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Effect of Low-dose Interferon-alfa2a on Peri-operative Immune Suppression

Phase 2
Recruiting
Conditions
Colon Cancer
Interventions
Drug: Saline
Registration Number
NCT04798612
Lead Sponsor
Zealand University Hospital
Brief Summary

The aim of this randomized double-blinded placebo-controlled phase 2 study is to determine efficacy of preoperative treatment with interferon-alfa2a in patients with pMMR colon cancer on perioperative immune suppression and infiltration of lymphocytes in the primary tumor.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
68
Inclusion Criteria
  • Patients above 18 years of age.
  • Patients diagnosed with pMMR colonic adenocarcinoma and scheduled for laparoscopic hemicolectomy.
  • ASA class I-III (Classification of the American Society of Anesthesiology)
Exclusion Criteria
  • Patients with childbearing potential without a negative pregnancy test before initiating study drug and / or non-acceptance to the use of contraceptive methods *

  • ECOG score function> / = 3

  • Current liver or renal disease.

  • Severe heart disease

  • Previous depression diagnosed by a psychiatrist or in treatment with antidepressant

  • Autoimmune disease.

  • Uncontrolled thyroid disease.

  • Patients who are or have recently (within 6 months) received treatment with immunosuppressive agents other than corticosteroid treatment.

  • Epilepsy and / or other serious CNS disorders.

  • Patients that have undergone major surgery within one month before planned colon resection.

  • Known hypersensitivity to recombinant interferon or auxiliary products of Pegasys®.

    • Spiral, pill, implant, transdermal patch, vaginal ring or depot injection. Sterile / infertile subjects are exempt from the use of contraception. To be considered sterile or infertile must generally be surgical sterilization (vasectomy, bilateral tubectomy, hysterectomy or ovariectomy) or be postmenopausal, defined as absent menstruation for at least 12 months prior to study enrolment.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Intervention armPegasysTwo 45 mikrogram doses of interferon-alfa2a (Pegasys). Both will be applied subcutanously. First dose is at least one week before surgery. Second dose on the day of surgery before the procedure.
PlaceboSalineTwo 1 ml doses of saline liquid. Both will be applied subcutanously. First dose is at least one week before surgery. Second dose on the day of surgery before the procedure.
Primary Outcome Measures
NameTimeMethod
Flow-analysis of lymphocytic subpopulations in bloodChange between day of surgery (day 7-14 after first treatment) and postoperative day 1.

Change in CD3, CD4, and CD8 between intervention and placebo groups

T-cell infiltration in tumorDay of surgery (day 7-14 after first treatment)

Difference in CD3, CD4 and CD8 T-cell infiltration between intervention and placebo groups

Secondary Outcome Measures
NameTimeMethod
Quality of recovery (QoR-15)Third postoperative day and postoperative day 12-16

Difference in QoR-15 between intervention and placebo groups

Multiplex gene assay - NanoString Pan Cancer 360 IO panel analysis in blood and resected tumorDay of first treatment (Day 0) and day of surgery (day 7-14 after first treatment)

Difference in gene expressions between intervention and placebo groups

cfDNA analysis in bloodDay of first treatment (Day 0), day of surgery (day 7-14 after first treatment), postoperative day 2, postoperative day 12-16, and postoperative day 28-32.

Difference between intervention and placebo groups

CRP and neutrophil/lymphocyte ratioDay of surgery (day 7-14 after first treatment)

Difference in CRP and neutrophil/lymphocyte ratio between intervention and placebo groups

Immunological and inflammatory cytokines and interleukinsDay of surgery (day 7-14 after first treatment) and postoperative day 1.

Difference between intervention and placebo groups

Multiplex gene assay - NanoString Pan Cancer 360 IO panel analysis of tumor biopsy and resected specimenDay of standard endoscopic biopsy (Day -7-14 before treatment) and day of surgery (day 7-14 after first treatment)

Difference in gene expressions in tumor biopsies and resected specimen between intervention and placebo groups

Trial Locations

Locations (1)

Herlev University Hospital

🇩🇰

Herlev, Zealand, Denmark

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