A Trial Using Novel Markers to Predict Malignancy in Elevated-Risk Women

NCT ID: NCT01121640

Last Updated: 2018-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

854 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-11-30

Study Completion Date

2015-05-07

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The Novel Markers Trial will compare the safety, feasibility and effectiveness of two different epithelial ovarian cancer screening strategies that use CA125 and add HE4 as either a first or second line screen. This study is the next step in a larger research effort to develop a blood test that can be used as a screening method for the early detection of epithelial ovarian cancer.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Epithelial ovarian cancer (EOC) is usually lethal unless it is diagnosed at an early stage, thus early detection is likely to play an important role in reducing its mortality. Within the Ovarian Specialized Programs of Research Excellence Pacific Ovarian Cancer Research Consortium (POCRC) researchers have been working for a decade to discover, develop, and validate biomarkers (proteins or substances found in blood) that could help save lives by detecting EOC early. During the last five years several biomarkers, including CA125, have been evaluated for their ability to detect EOC at an earlier stage. The best markers will now be studied in a new randomized controlled trial of ovarian cancer screening.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Epithelial Ovarian Cancer

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Ovarian Cancer Screening Biomarkers

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

CA125 every screen, HE4 at confirmatory screen.

CA125 will be used at every screen. Women with a parametric empirical Bayes (PEB) longitudinal algorithm score above the 90th percentile will be asked to return for early recall screening. Women with a PEB score above the 95th percentile will be referred for confirmatory measurements of CA125 and HE4. If confirmatory test results are higher than expected, a transvaginal ultrasound will be performed.

Group Type OTHER

CA125 assay on Abbott Architect i1000SR platform

Intervention Type PROCEDURE

Bead-based sandwich ELISA style assay

HE4 assay on Architect i1000SR platform

Intervention Type PROCEDURE

Bead-based sandwich ELISA style assay

Transvaginal Ultrasound

Intervention Type PROCEDURE

Sonogram will be obtained only if confirmatory markers are elevated. Exam is restricted to ovarian evaluation.

CA125 and HE4 at every screen.

CA125 and HE4 will both be used at every screen. Women with a PEB score above the 95th percentile on either CA125 or HE4 will be referred for confirmatory measurements of CA125 and HE4. If confirmatory test results are higher than expected, a transvaginal ultrasound will be performed.

Group Type OTHER

CA125 assay on Abbott Architect i1000SR platform

Intervention Type PROCEDURE

Bead-based sandwich ELISA style assay

HE4 assay on Architect i1000SR platform

Intervention Type PROCEDURE

Bead-based sandwich ELISA style assay

Transvaginal Ultrasound

Intervention Type PROCEDURE

Sonogram will be obtained only if confirmatory markers are elevated. Exam is restricted to ovarian evaluation.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

CA125 assay on Abbott Architect i1000SR platform

Bead-based sandwich ELISA style assay

Intervention Type PROCEDURE

HE4 assay on Architect i1000SR platform

Bead-based sandwich ELISA style assay

Intervention Type PROCEDURE

Transvaginal Ultrasound

Sonogram will be obtained only if confirmatory markers are elevated. Exam is restricted to ovarian evaluation.

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Abbott Architect CA125 assay Abbott Architect HE4 assay

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

Risk Group 1, Women ages 25 - 80:

* The subject has tested positive for a deleterious germ line mutation in BRCA1 or BRCA2.

Risk Group 2, Women ages 35 - 80, Pedigree conditions can be satisfied by multiple primary cancers in the same person:

* The subject has a personal history of breast cancer diagnosed before or at age 50.
* OR the subject has a personal history of bilateral breast cancer
* OR the subject has one first-degree relative with breast cancer diagnosed before or at age 50.
* OR the subject has two breast cancers in the first or second degree relatives, same lineage, with at least one breast cancer diagnosed before or at age 50.
* OR the subject has three or more first or second degree relatives, same lineage, with breast cancer diagnosed at any age.
* OR The family contains at least one ovarian cancer diagnosed at any age in the first or second degree relatives.
* OR the subject is of Ashkenazi ancestry and has had breast cancer diagnosed at any age.
* OR The subject is of Ashkenazi Jewish ethnicity and has one first or second degree relative with breast cancer diagnosed at any age (must be in the same lineage as the Ashkenazi ancestry)
* OR The subject has a male relative with breast cancer diagnosed at any age
* OR The subject has a personal history of a positive genetic test result for a deleterious germline mutation in the P53 gene.
* OR The subject has tested positive for a deleterious germline mutation in one of the DNA mismatch repair (MMR) genes associated with the Hereditary Non-Polyposis Colorectal Cancer Syndrome (HNPCC, also known as Lynch Syndrome) The MMR genes include MLH1, MSH2, MSH6 and PMS2.
* OR the subject has a first or second degree relative with an identified deleterious germline BRCA1 or BRCA2 mutation, but has not yet undergone testing herself.
* OR the subject has a first or second degree relative with an identified deleterious germline MMR gene mutation, but has not yet undergone testing herself.
* OR Probability of carrying a BRCA1 or BRCA2 mutation given family pedigree of breast and ovarian cancers exceeds 20% by any existing BRCA mutational probability model.

Risk Group 3, Women ages 45 - 80:

* Have measurement of CA125, HE4, MMP7 or Mesothelin exceeding the 95th percentile;
* OR have a relative risk of at least 2 based on the EpiRisk logistic regression model including age, family history, and other risk factors.

Exclusion Criteria

* Removal of both ovaries for any reason.
* History of ovarian, fallopian tube cancer or peritoneal carcinomatosis.
* Currently pregnant.
* Unable or unwilling to provide informed consent.
* Unwilling to provide the name of a physician.
* Unwilling to sign informed consent and/or medical records release form.
* Current untreated malignancy (other than non-melanoma skin cancer).
* Currently receiving adjuvant chemotherapy or radiation therapy for cancer (except tamoxifen or aromatase inhibitors +/- lupron). Patients who are being treated may enroll 3 months after completion of last treatment.
* Intraperitoneal surgery within the last 3 months (laparoscopy or laparotomy).
* A medical condition that would place subject at risk as a result of the blood donation, including but not limited to bleeding disorders, chronic infectious disease, emphysema or serious anemia.
* Subject has a family member who is a carrier of a BRCA or MMR gene mutation and the subject has undergone genetic testing that included the family mutation and no mutation was found, and there are no cases of ovarian cancer in the family.
Minimum Eligible Age

25 Years

Maximum Eligible Age

80 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

The Marsha Rivkin Center for Ovarian Cancer Research

OTHER

Sponsor Role collaborator

Canary Foundation

OTHER

Sponsor Role collaborator

Swedish Medical Center

OTHER

Sponsor Role collaborator

City of Hope Medical Center

OTHER

Sponsor Role collaborator

Cedars-Sinai Medical Center

OTHER

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role collaborator

Fox Chase Cancer Center

OTHER

Sponsor Role collaborator

Fred Hutchinson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Nicole Urban, ScD

Role: PRINCIPAL_INVESTIGATOR

Fred Hutchinson Cancer Center

Beth Karlan, MD

Role: PRINCIPAL_INVESTIGATOR

Cedars-Sinai Medical Center

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

City of Hope

Duarte, California, United States

Site Status

Cedars-Sinai Medical Center

Los Angeles, California, United States

Site Status

Stanford University

Stanford, California, United States

Site Status

Fox Chase Cancer Center

Philadelphia, Pennsylvania, United States

Site Status

Fred Hutchinson Cancer Research Center

Seattle, Washington, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Anderson GL, McIntosh M, Wu L, Barnett M, Goodman G, Thorpe JD, Bergan L, Thornquist MD, Scholler N, Kim N, O'Briant K, Drescher C, Urban N. Assessing lead time of selected ovarian cancer biomarkers: a nested case-control study. J Natl Cancer Inst. 2010 Jan 6;102(1):26-38. doi: 10.1093/jnci/djp438. Epub 2009 Dec 30.

Reference Type BACKGROUND
PMID: 20042715 (View on PubMed)

Lowe KA, Andersen MR, Urban N, Paley P, Dresher CW, Goff BA. The temporal stability of the Symptom Index among women at high-risk for ovarian cancer. Gynecol Oncol. 2009 Aug;114(2):225-30. doi: 10.1016/j.ygyno.2009.03.015. Epub 2009 May 7.

Reference Type BACKGROUND
PMID: 19427026 (View on PubMed)

Andersen MR, Karlan BY, Drescher CW, Paley P, Hawley S, Palomares M, Daly MB, Urban N. False-positive screening events and worry influence decisions about surgery among high-risk women. Health Psychol. 2019 Jan;38(1):43-52. doi: 10.1037/hea0000647. Epub 2018 Nov 15.

Reference Type DERIVED
PMID: 30431292 (View on PubMed)

Andersen MR, Goff BA, Lowe KA, Scholler N, Bergan L, Drescher CW, Paley P, Urban N. Use of a Symptom Index, CA125, and HE4 to predict ovarian cancer. Gynecol Oncol. 2010 Mar;116(3):378-83. doi: 10.1016/j.ygyno.2009.10.087. Epub 2009 Nov 28.

Reference Type BACKGROUND
PMID: 19945742 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://www.pocrc.org

homepage of the Pacific Ovarian Cancer Research Consortium

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

6973

Identifier Type: OTHER

Identifier Source: secondary_id

P50CA083636-01

Identifier Type: NIH

Identifier Source: org_study_id

View Link