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Clinical Trial Summary

Rationale: Lung cancer is the predominant cancer type worldwide in terms of incidence and mortality. Novel treatment techniques are continuously being developed, all of which need thorough evaluation before they can be implemented in clinical routine. The gold standard design for such evaluation is the randomized controlled trial (RCT), but this design has shown many challenges, particularly in the oncology setting. The 'Trials within Cohorts' (TwiCs) design, previously referred to as 'cohort multiple RCT' (cmRCT), is a promising design enabling multiple (simultaneous) randomized evaluations of experimental interventions, with advantages for recruitment, comparability, and long-term outcome data collection. This design will speed up the process of translating treatment innovations in daily clinical practice. Objective: 1) To collect information on patient characteristics, short- and long-term clinical and patient-reported outcomes; and 2) to create an infrastructure for efficient, fast, and pragmatic randomized evaluation of new interventions. Study design: Observational, prospective cohort study, according to the 'TwiCs' design. Study population: All patients with lung cancer referred to the Department of Pulmonology or the Department of Radiotherapy of the UMC Utrecht. Main study parameters/endpoints: Clinical parameters (performance status, co-morbidity, oncological history, symptoms, imaging, technical and treatment data), clinical endpoints (toxicity, reintervention and survival), and patient-reported outcomes.

Clinical Trial Description

The basis of the TwiCs approach is an observational prospective cohort, consisting of patients with the same condition of interest, who undergo standard treatment. The patient characteristics are captured at baseline, and clinical and patient-reported outcome measures are captured at fixed time points. When a new intervention is ready for formal evaluation, eligible patients within the observational cohort are identified. From this so-called sub-cohort, patients will be randomly selected to undergo the new intervention. The other eligible patients will not be approached and undergo the standard treatment. Outcomes of the selected patients receiving the new intervention will be compared with the outcomes of the non-selected patients receiving the standard treatment. Within this cohort, the same process can be simultaneously repeated for other interventions. Advantages of the TwiCs design include ongoing information as to the natural history of the condition and to treatment as usual, the ability to facilitate multiple simultaneous randomized evaluations, the improved comparability between trials, and the patient-centered informed consent procedure. By setting up the prospective U-COLOR cohort (Utrecht COhort for Lung cancer Outcome Reporting and trial inclusion), we aim to: - Gather data on natural disease progression, treatment response, disease recurrence, complications, quality of life and survival of patients with lung cancer; - Collect a patient group willing to participate in studies; - Facilitate multiple, parallel randomized controlled trials within the cohort. ;

Study Design

Related Conditions & MeSH terms

NCT number NCT05069792
Study type Observational
Source UMC Utrecht
Contact Pim JJ Damen, MD
Phone +31(0)887553139
Email [email protected]
Status Recruiting
Start date July 1, 2020
Completion date July 2030

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