Colorectal Cancer Metastatic
Conditions
Keywords
colorectal cancer, gut microbiome
Brief summary
In this study the characteristics and alterations of the gut microbiome during chemotherapy for metastasized or irresectable CRC are studied, as well as the relation between the gut microbiome and the effects of chemotherapy.
Detailed description
Although systemic treatment for metastasized or irresectable colorectal cancer (CRC) is becoming increasingly effective, overall survival is still poor and side effects of current treatment modalities are substantial. There is an urgent need for novel therapies, and in addition, better predictive tools are needed to select the right drug to the right patient. New data suggest that modulation of the microbiome of the gut might provide opportunities to increase anti-tumor efficacy of immunotherapy. Whereas the relation between the gut microbiome and immunotherapy is intensively studied, the relation between the gut microbiome and efficacy of conventional chemotherapy is unknown. A better understanding of the composition, function and dynamics of the gut microbiome before and during chemotherapy might help to identify factors that can be influenced during the treatment of patients with metastasized or irresectable CRC. Therefore, in this study the characteristics and alterations of the gut microbiome during chemotherapy for metastasized or irresectable CRC are studied, as well as the relation between the gut microbiome and the effects of chemotherapy.
Interventions
DIAGNOSTIC_TESTfecal sample
patients will collect fecal samples at home prior to treatment and at 3 months after start of treatment at the time of response evaluation using a standard stool-collection-kit.
BEHAVIORALquestionnaire
At the day of stool sampling, patients fill out a brief questionnaire about established factors that can change the microbiome such concurrent use of antibiotics and proton pump inhibitors.
DIAGNOSTIC_TESTBlood sample
4 tubes of blood are collected prior to treatment and at 3 months after start of treatment at the time of response evaluation and sent to the UMCG for storage.
Sponsors
University Medical Center Groningen
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years * Patients with histologically confirmed CRC with an indication for palliative systemic anti-tumor therapy (ANY combination of chemotherapy with/without anti-VEGF of anti-EGFR therapy) * Measurable disease according to RECIST v1.1. * Stored pathological specimens available * Life expectancy ≥ 12 weeks * Signed Informed Consent Form * Ability to comply with protocol
Exclusion criteria
* Previous (neo)adjuvant chemotherapy \< 6 months * Previous radiotherapy on the small or large intestine \< 1month * Previous surgery of the small or large intestine \< 1 month * Uncontrolled inflammatory bowel disease * Participation in a study with a potential effect on the gut microbiome
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prediction of response to conventional systemic anti-tumor therapy conventional systemic anti-tumor therapy for metastatic or irresectable colorectal cancer | 2 years | To determine which bacteria species in the microbiome predict response to conventional systemic anti-tumor therapy according to RECIST v1.1 for metastatic or irresectable colorectal cancer |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Prediction of serious side effects to conventional systemic anti-tumor therapy for metastatic or irresectable colorectal cancer | 2 years | To determine which bacteria strains in the microbiome predict serious side effects (grade 3/4 according to CTCAE v4.03) to conventional systemic anti-tumor therapy for metastatic or irresectable colorectal cancer |
Countries
Netherlands
Contacts
Primary ContactJ. J. de Haan, MD, PhD
Backup ContactD. J. de Groot, MD, PhD
Outcome results
None listed