MedPath

Microbiota and Pancreatic Cancer Cachexia

Recruiting
Conditions
Pancreatic Cancer
Microbiota
Cachexia
Registration Number
NCT05606523
Lead Sponsor
Genton Graf Laurence
Brief Summary

This monocentric study aims at evaluating the effects of fecal microbiota transplantation from newly diagnosed cachectic and non-cachectic pancreatic cancer patients, and healthy volunteers on several cachexia-related parameters of germ-free mice.

Detailed Description

Aim: Evaluating the effects of fecal microbiota transplantation (FMT) from 6 newly diagnosed cachectic and 6 non-cachectic pancreatic cancer patients, and 12 healthy age-and sex-matched volunteers on several cachexia-related parameters of 96 germ-free mice (4 per donor) over a 30-day period. The fecal material of all 12 pancreatic cancer patients will be collected at diagnosis before any cancer treatment onset.

Hypothesis: FMT of cachectic patients with pancreas cancer, naïve of any anti-cancer treatment and artificial nutrition, into germ-free mice impairs weight gain, in contrast to FMT of non-cachectic patients and healthy controls.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
24
Inclusion Criteria

Patients with pancreatic cancer (n=12)

  • ≥18 years and
  • Newly diagnosed of pancreatic adenocarcinoma (local or metastatic) and
  • Tube feeding or parenteral nutrition ≤ 14 days

Cachectic pancreatic cancer patients (n=6)

  • Cachexia according to the Fearon criteria 1: involuntary weight loss >5% over the last 6 months, or any level of weight loss >2% and a BMI <20 kg/m2 or sarcopenia. Sarcopenia will be diagnosed by BIA (fat-free mass index is <17 kg/m2 in men and <15 kg/m2 in women) 81, and not by CT, as it is faster and can be performed at the bedside of the patient. Non-cachectic pancreatic cancer patients (n=6)
  • Normal nutritional state: weight stability (± 2% of habitual weight) over the last 6 months, no anorexia before the diagnosis (appetite rating on a visual analogue scale of 100mm), no known impaired glucose tolerance.

Healthy matched subjects (n=12)

  • ≥18 years and
  • BMI between 18.5 and 30 kg/m2 and
  • Absence of chronic or acute disease and
  • Matching for gender and age (± 5 years) with an included pancreatic cancer patient
Exclusion Criteria
  • < 18 years or
  • Inability to give consent or
  • Insufficient knowledge of project language (French, German) or
  • Pancreatic adenocarcinoma already treated by chemo- or radiotherapy, or major surgery as duodenopancreatectomy or biliary diversion
  • Known rheumatologic or immunologic diseases
  • Therapeutic antibiotics or immunosuppressive drugs (for instance glucocorticoids, cytostatics, antibodies) in the 30 days preceding the inclusion

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Body weight changes in mice after fecal material transplantation.Between days 0 and 30

Body weight (g)

Secondary Outcome Measures
NameTimeMethod
Muscle massat diagnosis

surfaces of the paraspinal and abdominal wall muscles at the level of L3-L4 disk space by CT for pancreatic cancer patients

Nutritional intakeat diagnosis

by 3-day food diary between cachectic patients non-cachectic patients and healthy volunteers

Differences in fecal microbiotaat diagnosis

by 16S rRNA gene amplicon sequencing and functional profiles by metagenomic sequencing between cachectic patients non-cachectic patients and healthy volunteers

Homeostatic model assessment (HOMA)-scoreat diagnosis

by fasting glycemia (mmol/l) and fasting insulinemia (mU/ml)) between cachectic patients non-cachectic patients and healthy volunteers

Glycemiaat diagnosis

by fasting glycemia (mmol/l) between cachectic patients non-cachectic patients and healthy volunteers

Body weightat diagnosis

in kilograms between cachectic patients non-cachectic patients and healthy volunteers

Resting energy expenditure (REE)at diagnosis

by indirect calorimetry between cachectic patients non-cachectic patients and healthy volunteers

Waist-to-hip ratioat diagnosis

waist circumference (cm) and hip circumference (cm) between cachectic patients non-cachectic patients and healthy volunteers

Fat massat diagnosis

by bioelectrical impedance analysis (BIA) between cachectic patients non-cachectic patients and healthy volunteers

Fat-free massat diagnosis

by bioelectrical impedance analysis (BIA) between cachectic patients non-cachectic patients and healthy volunteers

Appetiteat diagnosis

by fasting level of plasma cholecystokinin between cachectic patients non-cachectic patients and healthy volunteers

Insulinemiaat diagnosis

by fasting insulinemia (mU/ml) between cachectic patients non-cachectic patients and healthy volunteers

Physical activityat diagnosis

by the International Physical Activity Questionnaire (IPAQ) between cachectic patients non-cachectic patients and healthy volunteers

Mortalityat diagnosis

by tumor progression between cachectic patients non-cachectic patients

Physical functionat diagnosis

by handgrip strength between cachectic patients non-cachectic patients and healthy volunteers

Quality of lifeat diagnosis

by the European Organisation for Research and Treatment of Cancer questionnaire (EORTC QLQ-C30) between cachectic patients non-cachectic patients and healthy volunteers

Epithelial permeabilityat diagnosis

by fasting levels of plasma glucagon-like peptide-2 between cachectic patients non-cachectic patients and healthy volunteers

Oral microbiotaat diagnosis

by 16SrRNA gene amplicon sequencing and metagenomic sequencing between cachectic patients non-cachectic patients and healthy volunteers

GALT function and systemic inflammationat diagnosis

by myeloid derived suppressor cells (MDSC) levels and phenotype between cachectic patients non-cachectic patients and healthy volunteers

Trial Locations

Locations (1)

Geneva University Hospitals

🇨🇭

Geneva, Switzerland

© Copyright 2025. All Rights Reserved by MedPath