New Strategies to Detect Cancers in Carriers of Mutations in RB1

Retinoblastoma Clinical Trial

— NIRBTEST  

Official title:

New Strategies to Detect Cancers in Carriers of Mutations in RB1: Blood Tests Based on Tumor-educated Platelets, or Extracellular Vesicles.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04164134
• Other study ID #: 129
• Secondary ID: NL8013
• Status: Completed
• Start date: December 13, 2018
• Est. completion date: March 31, 2023

Study information

• Verified date: July 2023
• Source: Amsterdam UMC, location VUmc
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Rationale: Individuals with a cancer predisposition due to a mutation in the paradigm tumor suppressor gene RB1, have a high risk to develop the childhood cancer retinoblastoma (Rb). Biopsies are not possible in Rb, before treatment selection. Heritable Rb patients have also a high risk to develop other types of second primary, either childhood or adult, malignancies (SPMs), notably sarcomas and melanomas. Remarkably, SPMs are now the leading cause of death in heritable-Rb-survivors. Unfortunately, there are no well-developed regular surveillance protocols for SPMs in Rb survivors available right now. Recently, new non-invasive cancer test have been developed, based on either RNA-sequencing data from platelets (ThromboSeq), or on extracellular membrane vesicles (EVs) derived from tumor cells present in blood.

Objective:

• Determine the non-cancerous baseline in adult RB1-mutation carriers (heritable-Rb-survivors).

• Contribute to the biobanking of blood and cancerous tissues from RB1-mutation carriers with SPMs.

• The development of blood-based tests, either platelet or EV-based, for the detection of (the type of) tumors in RB1-mutation carriers.

Study design: Cross-sectional multicenter trial.

Study population:

• 40 Rb patients (children),

• 40 controls (children),

• 153 Rb survivors (adults),

• 153 controls (adults),

• 10 Rb survivors with SPM (children/adults).

Main study parameters/endpoints:

• Determine the non-cancerous baseline in adult RB1-mutation carriers (heritable-Rb-survivors).

• Contribute to the biobanking of blood and cancerous tissues from RB1-mutation carriers with SPMs.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness:

Two blood samples totalling 10ml blood will be collected for every participant. Additionally, a short questionnaire has to be filled in concerning their and their family's cancer history. Blood draws will be done, when participants are already present in the hospital for other appointments, and thus no extra visits are required. For all children, blood will be collected through an already present IV, and so no extra venepuncture is required. Children have to be included because Rb is a tumor only present in this patient group.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 378
• Est. completion date: March 31, 2023
• Est. primary completion date: March 31, 2023
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 0 Years to 99 Years

Eligibility

Inclusion Criteria:

Adult (16 years and older):

• Group 1: germline mutation RB1.

• Group 2 (control): no germline mutation RB1.

Pediatric (until 6 years of age):

• Group 1: somatic or germline mutation RB1 and retinoblastoma.

• Group 2 (control): no mutation RB1.

Exclusion Criteria:

Adult (16 years and older):

• Group 1: concomitant heritable (inherited) disorder other than caused by monoallelic mutation of RB1.

• Group 2 (control): cancer or already known cancer predisposition syndrome.

Pediatric (until 6 years of age):

• Group 1: concomitant heritable (inherited) disorder other than caused by monoallelic mutation of RB1.

• Group 2: cancer or already known cancer predisposition syndrome.

Related Conditions & MeSH terms

• Neoplasms
• Retinoblastoma
• Secondary Primary Malignancies After Retinoblastoma

Intervention

Other:
• blood draw
Control samples for the Rb survivor group (adult) are already available at the VUMC for the platelet study; unselected volunteers from an anti-cancer campaign. Control samples (adult) for the EV study will be collected in a blooddrive at the Essen site. Pediatric patients. For the pediatric Rb patients, blood draw is part of standard care (3mth-4y). The control blood samples of healthy children (12) will be drawn from healthy children, where the blood draw is already part of otherwise planned care (e.g. patients which are completely healthy besides having an unrelated problem for which surgery is required). Controls will be age-matched as much as possible.

Locations

Country	Name	City	State
France	Institute Curie	Paris
Germany	University Hospital Essen (UHE)	Essen
Netherlands	Amsterdam UMC, location VUmc	Amsterdam

Sponsors (4)

Lead Sponsor	Collaborator
Amsterdam UMC, location VUmc	Institut Curie, Ligue contre le cancer, France, University Hospital, Essen

Countries where clinical trial is conducted

France,  Germany,  Netherlands, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	RNA expression on platelets and allelic DNA balance of EVs in the blood of adult RB1 mutation carriers (Rb-survivors) and retinoblastoma patients (children).	blood analyses at time of inclusion to determine baseline	blood will be taken at study inclusion, patients will be followed throughout the study, max 3 years and 9 months.
Secondary	RNA expression on platelets, allelic DNA balance of EVs in blood and genomic analysis on tumor tissue of RB1-mutation carriers diagnosed with a second primary malignancy.	Comparison of blood at time of inclusion and blood at time of SPM diagnosis versus tumor tissue (if available)	blood will be taken at study inclusion, patients will be followed throughout the study, max 3 years and 9 months. In case of second primary tumor a second sample will be taken.