC surgery. Patients also undergo blood sample collection throughout the study and collection of tissue sample during surgery.
Receives: Procedure: Biospecimen Collection; Other: Electronic Health Record Review; Drug: Fentanyl Citrate; Drug: Propofol; Other: Questionnaire Administration; Procedure: Surgical Procedure

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Neutrophil extracellular traps (NET) formation

    The Neutrophil extracellular traps (NET) formation will be assessed by DNA complexes in myeloperoxidase (MPO). MPO are enzymes that come from white blood cells. The level of these enzymes will be compared by study group using statistical models. The time you are under anesthesia, the amount of anesthesia you are given, the type of surgery you have are all variables that will be considered when evaluating the two types of anesthesia.

    Measured: Post-operative day (POD) 1 to POD 6 months

Secondary outcomes (13)
  1. Early post-operative recovery

    The QoR-40 is a recovery-specific and patient-rated questionnaire that contains 40 items measuring five dimensions: the physical comfort (12 items), emotional state (nine items), physical independence (five items), psychological support (seven items) and pain (seven items). Recovery will be assessed starting at Post-Operative Day Zero until the time you are discharged from the hospital.

    Measured: Post-Operative Day 0 to post-operative discharge, approximately 2-4 days

  2. Global and post-operative recovery

    The QoR-40 is a recovery-specific and patient-rated questionnaire that contains 40 items measuring five dimensions: the physical comfort (12 items), emotional state (nine items), physical independence (five items), psychological support (seven items) and pain (seven items). Recovery will be assessed starting at Post-Operative Day Zero, Day One Post-Operative, Day Three Post Operative, Week Three Post-Operative, Week Six Post-Operative, Month Three Post-Operative, and Month Six Post-Operative.

    Measured: Post-Operative Day 0 to 6 months post-operatively

  3. Post-operative nausea scores

    The post operative nausea scores will be assessed using standardized nursing assessments captured in the patient's medical record. These scores will be evaluated starting at Post-Operative Day Zero until patient discharge from the hospital.

    Measured: Post-Operative Day 0 to post-operative discharge, approximately 2-4 days

  4. Number and cumulative amount of doses of anti-emetics

    The number and amount of doses of antiemetics will be assessed in the patient's medical record starting at Post-Operative Day Zero until the time they are discharged from the hospital.

    Measured: Post-Operative Day 0 to post-operative discharge, approximately 2-4 days

  5. Total hospital opioid use

    The patient's total opioid use will be assessed in the patient's medical record starting at Post-Operative Day Zero until the time they are discharged from the hospital.

    Measured: Post-Operative Day 0 to post-operative discharge, approximately 2-4 days

  6. Patient-reported pain scores

    The patient's total opioid use will be assessed in the patient's medical record starting at Post-Operative Day Zero until the time they are discharged from the hospital.

    Measured: Post-Operative Day 0 to post-operative discharge, approximately 2-4 days

  7. Number of times a pro re nata (PRN) medication administered

    The number of times a patient is administered medication PRN (as needed) will be assessed in the patient's medical record starting at Post-Operative Day Zero until the time they are discharged from the hospital.

    Measured: Post-Operative Day 0 to post-operative discharge, approximately 2-4 days

  8. First post-op day when participant tolerates a regular diet (at the discretion of the surgical team)

    The first day when the patient is able to tolerate a regular diet. This will occur between Post-Operative Day Zero and the time they are discharged from the hospital.

    Measured: Post-Operative Day 0 to post-operative discharge, approximately 2-4 days

  9. Time from study entry and from surgery to disease recurrence, death, or loss to follow up

    The length of time the patient is on the study and the time from surgery to either the cancer returning, the patient passing away, or the loss contact with the patient starting at Post-Operative Day Zero through the duration on the study (up to five years) unless the patient's disease returns, they pass away, or the study team loses contact with them.

    Measured: Post-Operative Day 0 up to Five Years Post-Operation

  10. Post-operative complications

    Complications will be assessed via the patients' medical record, and the Clavien-Dindo classification system which includes the comprehensive complication index. The Clavien-Dindo classification system consists of complication index consists of the of the following grades: I, II, IIIa, IIIb, IVa, IVb, V. Post-operative complications will be assessed Post-Operative Day Zero, Week Three Post-Operative, Week Six Post-Operative, Month Three Post-Operative.

    Measured: Post-Operative Day 0 to Three Months Post-Operatively

  11. Post-operative immune suppression

    Will be assessed by the notes in the patients' medical records and the biomarkers collected in the research blood tests. Post-operative immune suppression will be evaluated Post-Operative Day Zero, Week Three Post-Operative, Week Six Post-Operative, Month Three Post-Operative, and Month Six Post-Operative.

    Measured: Post-Operative Day 1 to 6 months Post-Operatively

  12. Circulating tumor deoxyribonucleic acid (ctDNA)

    Will be assessed by blood tests using commercially available, FDA approved, assays according to the standard practices of the University of Kansas Cancer Center (KUMC) Division of Medical Oncology GI Oncology Group. Differences between groups will be compared using regression based and/or non-parametric analyses as appropriate.

    Measured: Post-Operative Day 0 up to 5 years

  13. Changes in gene expression

    RNA sequencing of resected tumors will be used to investigate differences in gene expression by anesthesia type.

    Measured: Immediately post-operatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Aug 2023
  2. Study start22 May 2023
  3. Primary completion22 May 2025 (estimated)
  4. Study completion22 May 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06017141
Sponsor's protocol ID
STUDY00149314
Other IDs
NCI-2023-05587, IIT-2022-VIVA, STUDY00149314, P30CA168524
Status last verified
Aug 2023
First submitted
31 Jul 2023
Last updated
30 Aug 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Biospecimen Collection, Electronic Health Record Review and Fentanyl Citrate in people with Colon Adenocarcinoma, run by University of Kansas Medical Center at 1 site in United States.

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 7 inclusion and 10 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 30 Aug 2023. 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 United States. 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.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

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?

Each site lists its own contact: choose the nearest one under Trial locations. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Neutrophil extracellular traps (NET) formation (time frame: Post-operative day (POD) 1 to POD 6 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 30 Aug 2023; AzTrials last refreshed its copy on 7 Nov 2026.

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