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Intestinal Microbiota in Prostate Cancer Patients as a Biomarker for Radiation-INduced Toxicity (IMPRINT)

Not Applicable
Completed
Conditions
Prostate Cancer
Prostate Adenocarcinoma
Prostatic Neoplasms
Interventions
Other: Collection of human biofluids
Other: Patient reported outcome measures
Registration Number
NCT04638049
Lead Sponsor
University Hospital, Ghent
Brief Summary

Radiotherapy (RT) of the abdomen and/or pelvis is known to cause acute and late gastrointestinal (GI) toxicities. While radiation dose and volume are known risk factors for developing such side effects, recent evidence suggests patterns of disturbance in the composition of the GI microbiota - so called "dysbiosis" - may also promote the host's susceptibility to GI toxicities through impaired intestinal barrier function and inflammation. The IMPRINT-study aims to expand the current knowledge on the role of intestinal bacteria and their metabolites involved in the pathophysiology of radiation-induced GI toxicities by longitudinally examining the microbiota composition (feces), the associated metabolome (blood, feces and urine) and bacterial extracellular vesicles (BEVs) (blood and feces).

Detailed Description

The IMPRINT-study is a prospective biomarker study assessing the impact of different treatment field sizes and associated radiation doses on the patient's microbiome and metabolome, whereby the link with radiation-induced GI toxicities will be emphasized. Blood, urine and fecal samples will be longitudinally collected at 4 different time points: (1) shortly before, (2) during and (3) shortly after RT treatment, as well as (4) one-month post-RT. To our knowledge, this is the first clinical research project relating the impact of multiple radiation parameters on fecal-, urine- and blood-based biomarkers to risk of GI toxicities in a homogeneously defined study population.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
50
Inclusion Criteria
  • Histologically proven (initial) adenocarcinoma of the prostate
  • Localized (confined to primary site) and/or regional (spread to regional pelvic lymph nodes) disease stage at diagnosis
  • Age ≥ 18 years
  • RT is an integral part of the treatment - primary, adjuvant or salvage
  • WHO performance status 0-2
  • Administration of androgen deprivation therapy (ADT) before RT
  • Absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule
  • Signed informed consent form (ICF) according to ICH/GCP and national/regional regulations
Exclusion Criteria
  • Other primary tumor (except for non-melanoma skin cancer) diagnosed < 5 years before enrollment
  • Diagnosis of inflammatory bowel disease (e.g. Crohn's disease or ulcerative colitis)
  • Administration of systemic therapy during RT other that ADT
  • Subjected to antibiotic treatment or medically imposed dietary restrictions < 1 month prior to enrollment
  • Body mass index (BMI) > 35
  • Administration of pelvic RT < 1 year

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Prostate (Bed) only RadioTherapy (PBRT)Patient reported outcome measuresPrimary, adjuvant or salvage RT of the prostate (bed) without RT of the pelvic nodal regions in the small pelvis, according to local hospital guidelines and protocols.
Whole Pelvis RadioTherapy (WPRT)Collection of human biofluidsPrimary, adjuvant or salvage RT of the pelvic nodal regions in the small pelvis with possible additional RT of the prostate (bed), according to local hospital guidelines and protocols.
Whole Pelvis RadioTherapy (WPRT)Patient reported outcome measuresPrimary, adjuvant or salvage RT of the pelvic nodal regions in the small pelvis with possible additional RT of the prostate (bed), according to local hospital guidelines and protocols.
Prostate (Bed) only RadioTherapy (PBRT)Collection of human biofluidsPrimary, adjuvant or salvage RT of the prostate (bed) without RT of the pelvic nodal regions in the small pelvis, according to local hospital guidelines and protocols.
Primary Outcome Measures
NameTimeMethod
Metabolome profiles as assessed by fecal, blood and urine samplesUp to 3.5 months after inclusion

Characterization of dynamic changes in the concentration of all small molecules (metabolites) in feces, blood and urine using ultra-high performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-HRMS)

Microbiome profiles as assessed by fecal samplesUp to 3.5 months after inclusion

Characterization of dynamic changes in the intestinal microbiota composition using 16S rRNA sequencing technology

Secondary Outcome Measures
NameTimeMethod
Concentration of BEVs in fecal and blood samplesUp to 3.5 months after inclusion

BEVs in fecal and blood samples will be separated and analyzed through the orthogonal implementation of ultrafiltration, size-exclusion chromatography (SEC) and density-gradient centrifugation, followed by biochemical characterization

Patient reported QOL as per EORTC-QLQ PR25Up to 3.5 months after inclusion

Validated questionnaire assessing the health-related QOL of prostate cancer patients

Discovery of potential predictive biomarkers for the development of RT-induced GI toxicitiesUp to 3.5 months after inclusion

The identified microbiota and metabolite signatures will be investigated for association with incidence and severity of GI toxicities

Incidence of GI and Genitourinary (GU) toxicitiesUp to 3.5 months after inclusion

GI and GU toxicities as per Common Terminology for Adverse Events (CTCAE) v4.0

Patient reported QOL as per EORTC-QLQ C30Up to 3.5 months after inclusion

Validated questionnaire assessing different health-related parameters (psychological, physical and social well-being) in cancer patients

Trial Locations

Locations (1)

Ghent University Hospital

🇧🇪

Ghent, Belgium

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