Cigarette Smoking-Related Carcinoma, Lung Carcinoma
Conditions
Brief summary
This phase II trial tests the impact of canakinumab on biologic samples (buccal, nasal, and blood) from former smokers with increased risk of cancer. Canakinumab blocks the activity of a protein called interleukin-1 beta (IL-1b), an agent of the inflammatory system and is used for the treatment of different non-cancer diseases (like auto-inflammatory diseases). Giving canakinumab may block the inflammatory system and could have positive effects to reduce cancer growth.
Detailed description
PRIMARY OBJECTIVE: I. To compare baseline bronchoscopy biospecimens with samples approximately 70 days after administration of canakinumab (2 doses, approximately 14 days apart) in healthy former smokers. SECONDARY OBJECTIVE: I. Determine the impact of IL-1beta inhibition on downstream inflammatory pathways. OUTLINE: Patients undergo bronchoscopy over 30-60 minutes on day 7 and receive canakinumab subcutaneously (SC) 60 minutes and 2 weeks after the initial bronchoscopy. Patients undergo an additional bronchoscopy on day 77. Patients undergo buccal, nasal, and blood sample collection and carbon monoxide (CO testing on study).
Interventions
Undergo buccal, nasal, and blood sample collection
Undergo bronchoscopy
Given SC
Undergo CO testing
Ancillary studies
Sponsors
Study design
Eligibility
Inclusion criteria
Eligibility Criteria Age 40-73 (age criteria aligns with CANTOS trial) If female: evidence of post-menopausal status1 or negative urinary or serum pregnancy test (unknown impact on pregnancy) Former smoker with no use in ≥ 3 years prior to enrollment (targets former smoker population) CO ≤ 8ppm (targets/confirms former smoker population) Pack-years history of ≥ 20 (defined as high risk) No unstable or significant medical conditions as determined by medical history (see
Exclusion criteria
below - to ensure safety of the subject, to minimize the effects of poor health on biomarker measures and to maximize compliance to study procedures) Negative COVID-19 test (if applicable)2 Able to read adequately to complete the survey and related study documents or give consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in ASCs (apoptosis-associated speck-like protein containing a caspase activation and recruitment domain) | At baseline and day 77 | Will be assessed by a generalized linear mixed model (GLM) and will be employed with measure as the dependent variable, a main effect of baseline vs. follow-up, covariables sex and age, and a random effect for subject. |
| Change in caspase-1 | At baseline and day 77 | Will be assessed by a GLM and will be employed with measure as the dependent variable, a main effect of baseline vs. follow-up, covariables sex and age, and a random effect for subject. |
| Change in interleukin-1 beta (IL-1beta) | At baseline and day 77 | Will be assessed by a GLM and will be employed with measure as the dependent variable, a main effect of baseline vs. follow-up, covariables sex and age, and a random effect for subject. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in immune cell composition in bronchoalveolar lavage (BAL) by mass cytometry (CyTOF) | At baseline and day 77 | Will be performed using SPADE to create a global map of cell types present across samples and how the frequency or activation state of each cell type differs between baseline vs. follow-up (single arm). Will assess batch effects and include batch as a co-variable in the models. Will be assessed by the human magnetic luminex assay on the Luminex platform and inflammatory gene expression by ribonucleic acid sequence (RNASeq). |
| Changes in cytokines in the blood | At baseline and day 77 | Will be assessed by the human magnetic luminex assay on the Luminex platform and inflammatory gene expression by RNASeq. |
| Changes in BAL | At baseline and day 77 | Will be assessed by the human magnetic luminex assay on the Luminex platform and inflammatory gene expression by RNASeq. |
| Bronchoscopy for fractional concentration of exhaled nitric oxide (FeNO) | At baseline and day 77 | Will be assessed by the human magnetic luminex assay on the Luminex platform and inflammatory gene expression by RNASeq. |
Countries
United States
Contacts
Ohio State University Comprehensive Cancer Center