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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05557487
Other study ID # CS1-22111
Secondary ID
Status Recruiting
Phase
First received
Last updated
Start date December 15, 2022
Est. completion date December 31, 2028

Study information

Verified date February 2024
Source Chung Shan Medical University
Contact GeeChen Chang, MD. PhD
Phone +886-4-24739595
Email geechen@gmail.com
Is FDA regulated No
Health authority
Study type Observational

Clinical Trial Summary

Lung cancer is the leading cause of mortality in the world, and also in Taiwan.Despite the researches and availability in new therapies, it causes the highest mortality and is one of the most preventable cancers as well. Smoking is the most common cause of lung cancer worldwide. Compared to lung cancer in smokers, lung cancer in never-smokers is associated with East Asian ethnicity, female sex, and adenocarcinoma histology. This unique risk group is likely to have distinct molecular drivers, especially EGFR, ALK, and ROS1 mutations.In National Taiwan Cancer Registry data, more than half (53%) of all newly diagnosed lung cancer patients and 93% of female patients are lifelong never-smokers. This scenario is common in East Asia. It is essential to develop a different strategy for screening lung cancer patients with other high-risk profiles. Several risk factors have been identified in never-smoking lung cancer and one of the most important factor is a lung cancer family history (LCFH) in a first-degree relative. Other high-risk occupational or environmental factors include air-pollution exposed occupations (such as traffic policeman and street cleaners) for at least 10 years, cooking index ≥ 110, defined as 2/7 * days cooking by pan frying, stir frying, or deep frying in one week * years cooking, cooking without using ventilation, passive smoke exposure, and history of pulmonary tuberculosis or chronic obstructive pulmonary disorders. As described above, three high risk groups are interested in this study, the previous heavy smokers (group 1); those who has family history (group 2) and those who have high risk occupation or environment factors (group 3). From the published researches, we assume the detection rate to be 1.1% for group 1 based on NLST results16, 2.6% for group 2 (395 out of 12,011 subjects in TALENT), and we assume the detection Group 3 to be 1% after consulting board-certified senior specialists in this field. This is a prospective, multi-center, single arm study in Taiwan of subjects who are eligible to receive LDCT screening based on recommendation of Health Promotion Administration of Taiwan. The primary objective of TRIO part A is the LDCT screening acceptance rate of high lung cancer risk subjects. The primary objective of TRIO part B is the exact lung cancer detection rates in these three groups. Other secondary objectives are also included.


Recruitment information / eligibility

Status Recruiting
Enrollment 6618
Est. completion date December 31, 2028
Est. primary completion date December 31, 2024
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 20 Years to 80 Years
Eligibility Inclusion Criteria: Group 1: Previous heavy smokers Age 50 to 80 years, meet both criteria in the followings. 1. Cigarette smoking of at least 20 pack-years 2. With successful smoking cessation history (stopping smoking for more than 6 months), but less than 15 years Group 2: First-degree relatives of lung cancer patients 1. aged more than 50 years 2. age less than 50 years old, but older than the age at diagnosis of the youngest lung cancer proband in the family Group 3: With other high-risk occupational or environmental factors Age 50 to 80 years, meet one or more of the following criteria. 1. air-pollution exposed occupations (such as traffic policemen, and street cleaners….) for at least 10 years 2. cooking index = 110, defined as 2/7 * days cooking by pan frying, stir-frying, or deep frying in one week * years cooking. 3. cooking without using ventilation for more than 20 years 4. history of pulmonary tuberculosis and complete anti-tuberculosis treatment with intervals more than 5 years before this study Exclusion Criteria: 1. previous history of lung cancer 2. another malignancy except for cervical carcinoma in situ or non-melanomatous carcinoma of the skin within 5 years 3. an inability to tolerate transthoracic procedures or thoracotomy 4. chest CT examination was performed within 18 months 5. hemoptysis of unknown etiology within one month 6. body weight loss of more than 6 kg within one year without an evident cause 7. a known pregnancy 8. Not capable of understanding or responding to the written questionnaire even through the help from the study team

Study Design


Intervention

Diagnostic Test:
Low dose computed tomography
Participants belonging to modified Lung RADS category 1 and 2 at baseline screening will undergo the LDCT next year after the discussion with the physicians in charge. Participants with nodules belonging to modified Lung RADS category 3 and 4, growing nodules, or new nodules found on follow-up LDCT scans will undergo repeat CT every 3 to 6 months or be referred for diagnostic workup depending on the size and characteristics of the nodules as the regular clinical practice. Volume doubling time (VDT) will be performed in the special groups with Lung RADS category 3 or 4, but the nodules with solid components ? 6mm and < 9mm. A repeat LDCT scan will be performed around 3 months after the baseline screening. Check total bilirubin, urinary heavy metals, serum tumor marker, including CEA, alpha-fetal protein, etc. Check pulmonary function test.

Locations

Country Name City State
Taiwan National Taiwan University Hospital Hsin-Chu Branch Hsinchu
Taiwan Hualien Tzu Chi Hospital Hualien City
Taiwan E-Da Hospital Kaohsiung
Taiwan Kaohsiung Medical University Chung-Ho Memorial Hospital Kaohsiung
Taiwan Ministry of Health and Welfare Shuang-Ho Hospital New Taipei City
Taiwan Chung Shan Medical University Taichung
Taiwan National Taiwan University Hospital Taipei city

Sponsors (2)

Lead Sponsor Collaborator
Gee-Chen Chang AstraZeneca

Country where clinical trial is conducted

Taiwan, 

References & Publications (6)

de Koning HJ, van der Aalst CM, de Jong PA, Scholten ET, Nackaerts K, Heuvelmans MA, Lammers JJ, Weenink C, Yousaf-Khan U, Horeweg N, van 't Westeinde S, Prokop M, Mali WP, Mohamed Hoesein FAA, van Ooijen PMA, Aerts JGJV, den Bakker MA, Thunnissen E, Vers — View Citation

Kim H, Kim HY, Goo JM, Kim Y. Lung Cancer CT Screening and Lung-RADS in a Tuberculosis-endemic Country: The Korean Lung Cancer Screening Project (K-LUCAS). Radiology. 2020 Jul;296(1):181-188. doi: 10.1148/radiol.2020192283. Epub 2020 Apr 14. — View Citation

National Lung Screening Trial Research Team; Church TR, Black WC, Aberle DR, Berg CD, Clingan KL, Duan F, Fagerstrom RM, Gareen IF, Gierada DS, Jones GC, Mahon I, Marcus PM, Sicks JD, Jain A, Baum S. Results of initial low-dose computed tomographic screen — View Citation

Patz EF Jr, Pinsky P, Gatsonis C, Sicks JD, Kramer BS, Tammemagi MC, Chiles C, Black WC, Aberle DR; NLST Overdiagnosis Manuscript Writing Team. Overdiagnosis in low-dose computed tomography screening for lung cancer. JAMA Intern Med. 2014 Feb 1;174(2):269 — View Citation

Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015 Mar;65(2):87-108. doi: 10.3322/caac.21262. Epub 2015 Feb 4. — View Citation

US Preventive Services Task Force; Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, Davis EM, Donahue KE, Doubeni CA, Kubik M, Landefeld CS, Li L, Ogedegbe G, Owens DK, Pbert L, Silverstein M, Stevermer J, Tseng CW, Wong JB. Screening f — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary The rate of willingness and completeness of LDCT screening after the detailed questionnaire survey for the eligible participants. Eligible participants must meet the inclusion and exclusion criteria of this study
Only the one who completes the detailed questionnaire survey is counted.
2 years
Primary To investigate overall lung cancer detection rate of high lung cancer risk individuals Cytological or Pathological proof of lung cancer to investigate the overall lung cancer detection rate 2 years
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