Implementation of Personalized Medicine for Optimal Drug Therapy in Cancer

NCT ID: NCT05830279

Last Updated: 2025-07-09

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

Total Enrollment

600 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-05-01

Study Completion Date

2026-04-30

Brief Summary

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A prospective longitudinal cohort study that will assess the effect of a Personalized Medicine (PM) clinic recommendations on pharmacogenetic variation and/or interacting drugs on plasma drug exposure, effectiveness or toxicity of commonly used antidepressant, pain, and antiemetic medications in cancer patients. Such recommendations will entail genotype-guided treatment suggestions while also considering potential DDI, and will be provided to patients during their clinic visit, and referring physicians thereafter. Drug concentration and therapeutic effectiveness will be assessed before (baseline) and 6 months after recommendations have been provided. To assess effectiveness, patient-reported outcomes will be evaluated using validated scales for symptoms of depression, pain and chemotherapy-induced nausea/ vomiting

The investigators hypothesize that the pharmacogenetic variation and DDI, if applicable, determine steady state drug concentration and therapeutic response or toxicity of the investigated antidepressant, pain or antiemetic treatments at baseline, while there is a clinically significant reduction or absence of the effect 6 months after the PM clinic recommendations to referring physicians and patients.

Detailed Description

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This prospective longitudinal study will consist of three cohorts of adult cancer patients routinely referred to the PM clinic for genotype-guided chemotherapy including 5-FU or tamoxifen that are also taking antidepressant, analgesic and/or antiemetic medications.

Patients will be assigned to one or more cohorts, as appropriate, at the screening visit: Cohort 1 (n=200) if prescribed antidepressants including the selective serotonin reuptake inhibitors (SSRI) citalopram or escitalopram, or the selective norepinephrine reuptake inhibitors (SNRI) venlafaxine or desvenlafaxine; Cohort 2 (n=200) if prescribed opioid pain medications including codeine, oxycodone, hydrocodone, or tramadol; and/or Cohort 3 (N=200) if prescribed the antiemetic agent ondansetron.

Each patient will participate in a PM clinic screening visit. Eligible patients will attend three subsequent study visits at 0.5, 4 (virtual), and 7 months after screening. At each PM clinic visit, clinical information and a venous blood sample will be collected. Patients will also complete the ESAS survey and validated scores/ surveys to evaluate treatment effectiveness.

Conditions

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Nausea With Vomiting Chemotherapy-Induced Depression, Reactive Cancer Pain

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Anti-depressants

Patients who have been prescribed either 1) the selective serotonin reuptake inhibitors (SSRI) citalopram or escitalopram, or 2) the selective norepinephrine reuptake inhibitors (SNRI) venlafaxine or desvenlafaxine

Pharmacogenetic testing

Intervention Type GENETIC

Genotyping for CYP2D6 and CYP2C19

Drug-Drug interaction analysis

Intervention Type OTHER

Evaluating potential drug interactions with CYP2D6, CYP2C9 and CYP3A4 inhibitors and inducers using the Medical Letter.

Opioid pain medications

Patients who have been prescribed opioid pain medications including codeine, oxycodone, hydrocodone, or tramadol.

Pharmacogenetic testing

Intervention Type GENETIC

Genotyping for CYP2D6 and CYP2C19

Drug-Drug interaction analysis

Intervention Type OTHER

Evaluating potential drug interactions with CYP2D6, CYP2C9 and CYP3A4 inhibitors and inducers using the Medical Letter.

Anti-metics

Patients who have been prescribed the antiemetic agent ondansetron

Pharmacogenetic testing

Intervention Type GENETIC

Genotyping for CYP2D6 and CYP2C19

Drug-Drug interaction analysis

Intervention Type OTHER

Evaluating potential drug interactions with CYP2D6, CYP2C9 and CYP3A4 inhibitors and inducers using the Medical Letter.

Interventions

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Pharmacogenetic testing

Genotyping for CYP2D6 and CYP2C19

Intervention Type GENETIC

Drug-Drug interaction analysis

Evaluating potential drug interactions with CYP2D6, CYP2C9 and CYP3A4 inhibitors and inducers using the Medical Letter.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or older
* Prescribed a chemotherapy medication
* Currently taking one or more study medications (citalopram, escitalopram, venlafaxine, desvenlafaxine, codeine, oxycodone, hydrocodone, tramadol or ondansetron)

Exclusion Criteria

* Patients who are unable to complete study materials (surveys) with or without assistance, including non-English speaking patients
* Patients receiving palliative care
* Patients taking anti-depressants for reason other than depression or anxiety, i.e. hot flash (Only applies to antidepressant cohort)
* Patients with preexisting major depressive disorder prior to cancer diagnosis (Only applies to antidepressant cohort)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

OTHER

Sponsor Role lead

Responsible Party

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Richard Kim

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Richard Kim, MD

Role: PRINCIPAL_INVESTIGATOR

Western University, Canada

Locations

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Lawson Health Research Institute

London, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Richard Kim, MD

Role: CONTACT

519-685-8500 ext. 33553

Samantha Medwid, PhD

Role: CONTACT

519-685-8500 ext. 32099

Other Identifiers

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11642

Identifier Type: -

Identifier Source: org_study_id

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