Prospective, Longitudinal Biocollection in Thoracic Oncology, Including Newly Diagnosed Lung Cancer Patients
- Conditions
- Lung CancerCarcinoma, Non-Small-Cell LungMetastatic Lung CancerSmall Cell Lung Carcinoma
- Interventions
- Other: Blood Sampling (2*8mL Tubes)Other: PBMC Sampling (1*8mL Tubes)Other: Paxgene Sampling
- Registration Number
- NCT06481813
- Lead Sponsor
- Nantes University Hospital
- Brief Summary
In clinical trials, patients are selected according to strict eligibility criteria (inclusion and exclusion criteria). These criteria aim to ensure homogeneity within the trial population, but may omit patients with specific characteristics, comorbidities or co-medications. Indeed, patients of advanced age, with comorbidities or brain metastases, who are frequently encountered in clinical practice, are often excluded from clinical trials. Real-life data in oncology play a vital role in assessing the efficacy of therapies and therapeutic strategies, complementing data from controlled clinical trials. They make it possible to analyze a larger population and take into account multiple variables such as patient history, co-medications and comorbidities, but also to analyze efficacy and toxicity data in populations not represented in clinical trials. The establishment of a prospective cohort including various stages and histologies will make it possible to set up a platform of available data, including a maximum of data linked to the patient, his tumor and his treatments, collected longitudinally until the patient's death (or the end of the study).
In parallel with this cohort, the project aims to set up a longitudinal plasmatheque (from diagnosis to death, or at the end of the study), as well as a tumorotheque (samples systematically stored as part of care by the CHU tumorotheque, and for which patient consent allows their use in research depending on the material available) for patients with available tumor samples. This will enable the construction of ancillary projects to validate research hypotheses, for example concerning the identification of mechanisms of resistance to therapies.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 730
Patients :
- Adult
- Patient newly diagnosed with NSCLC or CPC
- Cared for at Nantes University Hospital
- Affiliated or beneficiaries of a social security scheme or similar
- Treated with a systemic therapy including chemotherapy and/or immunotherapy and/or targeted therapy and/or therapy as part of a clinical trial after agreement from the sponsors of the studies concerned (only in the absence of blinding).
- Having agreed to participate in this study by signing the biocollection consent.
Healthy subjects :
- Adult
- Affiliated or beneficiaries of a social security or similar scheme
- Who have agreed to participate in this study by signing the Biocollection consent form.
- No known infectious pathology
- No known history of cancer
- No known history of chronic autoimmune disease
- No background immuno-suppressive treatment
Ancillary Study :
-Metastatic NSCLC with a KRAS G12C mutation, receiving treatment with Sotorasib, Adagrasib, or another KRAS G12C inhibitor, either as monotherapy or in combination.
Patients :
- Previous anticancer treatment for Lung cancer
- Patients who have not consented to participate in the BREATHE collection
- History of cancer (excluding thoracic cancer) with evidence of disease for less than 2 years
- Inclusion in a therapeutic trial with blinded treatment
- Patients under guardianship
- Patients with AME.
- Pregnant or breast-feeding women
Healthy subjects :
- Person under guardianship
- Person benefiting from AME (State medical aid)
- Pregnant or breast-feeding women
Ancillary Study :
- Pregnant or breast-feeding women
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Cohort A Blood Sampling (2*8mL Tubes) Patients are prospectively enrolled the day before their surgery for lung cancer, following selection based on tumor size assessed by the latest CT scan. The lesion size must be ≥ 20 mm (to prioritize anatomopathological analyses performed as part of care). If patients receive adjuvant treatment, blood samples will be collected on the day of treatment initiation and during follow-up. Patients receiving neoadjuvant treatment will be enrolled at the time of their first consultation with the medical oncologist. Patients in this cohort must meet the following criteria: - Stage I / II / IIIA-B localized NSCLC (non-small-cell lung cancer) eligible for surgery and adjuvant or neoadjuvant therapy (15-20% of NSCLC) Intervention : patients will be sampled from 2 x 8 mL blood tubes (EDTA tubes) Cohort B Blood Sampling (2*8mL Tubes) Patients are prospectively enrolled at the diagnosis of lung neoplasm, during the establishment of the therapeutic plan by the referring oncologist or pneumo-oncologist. Enrollment can also occur at the initiation of first-line treatment if it was not done at the time of the diagnostic consultation. Patients in this cohort must meet the following criteria: - metastatic NSCLC or SCLC (small-cell bronchial cancers), with drained or punctured pleural effusion and anatomopathological evidence of tumor cells Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Cohort B Paxgene Sampling Patients are prospectively enrolled at the diagnosis of lung neoplasm, during the establishment of the therapeutic plan by the referring oncologist or pneumo-oncologist. Enrollment can also occur at the initiation of first-line treatment if it was not done at the time of the diagnostic consultation. Patients in this cohort must meet the following criteria: - metastatic NSCLC or SCLC (small-cell bronchial cancers), with drained or punctured pleural effusion and anatomopathological evidence of tumor cells Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Cohort BMB PBMC Sampling (1*8mL Tubes) Patients are enrolled preoperatively, at the diagnosis of metastatic lung cancer at the cerebral level. The patient signs consent preoperatively (consent provided by the neurosurgeon). Subsequently, they are prospectively followed as part of their management in medical oncology, postoperatively. Patients in this cohort must meet the following criteria: - Patient operated on for brain metastasis as part of care, and diagnosed with lung cancer. Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Cohort BMB Paxgene Sampling Patients are enrolled preoperatively, at the diagnosis of metastatic lung cancer at the cerebral level. The patient signs consent preoperatively (consent provided by the neurosurgeon). Subsequently, they are prospectively followed as part of their management in medical oncology, postoperatively. Patients in this cohort must meet the following criteria: - Patient operated on for brain metastasis as part of care, and diagnosed with lung cancer. Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Cohort B PBMC Sampling (1*8mL Tubes) Patients are prospectively enrolled at the diagnosis of lung neoplasm, during the establishment of the therapeutic plan by the referring oncologist or pneumo-oncologist. Enrollment can also occur at the initiation of first-line treatment if it was not done at the time of the diagnostic consultation. Patients in this cohort must meet the following criteria: - metastatic NSCLC or SCLC (small-cell bronchial cancers), with drained or punctured pleural effusion and anatomopathological evidence of tumor cells Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Cohort C PBMC Sampling (1*8mL Tubes) Cohort C patients are recruited in the same way as for cohort B. Patients in this cohort must meet the following criteria: * Stage IV metastatic NSCLC receiving systemic chemotherapy, immunotherapy and/or targeted therapy * Locally advanced stage III NSCLC treated with radio-chemotherapy +/- immunotherapy * Extra-thoracic SCLC treated with chemotherapy +/- immunotherapy * Intra-thoracic SCLC treated with radio-chemotherapy Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Cohort BMB Blood Sampling (2*8mL Tubes) Patients are enrolled preoperatively, at the diagnosis of metastatic lung cancer at the cerebral level. The patient signs consent preoperatively (consent provided by the neurosurgeon). Subsequently, they are prospectively followed as part of their management in medical oncology, postoperatively. Patients in this cohort must meet the following criteria: - Patient operated on for brain metastasis as part of care, and diagnosed with lung cancer. Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Cohort C Blood Sampling (2*8mL Tubes) Cohort C patients are recruited in the same way as for cohort B. Patients in this cohort must meet the following criteria: * Stage IV metastatic NSCLC receiving systemic chemotherapy, immunotherapy and/or targeted therapy * Locally advanced stage III NSCLC treated with radio-chemotherapy +/- immunotherapy * Extra-thoracic SCLC treated with chemotherapy +/- immunotherapy * Intra-thoracic SCLC treated with radio-chemotherapy Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Cohort C Paxgene Sampling Cohort C patients are recruited in the same way as for cohort B. Patients in this cohort must meet the following criteria: * Stage IV metastatic NSCLC receiving systemic chemotherapy, immunotherapy and/or targeted therapy * Locally advanced stage III NSCLC treated with radio-chemotherapy +/- immunotherapy * Extra-thoracic SCLC treated with chemotherapy +/- immunotherapy * Intra-thoracic SCLC treated with radio-chemotherapy Intervention, the following volumes of blood will be drawn at each visit : * 2\*8ml (EDTA tubes) * 1\*8mL PBMC (only for patients receiving immunotherapy, collected before the 1st course of treatment, before the 2nd course of treatment, and at relapse) * 1\*6mL Paxgene (only for patients with lung cancer of non-epidermoid histology, collected at 1st treatment, 2nd treatment and relapse) Healthy Controls : Blood Sampling (2*8mL Tubes) A population of healthy subjects will also be included. These healthy subjects will be either : * Companions of patients with lung cancer who have come to the oncology clinic for their loved ones. * Patients who have undergone atypical lung resection as part of their care for pneumothorax. Intervention : Healthy subject will be sampled from 2 x 8 mL blood tubes (EDTA tubes) In addition to blood samples from healthy subjects, healthy tissue remnants from atypical lung resections performed as part of care for pneumothorax management will be used to analyze the study objectives.
- Primary Outcome Measures
Name Time Method Overall survival up to 5 years Overall survival will be defined as the time elapsed between the date of the initial diagnosis of lung cancer and the date of death, regardless of the cause. Patients still alive at the end of the follow-up period will complete their participation in the cohort.
- Secondary Outcome Measures
Name Time Method Describe the care pathway for patients with lung cancer. Assess the time intervals between different steps in the initial management of lung cancer. up to 5 years The care pathway will be described through the collection of dates (surgery, radiotherapy, presentation at multidisciplinary consultation meetings, etc.) and types of medical consultations.
Evaluate the return to work for patients of working age who have been treated for lung cancer. up to 5 years Proportion of patients who returned to work after treatment, measurement of the average time taken, and factors associated with the return to work.
Identify specific biomarkers of lung cancer cells (primary tumors or metastatic tissues) in comparison to healthy lung tissues. up to 5 years Quantitative comparison and characterization of biomarkers (extracellular vesicles and miRNA signatures) between tumor tissues and non-cancerous tissues.
Evaluate the prognostic and predictive value of circulating biomarkers at diagnosis and during systemic treatments. up to 5 years Association between levels of circulating biomarkers and overall survival as well as treatment response.