Colorectal Cancer Clinical Trial
— ColIBRIOfficial title:
Colorectal Cancer Immunomodulation Combined to Radiofrequency ablatIon
The primary objective of the study aims to compare soluble CD154 (CD40L) levels before and
after radiofrequency ablation (RFA) in patients with colorectal cancer (CRC) liver
metastases.
The secondary objectives aims:
- to compare soluble CD154 (sCD40-L) levels before and after treatment by RFA or surgery
alone in patients with CRC liver metastases;
- to study the feasibility and reliability of soluble CD154 (sCD40-L) levels to detect and
quantify the induction of immun response in CRC liver metastases patients after RFA;
- to study the impact of surgery on plasma soluble CD154 levels;
- to study association between CD154 expression level before and after RFA in CRC liver
metastases patients and relapses rate at 1 year.
Status | Not yet recruiting |
Enrollment | 20 |
Est. completion date | March 2022 |
Est. primary completion date | March 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: 1. Histologically or cytologically proven CRC; 2. Age = 18 years; 3. For group of ablation by radiofrequency: non-resectable liver metastases from CRC without detectable extra-hepatic disease, on abdomino-pelvic computed tomography (CT) or magnetic resonance imaging (MRI) and chest CT by the consulting hepatobiliary surgeon and radiologist. 4. For surgery group: only histologically proven CRC or treatable resectable liver metastases by only surgery without radiofrequency; 5. Metastatic involvement of the liver =50%; 6. Complete treatment of all liver lesions judged possible, either by RFA alone or by combination with resection of resectable lesions and RFA of the remaining non-resectable liver deposits; 7. Serum albumin = 30 g / L ; 8. White blood cell count (WBC) = 3 000 / ml; 9. Absolute lymphocytes count = 1000 / ml; 10. Registration in a national health care system included CMU; 11. Any other prior therapy directed at the malignant tumor, including chemotherapy; chemoembolization therapy, molecular targeted therapy (including antiangiogenics), and radiotherapy, must be discontinued at least 3 weeks before day 1 on trial. Exclusion Criteria: 1. Major surgical procedures within 28 days before RFA; 2. Receipt of the last dose of anticancer therapy (investigational product, chemotherapy, targeted therapy, biologic therapy, tumor embolization, monoclonal antibodies) = 21 days prior to the RFA; 3. Histology other than adenocarcinoma; 4. Hilar lymph node or pedicular metastases; 5. Obstructive jaundice (bilirubin > 1.5 ULN) without adequate biliary drainage; 6. Any unresolved toxicity NCI CTCAE Grade = 2 from previous anticancer therapy with the exception of alopecia, neuropathy, and the laboratory values defined in the inclusion criteria; 7. History of allogenic organ transplantation; 8. Any systemic steroid therapy whatever the duration of this corticotherapy; Note: The following are exceptions to this criterion: - Intranasal, inhaled, topical steroids, or local steroid injections (e.g., intra articular injection) - Steroids as premedication for hypersensitivity reactions (e.g., CT scan premedication); 9. Active infection including tuberculosis, hepatitis B (known positive HBV surface antigen (HBsAg) result), hepatitis C, or human immunodeficiency virus (positive HIV 1/2 antibodies); Note: Patients with past HBV infection or resolved HBV infection (defined as having a negative HBsAg test and a positive hepatitis B core antigen [HBc] antibody test) are eligible. Note: Patients positive for HCV antibody are eligible only if polymerase chain reaction testing is negative for HCV ribonucleic acid (RNA). 10. Diagnosis of any second malignancy within the last 5 years, except for adequately treated basal cell or squamous cell skin cancer, or in situ carcinoma of the cervix uteri; 11. Active or prior documented autoimmune or inflammatory disorders (including inflammatory bowel disease [e.g., colitis or Crohn's disease], diverticulitis [with the exception of diverticulosis], systemic lupus erythematosus, Sarcoidosis syndrome, or Wegener syndrome [granulomatosis with polyangiitis, Graves' disease, rheumatoid arthritis, hypophysitis, uveitis, etc]), that has required systemic treatment (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs); Note: Patients with vitiligo, alopecia, or any chronic skin condition that does not require systemic therapy are exception to this criterion. 12. Uncontrolled intercurrent illness, including but not limited to, ongoing or active infection, symptomatic congestive heart failure, uncontrolled hypertension, unstable angina pectoris, cardiac arrhythmia, interstitial lung disease, serious chronic gastrointestinal conditions associated with diarrhea, or psychiatric illness/social situations that would limit compliance with study requirement, substantially increase risk of incurring AEs or compromise the ability of the patient to give written informed consent; 13. Live vaccine administration, within 30 days prior to the RFA; 14. Known allergy or hypersensitivity; 15. History or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with participation for the full duration of the trial; 16. Pregnancy and breastfeeding; 17. Tutelage or guardianship; 18. Patient refusal. |
Country | Name | City | State |
---|---|---|---|
France | Department of digestive surgery, Ambroise Paré Hospital, APHP | Boulogne-Billancourt |
Lead Sponsor | Collaborator |
---|---|
Assistance Publique - Hôpitaux de Paris |
France,
Allard MA, Bachet JB, Beauchet A, Julie C, Malafosse R, Penna C, Nordlinger B, Emile JF. Linear quantification of lymphoid infiltration of the tumor margin: a reproducible method, developed with colorectal cancer tissues, for assessing a highly variable prognostic factor. Diagn Pathol. 2012 Nov 13;7:156. doi: 10.1186/1746-1596-7-156. — View Citation
Dymicka-Piekarska V, Korniluk A, Gryko M, Siergiejko E, Kemona H. Potential role of soluble CD40 ligand as inflammatory biomarker in colorectal cancer patients. Int J Biol Markers. 2014 Sep 30;29(3):e261-7. doi: 10.5301/jbm.5000083. — View Citation
Lemdani K, Mignet N, Boudy V, Seguin J, Oujagir E, Bawa O, Peschaud F, Emile JF, Capron C, Malafosse R. Local immunomodulation combined to radiofrequency ablation results in a complete cure of local and distant colorectal carcinoma. Oncoimmunology. 2019 Jan 10;8(3):1550342. doi: 10.1080/2162402X.2018.1550342. eCollection 2019. — View Citation
Meier S, Stark R, Frentsch M, Thiel A. The influence of different stimulation conditions on the assessment of antigen-induced CD154 expression on CD4+ T cells. Cytometry A. 2008 Nov;73(11):1035-42. doi: 10.1002/cyto.a.20640. — View Citation
Tada N, Tsuno NH, Kawai K, Murono K, Nirei T, Ishihara S, Sunami E, Kitayama J, Watanabe T. Changes in the plasma levels of cytokines/chemokines for predicting the response to chemoradiation therapy in rectal cancer patients. Oncol Rep. 2014 Jan;31(1):463-71. doi: 10.3892/or.2013.2857. Epub 2013 Nov 19. — View Citation
Zhao P, Fang WJ, Chai L, Ruan J, Zheng Y, Jiang WQ, Lin S, Zhou SH, Zhang ZL. The prognostic value of plasma soluble CD40 ligand levels in patients with nasopharyngeal carcinoma. Clin Chim Acta. 2015 Jul 20;447:66-70. doi: 10.1016/j.cca.2015.05.015. Epub 2015 May 29. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Plasma CD154 level dosage | Plasma CD154 level dosage realized by ELISA in patients with CRC liver metastases. | at baseline | |
Primary | Plasma CD154 level dosage | Plasma CD154 level dosage realized by ELISA in patients with CRC liver metastases. | at day 1 | |
Primary | Plasma CD154 level dosage | Plasma CD154 level dosage realized by ELISA in patients with CRC liver metastases. | at month 2 | |
Secondary | Plasma CD154 level dosage in patients underwent surgery | Plasma CD154 level dosage in patients underwent surgery for CRC. | at baseline, at day 1 and at month 2 | |
Secondary | Plasma CD154 level dosage evolution | Plasma CD154 level dosage evolution. | at baseline, at day 1 and at month 2 | |
Secondary | Intraclass correlation of coefficient | Intraclass correlation of coefficient to evaluate the feasibility and reliability of plasma CD154 level dosage in triplicate with CRC patients. | at baseline, at day 1 and at month 2 | |
Secondary | Rate of liver metastases relapses | Liver metastases CRC relapses rate. | at 1 year | |
Secondary | Clinical evolution parameters | Clinical evolution parameters according to RECIST criteria. | at baseline, at day 1 and at month 2 |
Status | Clinical Trial | Phase | |
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