SingapOre Lung Cancer Screening Through Integrating CT With Other biomarkErs (SOLSTICE)

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

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

1000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-07-21

Study Completion Date

2029-12-31

Brief Summary

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This is a single arm screening study. All eligible participants will be subjected to low dose CT (LDCT) screening and biomarker testing.

The primary aim of the study is to determine the feasibility of conducting LDCT screening in at-risk populations for lung cancer in Singapore:

* For the smoker population, LDCT screening for lung cancer will be implemented in accordance to Academy of Medicine, Singapore screening test guidelines with the aim of investigating the feasibility of instituting lung cancer screening clinical service in Singapore.
* For the non-smoker population, LDCT screening for lung cancer will be introduced to systematically collect baseline data to better understand and provide evidence for lung adenocarcinoma in never-smoker phenotype that is unique to East Asia/Singapore. This will help address unmet needs in local population research as reported by Academy of Medicine, Singapore, to validate risk factors and inform future screening guidelines for the at-risk population.

Screening results will be reported based on Lung CT Screening Reporting \& Data System (Lung-RADS).

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Detailed Description

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This is a single arm cohort screening study. Briefly, this prospective study will involve screening the general population with risk factors for lung cancers with the aim of investigating the feasibility of implementing LDCT screening in the local context. Both smokers and non-smokers with the known risk factor of family history of lung cancer up to 2nd degree are eligible to participate in the study. Depending on emerging epidemiological data, additional high-risk cohorts may be included in this study. Subject demographics, smoking history, exposure to the aforementioned environmental factors, family history of lung cancer, history of tuberculosis and comorbidity will be captured in detail. The age range for inclusion is 55 to 74 years. Given the higher proportion of never-smoker lung cancer in Singapore, we aim to recruit 650 non-smoking and 350 smoking individuals for our study.

LDCT scan results will be reported based on the Lung-RADS classification. Participants will be stratified into various Lung-RADS groups based on the CT appearance and size of nodules. An alphanumeric Lung-RADS score will be assigned to each subject which will guide the downstream management of screened participants.

Participants with LDCT scan results of Lung-RADS score 2 and above will be referred to the nodule clinic under SingHealth DUKE-NUS Lung Centre for standardized follow-ups and/or diagnostic evaluation. These patients will undergo clinical surveillance (up to maximum of 5 years depending on their nodules) and will be managed as per current clinical practice. Participants with LDCT scan results of Lung-RADS score of 1 will undergo further screening surveillance which will end after 2 years if they have no nodules detected.

Conditions

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Lung Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Low-dose CT of the Chest (LDCT) + Blood sampling

Group Type EXPERIMENTAL

Low-dose CT of the Chest (LDCT) + Sampling for Biomarker Assays

Intervention Type DIAGNOSTIC_TEST

LDCT scan results will be reported based on the Lung-RADS classification. Participants will be stratified into various Lung-RADS groups based on the CT appearance and size of nodules. An alphanumeric Lung-RADS score will be assigned to each subject which will guide the downstream management of screened participants.

All subjects will be required to donate drawn blood samples (up to 30 ml) at every LDCT visit during screening surveillance, and at every LDCT/CT scan and/or biopsy visits during clinical surveillance for blood-based biomarker assays development and characterization. Subjects may also be asked to provide a sample of urine, saliva and breath for biomarker discovery.

Interventions

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Low-dose CT of the Chest (LDCT) + Sampling for Biomarker Assays

LDCT scan results will be reported based on the Lung-RADS classification. Participants will be stratified into various Lung-RADS groups based on the CT appearance and size of nodules. An alphanumeric Lung-RADS score will be assigned to each subject which will guide the downstream management of screened participants.

All subjects will be required to donate drawn blood samples (up to 30 ml) at every LDCT visit during screening surveillance, and at every LDCT/CT scan and/or biopsy visits during clinical surveillance for blood-based biomarker assays development and characterization. Subjects may also be asked to provide a sample of urine, saliva and breath for biomarker discovery.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

Smoker:

* Participant is willing and able to give informed consent for participation in the study
* Male or female, aged 50-80 years of age
* No prior history of cancer, or cancer free in the last 5 years and not currently on cancer treatment
* ECOG 0/1
* Current or former smokers with at least 30 pack years of smoking history
* Willing to comply with study follow-up schedule and tests
* Willing to cover the costs of downstream standard of care management and investigations including doctor's fee, CT scan and biopsy etc.
* A Singapore citizen/Permanent Resident of Singapore

Non-Smoker:

* Participant is willing and able to give informed consent for participation in the study
* Male, or female, aged 50-80 years of age
* No prior history of cancer, or cancer free in the last 5 years and not currently on cancer treatment
* ECOG 0/1
* Never smoker, or has smoked less than 10 pack-years and has quit smoking for at least 15 years
* Family history of lung cancer up to 2nd degree relatives
* Willing to comply with study follow-up schedule and tests
* Willing to cover the costs of downstream standard of care management and investigations including doctor's fee, CT scan and biopsy etc.
* A Singapore citizen/Permanent Resident of Singapore

Exclusion Criteria

* Uncontrolled medical comorbidity on enrolment
* Previous diagnosis of cancer
* Bleeding diathesis that will preclude blood sampling
* Fear of blood draw or needles
* Pregnancy

Minimum Eligible Age

50 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes