背景:尚未对患有非透明细胞(CC)肾细胞癌(RCC)的患者进行3期研究,仅由于该疾病的罕见发生和肿瘤形态的异质性。因此,没有最佳治疗的证据,需要新的方法。一种方法是基于肿瘤组织的基因测序来个体化治疗。此外,最近的研究涉及患者报告的结果(PRO)的患者接受治疗的转移性癌症已显示显著的好处的生活质量,中位总生存期,和总体生存率。基因测序和PROs的使用对罕见癌症类型的患者可能非常重要,包括非CCRCC患者,应该在临床试验中进行研究,尤其是在基于3期研究的证据难以获得的情况下。
目的:我们描述了INDIGO研究,其中患者,基于基因分析,将被分配到4个治疗臂包含14个治疗和使用电子PRO。我们的目标是改善非CCRCC患者的治疗。研究的终点将是总患者群体的总体反应率(完全和部分),这将基于RECIST(实体瘤的反应评估标准)1.1版标准,以及治疗失败的时间。
方法:INDIGO是一项前瞻性的2期试验,将招募30名患者。患者将接受基于其肿瘤组织的遗传分析的全身治疗。所有患者都将在专用应用程序中收到电子问卷-有关症状和副作用的问卷,以及与健康相关的生活质量的问卷。根据治疗方案,病人每三分之一就会被医生看到,第四,或者第六周,系统治疗的效果将通过计算机断层扫描每6周评估一次。该研究已获得丹麦药品管理局和国家卫生研究伦理委员会的批准(批准号:H-19041833),符合良好的临床实践指南,遵循一般数据保护条例,并在丹麦首都地区注册。
结果:招聘始于2020年3月,在提交本文时(2022年6月),共纳入9例患者.
结论:我们旨在探索改善非CC型肾癌患者治疗结果的方法。INDIGO研究将为稀有类型的RCC提供更多个性化医疗数据,并提供有关积极使用电子PRO的新知识。
背景:ClinicalTrials.govNCT0464432,https://clinicaltrials.gov/ct2/show/NCT0464432;欧盟药物监管机构临床试验数据库2019-001316-38,https://tinyurl.com/2p8mb4aw。
UNASSIGNED:DERR1-10.2196/36632。
BACKGROUND: No phase 3 studies have yet been conducted for patients with non-clear cell (CC) renal cell carcinoma (RCC) exclusively due to the rare occurrence of the disease and the heterogenicity in tumor morphology. Consequently, there is no evidence of the optimal treatment, and new approaches are needed. One approach is individualizing treatment based on the gene sequencing of tumor tissue. Additionally, recent studies involving the patient-reported outcomes (PROs) of patients treated for metastatic cancer have shown significant benefits for quality of life, median overall survival, and overall survival. The use of gene sequencing and PROs can be of great importance to patients with rare cancer types, including patients with non-CC RCC, and should be investigated in clinical trials, especially for cases where evidence based on phase 3 studies is difficult to obtain.
OBJECTIVE: We describe the INDIGO
study, in which patients, based on gene analyses, will be allocated into 4 treatment arms containing 14 treatments and use electronic PROs. We aim to improve the treatment of patients with non-CC RCC. The end points in the
study will be the overall response rate (complete and partial) in the total patient population, which will be based on the RECIST (Response Evaluation Criteria in Solid Tumors) version 1.1 criteria, and the time to treatment failure.
METHODS: INDIGO is a prospective phase 2
trial, and 30 patients will be enrolled. The patients will receive systemic treatment based on genetic analyses of their tumor tissue. All patients will receive electronic questionnaires in a dedicated app-a questionnaire regarding symptoms and side effects and another regarding health-related quality of life. Depending on the treatment regimen, the patients will be seen by a medical doctor every third, fourth, or sixth week, and the effect of the systemic treatment will be evaluated every 6 weeks via a computed tomography scan. The
study has been approved by the Danish Medicines Agency and the National Committee on Health Research Ethics (approval number: H-19041833), complies with good clinical practice guidelines, follows the General Data Protection Regulation, and is registered at the Capital Region of Denmark.
RESULTS: Recruitment started in March 2020, and at the time of submitting this paper (June 2022), a total of 9 patients have been enrolled.
CONCLUSIONS: We aim to explore methods for improving the treatment outcomes of patients with non-CC RCC, and the INDIGO
study will contribute further data on personalized medicine for rare types of RCC and provide new knowledge on the active use of electronic PROs.
BACKGROUND: ClinicalTrials.gov NCT04644432, https://clinicaltrials.gov/ct2/show/NCT04644432 ; European Union Drug Regulating Authorities Clinical Trials Database 2019-001316-38, https://tinyurl.com/2p8mb4aw.
UNASSIGNED: DERR1-10.2196/36632.