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Identification of a Predictive Metabolic Signature of Response to Immune Checkpoint Inhibitors in Non-Small Cell Lung Carcinoma

Completed
Conditions
Non Small Cell Lung Cancer
Interventions
Other: Immune signature in serum associated to the metabolic signature
Genetic: Meta-genomic signature of intestinal flora
Registration Number
NCT04189679
Lead Sponsor
University Hospital, Grenoble
Brief Summary

Immune checkpoints inhibitors (ICI) are becoming new standards of care for Non-Small Cell Lung Carcinoma (NSCLC) treatment. To date, no powerful predictive biomarker of response has been found.

The investigators hypothesize that metabolomics profile could represent a potent biomarker of response to ICI

Detailed Description

Immune checkpoints inhibitors (ICI) are becoming new standards of care for Non-Small Cell Lung Carcinoma (NSCLC) treatment, both as first and second line of treatment. To date, no powerful predictive biomarker of response has been found. It has been recently shown that microbiota composition could dictate the ability of patients to respond to ICI. Since, the microbiota produces circulating metabolites that will subsequently act on immune system, the investigators hypothesized that metabolic signature, reflecting microbiota function, could represent a predictive biomarker of response to ICI.

Primary objective is to identify baseline metabolic signature (metabolomics analysis by Mass spectrometry) associated to ICI response. Secondary objectives are to link metabolic signature with microbiota composition (metagenomics analysis RNA 16S) and immune profile, and altogether with clinic response to ICI. Profile evolution (metabolic, metagenomics and immune) will be also analyzed at 2-month post ICI initiation and at tumor progression, if any.

In order to do so, the investigators thus plan to enroll 60 NSCLC patients treated by ICI as 1st, 2nd or 3rd line of treatment in CHUGA in 18 months. Blood as well feces will be collected prior to, and at 2 month following ICI treatment initiation as well as at progression. Will be excluded from this study, patients that have received antibiotic or corticotherapy 2 or 4 weeks before ICI initiation, respectively.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
62
Inclusion Criteria
  • NSCLC diagnosis
  • Patient treated by a ICI in first, second or third line of treatment, or by the combination of chemotherapy and IPCI in first line of treatment
  • Patient with at least one measurable lesion as defined by RECIST
Exclusion Criteria
  • Patient treated with antibiotic treatment within 2 weeks before the start of ICI or corticosteroids (>20 mg per day) within 4 weeks before the start of ICI

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Second or third lineMeta-genomic signature of intestinal flora40 patients in second and third line of treatment
First lineImmune signature in serum associated to the metabolic signature20 patients in first line of treatment
First lineMeta-genomic signature of intestinal flora20 patients in first line of treatment
Second or third lineImmune signature in serum associated to the metabolic signature40 patients in second and third line of treatment
Primary Outcome Measures
NameTimeMethod
Identification of the change from baseline Metabolic signature as predictive factor of the ICI response at 6 months or at the tumoral progressionbaseline, 6 months or tumoral progression

To identify the link of the change from baseline of Metabolic signature in serum (metabolomics analysis performed using a Mass spectrometry) and the ICI response at 6 months or at the tumoral progression

Secondary Outcome Measures
NameTimeMethod
Description of the profile change of Meta-genomic signature2 months or tumoral progression

To describe the change from baseline of the Meta-genomic signature at 2 months or at the tumoral progression

Identification of change of immune signature and the ICI response at 2 months or at the tumoral progressionBaseline and (2 months or tumoral progression)

To identify the link between the profile change from baseline of immune signature and the ICI response at 2 months or at the tumoral progression

Description of the profile change of Immune signature at 2 months or at the tumoral progressionBaseline and 2 months or tumoral progression

To describe the change from baseline of the Immune signature at 2 months or at the tumoral progression

Description of the survival without progression under ICI at 6 months or at the tumoral progression6 months or tumoral progression

To describe the survival without progression under ICI at 6 months or at the tumoral progression

Identification of the link between the Meta-genomic and immune signatures and the metabolic signature at 6 months or at the tumoral progression6 months or tumoral progression

To identify the link between the Meta-genomic signature of intestinal flora (microbiota composition analysed by RNA 16 S) with the Immune signature in serum and the metabolic signature at 6 months or at the tumoral progression

Identification of the link between the profile change of meta-genomic signature and the ICI response at 2 months or at the tumoral progressionBaseline and (2 months or tumoral progression)

To identify the link between the profile change from baseline of meta-genomic signature and the ICI response at 2 months or at the tumoral progression

Identification of the link between the Meta-genomic and immune signatures and ICI response at 6 months or at the tumoral progression6 months or tumoral progression

To identify the link between the Meta-genomic signature of intestinal flora with the Immune signature in serum and the ICI response at 6 months or at the tumoral progression

Description of overall survival under ICI at 6 months or at the tumoral progression6 months or tumoral progression

To describe of the overall survival under ICI at 6 months or at the tumoral progression

Trial Locations

Locations (1)

University Hospital, Grenoble

🇫🇷

La Tronche, Isère, France

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