HEPHESTOS - Hereditary Pheochromocytoma Assessment of Tumour Immunologies
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 200
- 试验地点
- 1
- 主要终点
- Immune cell response in circulation, both after stimulation and in an unstimulated state, measured as the concentration of inflammatory molecules and proteins.
研究概览
简要总结
In this study, the investigators are examining the role of the immune system in pheochromocytoma and paraganglioma. The investigators aim to examine the differences in the immune system between people who have these tumors with and without a hereditary predisposition. The investigators also want to see how the immune system changes during the development of the tumor in people with a hereditary predisposition. Finally, the investigators will compare the data with a control group of people without these tumors. Ultimately, the investigators hope that the results will contribute to the discovery of new immune system-targeted medications for pheochromocytoma and paraganglioma.
详细描述
Rationale: Pheochromocytoma and Paraganglioma (PPGL) represent rare, catecholamine-secreting tumours (1). Genetic or sporadic mutations, accounting for approximately 70% of cases, significantly contribute to PPGL development, and are categorized into three clusters based on tumour formation mechanisms (2,3). Current treatment options, particularly for advanced or metastatic disease, are limited (4). Understanding the immune system's role and the impact of genetics on tumour immunology in PPGL could unveil crucial insights for therapeutic advancements. Earlier studies emphasized the immunogenic nature of PPGL, highlighting the tumour microenvironment (TME) and circulatory factors as key components (5-7). However, these studies lack specific examination of genotypes' effect on the immune system. This study aims to address this gap in two parts, particularly focusing on differences between genetic clusters.
Objective: To examine the differences in the immune system in PPGL regarding genetics. Part I will examine immune cell composition and response in circulation. Part II will examine immune cell composition in TME.
Study design: Part I will be a partly cross-sectional and partly prospective cohort study. Part II will be a histological study of retrospectively and prospectively collected PPGL samples.
Study population: Part I will include 80 patients with PPGL, 80 carriers of germline mutations predisposing for PPGL, and 40 sex and age matched healthy volunteers. Part II will include histological samples of 80 patients with hereditary disease and 80 patients with sporadic disease.
Main study parameters/endpoints: The main study outcomes are inflammatory molecules and proteins produced by stimulated and unstimulated immune cells from circulation, immune cell composition in histological PPGL samples and in circulation, and their genetic determinants. Secondary outcomes will comprise of transcriptional and epigenetic signature of circulating immune cells, circulating immunomodulating metabolites, trained immunity, and clinical outcomes such as tumour metastasis, survival.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Other
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Newly diagnosed patients with PPGL or newly diagnosed patients with (metastatic) PPGL recurrence.
- •OR patients with mutations which predispose for the development of PPGL.
- •Aged > 18 years.
- •Confirmed PPGL on pathology.
- •Aged > 18 years.
排除标准
- •Unable to provide informed consent.
- •Active inflammatory or infectious comorbidities.
- •Other malignancies which are under active treatment (except for basal cell carcinoma, other in situ carcinomas).
- •Using medication interfering with the immune system
- •Pregnancy or breastfeeding
- •A self-reported alcohol consumption of >21 units per week
结局指标
主要结局
Immune cell response in circulation, both after stimulation and in an unstimulated state, measured as the concentration of inflammatory molecules and proteins.
时间窗: Before surgery, 6 weeks after surgery, after 1 year, after 2 years.
e.g. cytokines
Immune cell composition in histological PPGL specimens and in circulation.
时间窗: Before surgery, 6 weeks after surgery, after 1 year, after 2 years. Histological specimens will only be obtained during surgery.
次要结局
- Concentration of immunomodulating metabolites in circulation.(Before surgery, 6 weeks after surgery, after 1 year, after 2 years.)
- Tumour recurrence rate(After 1 year, after 2 years.)
- Transcriptional and epigenetic signature of circulating immune cells.(Before surgery, 6 weeks after surgery, after 1 year, after 2 years.)
- Survival rate(After 1 year, after 2 years.)
- Trained immunity assessment of circulating immune cells.(Before surgery, 6 weeks after surgery, after 1 year, after 2 years.)
- Metastasis rate(Before surgery, after 1 year, after 2 years.)