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Biospecimen Collection to Identify Gene Mutations for High Risk Pancreatic Cancer in Pediatric Patients, INSPPIRE 2 Study

Recruiting
Conditions
Chronic Pancreatitis
Exocrine Pancreas Carcinoma
Recurrent Acute Pancreatitis
Registration Number
NCT06651580
Lead Sponsor
M.D. Anderson Cancer Center
Brief Summary

This clinical trial collects blood, saliva, urine, or stool samples to help identify possible genetic mutations that may increase a person's chance at developing pancreatic cancer. Finding genetic markers among pediatric patients with acute recurrent pancreatitis and chronic pancreatitis may help identify patients who are at risk of pancreatic cancer.

Detailed Description

PRIMARY OBJECTIVE:

I. To comprehensively characterize the pediatric population with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP) and determine predictors of early onset CP and its sequelae.

OUTLINE:

Patients complete quality-of-life (QoL) assessment and complete questionnaires for over 2 hours every 12 months for 4 years. Patients also undergo collection of blood and/or saliva (if blood samples are not available), urine, or stool at baseline or follow-up (if inadequate samples collected or missed at baseline).

After completion of the study, patients are followed up every 12 months.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
1600
Inclusion Criteria
  • All subjects/parents must sign an informed consent and/or assent indicating that they are aware of the investigational nature of this study

  • Subjects/parents must have signed an authorization for the release of their or their child's protected health information

  • All children must be under 18 years of age at the time of enrollment

  • All children providing samples should fit the ARP or CP inclusion criteria defined below:

    • Acute pancreatitis (AP): AP is defined as requiring 2 of the following:

      • Abdominal pain compatible with AP
      • Serum amylase and/or lipase values >= 3 times upper limits of normal
      • Imaging findings of AP, such as gland enlargement, acute inflammatory changes, and fluid collections
    • ARP is defined as: At least 2 episodes of acute pancreatitis with complete resolution of pain and a >= 1 month pain-free interval between episodes

    • Chronic Pancreatitis:

      • Children with at least:

        • One irreversible structural change in the pancreas with or without abdominal pain +/- exocrine pancreatic insufficiency +/- diabetes

          • Irreversible structural changes:

            • Ductal calculi, dilated side branches, parenchymal calcifications found in any imaging (abdominal ultrasound [abd US], magnetic resonance imaging/magnetic resonance cholangiopancreatography [MRI/MRCP], computerized tomography [CT], endoscopic retrograde cholangiopancreatography [ERCP], endoscopic US [EUS])
            • Ductal obstruction or stricture/dilatation/irregularities that are persistent (for >= 2 months) on any imaging
            • Parenchymal atrophy, irregular contour, accentuated lobular architecture, cavities alone are not diagnostic findings for CP
            • Surgical or pancreatic biopsy specimen demonstrating histopathologic features compatible with CP (acinar atrophy, fibrosis, protein plugs, infiltration with lymphocytes, plasma cells, macrophages)
Exclusion Criteria
  • Subjects must not have any significant medical illnesses that in the investigator's opinion cannot be adequately controlled with appropriate therapy or would compromise the subject's ability to tolerate study interventions

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Characterize the pediatric population with acute recurrent pancreatitis (ARP) and chronic pancreatitis (CP)Up to 4 years

Two-sample t-test or Wilcoxon rank-sum test will be used for the continuous/ordinal variables and Pearson Chi-square test for the categorical variables. The variables that suggest differences between ARP and CP (p value \< 0.15) will be included as independent variables in a multivariable logistic regression analysis for CP progression.

Risk factors that predispose children to CP sequelae and high disease burdenUp to 4 years

A two-sample t-test or Wilcoxon rank-sum test for the continuous/ordinal variables and Pearson Chi-square test for the categorical variables. The variables that suggest an association with sequelae/disease burden (p-value \< 0.15) will be included as independent variables in a regression model for sequelae/disease burden. Normal/logistic/multinomial regression model will be used for continuous/binary/ordinal disease burden and sequelae outcomes. For repeated measures, random effects will be added to these models to account for correlation among the measures.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (26)

Children's Hospital Los Angeles

🇺🇸

Los Angeles, California, United States

Cedars Sinai Medical Center

🇺🇸

Los Angeles, California, United States

UCSF Benioff Children's Hospital Oakland

🇺🇸

Oakland, California, United States

Stanford Cancer Institute Palo Alto

🇺🇸

Palo Alto, California, United States

University of Colorado

🇺🇸

Denver, Colorado, United States

Emory University Hospital/Winship Cancer Institute

🇺🇸

Atlanta, Georgia, United States

Riley Hospital for Children

🇺🇸

Indianapolis, Indiana, United States

University of Iowa/Holden Comprehensive Cancer Center

🇺🇸

Iowa City, Iowa, United States

Ochsner Medical Center Jefferson

🇺🇸

New Orleans, Louisiana, United States

Johns Hopkins University/Sidney Kimmel Cancer Center

🇺🇸

Baltimore, Maryland, United States

Boston Children's Hospital

🇺🇸

Boston, Massachusetts, United States

University of Minnesota/Masonic Children's Hospital

🇺🇸

Minneapolis, Minnesota, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Cincinnati Children's Hospital Medical Center

🇺🇸

Cincinnati, Ohio, United States

Nationwide Children's Hospital

🇺🇸

Columbus, Ohio, United States

Children's Hospital of Philadelphia

🇺🇸

Philadelphia, Pennsylvania, United States

Children's Hospital of Pittsburgh of UPMC

🇺🇸

Pittsburgh, Pennsylvania, United States

University of Texas Southwestern/Children's Medical Center

🇺🇸

Dallas, Texas, United States

M D Anderson Cancer Center

🇺🇸

Houston, Texas, United States

Texas Children's Hospital

🇺🇸

Houston, Texas, United States

Children's Hospital of San Antonio

🇺🇸

San Antonio, Texas, United States

Children's Hospital of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Sydney Children's Hospital

🇦🇺

Randwick, New South Wales, Australia

Hospital for Sick Children

🇨🇦

Toronto, Ontario, Canada

The Montreal Children's Hospital of the MUHC

🇨🇦

Montreal, Quebec, Canada

Hadassah University Hospital

🇮🇱

Jerusalem, Israel

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