Multiple Endocrine Neoplasia Clinical Trial
— GENEMOfficial title:
Study and Follow-up of Multiple Endocrine Neoplasia Type 1
Multiple Endocrine Neoplasia type I (MEN1) or Wermer syndrome is an autosomal dominant
disease that predisposes patients to the development of endocrine tumours, principally
parathyroid, pituitary or duodenal-pancreatic tumours. It is due to mutations that abolish
the function of the MEN1 gene, which contributes to tumour regulation. It is a rare disease,
with an estimated prevalence in the general population of 1/30,000. Penetrance of the disease
is late but very high (almost 100% at 50 years of age). The first clinical manifestations
usually appear after the age of 30 or 40 years.
The three cardinal endocrine characteristics of MEN1 are secreting tumours of the
parathyroid, the pituitary gland and the pancreas. Tumours of the adrenal glands, bronchial
or thymic endocrine tumours, ependymoma and meningioma of the central nervous system,
visceral leiomyomas, and certain cutaneous tumours can also be found as well as these
cardinal tumours.
The diagnosis of MEN1 is essential to ensure 1) appropriate therapeutic management of the
proven endocrine manifestations 2) screening for other endocrine and non-endocrine tumours
(lesions), 3) family screening of affected relatives whether they are symptomatic or not 4)
the surveillance of thus diagnosed patients. Studies on mortality in MEN1 have shown that the
causes of death are mainly due to the disease. The non-diagnosis of MEN1 is a cause of
therapeutic failure in the management of the endocrine lesions. For the success of the
surgical treatment of an isolated endocrine lesion it is important for patients to be
oriented towards a diagnosis of MEN1 as the management is different from that in usual
situations. Detection is thus of major importance, as early diagnosis can improve the
management.
Even though the syndrome was discovered in 1903 by Erdheim and correctly documented in 1954
by Wermer, it was only in the 1970s that we became aware of the variety of clinical forms and
attempted to codify its treatment. Nonetheless, published studies are fragmented and concern
selected populations of few patients. They only partially answer questions arising in
clinical practice concerning the prognosis and optimal management of patients. The natural
history of the disease in all of its clinical forms is still poorly understood. Although
advances in genetics have helped in the diagnosis of MEN1, some clinical forms are still
difficult to associate with the syndrome: atypical forms, forms with hardly any symptoms and
no genetic diagnosis (10%). These clinical forms need to be clarified to ensure optimal care.
Only a large cohort will make it possible to describe the different forms of this disease and
to clarify its prognosis
Status | Recruiting |
Enrollment | 2000 |
Est. completion date | July 2031 |
Est. primary completion date | July 2031 |
Accepts healthy volunteers | No |
Gender | All |
Age group | N/A and older |
Eligibility |
Inclusion Criteria: - Symptomatic individuals with a confirmed diagnosis of MEN1 and who live in France. Patients with the following characteristics will also be included in the cohort: - At least two of the three cardinal clinical lesions (parathyroid, pancreas, pituitary), - OR an isolated known lesion of the disease, cardinal or not (parathyroid, pancreas, pituitary, adrenal, thymus, bronchus, tumour of the central nervous system) associated with a mutation of the MEN1 locus on chromosome 11q13, - OR an isolated lesion, cardinal or not (parathyroid, pancreas, pituitary, adrenal, thymus, bronchus, tumour of the central nervous system) in an individual with a confirmed family history of MEN1. asymptomatic patients who carry a characteristic mutation of MEN1. Current knowledge suggests that these patients will develop symptoms during their follow-up. Exclusion Criteria: patients who present a single-organ genetic endocrine disease associated with another genetic syndrome (familial isolated pituitary adenoma FIPA, familial isolated hyperparathyroidism FIHP) |
Country | Name | City | State |
---|---|---|---|
France | CHU Dijon Bourgogne | Dijon |
Lead Sponsor | Collaborator |
---|---|
Centre Hospitalier Universitaire Dijon |
France,
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---|---|---|---|---|
Primary | Questionnaire or Life quality | through study completion, an average of 19 years |
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