Sepsis in Oncology Patients

NCT ID: NCT06046677

Last Updated: 2023-09-21

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

NOT_YET_RECRUITING

Total Enrollment

180 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-09-30

Study Completion Date

2027-09-30

Brief Summary

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The overall objective of this prospective observational study is to address the significant knowledge gap that exists around the impact of immune dysfunction on the development and survival from sepsis in patients with cancer. This proposal primarily focuses on establishing the transcriptomic immune profiles of sepsis patients with a background of cancer. This analysis will be complemented with in vitro functional analyses, and in addition will commence a collection of genome-wide data, including a focus on predicting white cell number and function in health. Uniquely, the investigators propose to establish a robust link between these analyses: transcriptomic, in vitro, and genome-wide, to enable them to comprehensively explore septic oncology patient 'immune phenotypes' and effectively identify novel exploitable therapeutic pathways.

To this end, this project will collect, analyse and/or sequence DNA, RNA, leukocytes and soluble materials from a cohort of oncology patients presenting to intensive care with sepsis. This cohort will include all-comers with an oncological background but will also focus on two core groups at high risk of sepsis where baseline samples can also be sought prior to major immunosuppressive events in the cancer pathway. These are:

1. Oesophageal/upper gastrointestinal (GI) cancer patients prior to systemic anticancer therapy initiation or surgery
2. Haematological malignancy patients prior to stem cell transplantation.

These sub-cohorts will provide a previously unexplored unique insight into the role of pre-existing patient transcriptomic phenotypes.

Detailed Description

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The specific aims will be to perform multi-modal parallel immune phenotyping to determine:

* The transcriptomic (RNA) phenotypes (or 'signatures') of cancer patients with sepsis
* The association of these transcriptomic phenotypes with:

1. Leukocyte function in sepsis, as quantified by cell surface and functional assays and plasma soluble mediator content
2. Pre-existing genomic determinants such as leukocyte numbers
3. Severity of, and outcome from, sepsis in oncology patients

Conditions

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Sepsis in Cancer Patients

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Sepsis cohort

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection.

Organ dysfunction can be identified as an acute change in total SOFA score ≥2 points consequent to the infection.

No intervention

Intervention Type OTHER

No intervention

Elective cohort

Elective pre-operative upper GI surgical patients or elective stem cell transplant patients will be consented and enrolled at baseline, immediately prior to these procedures. If they go on to develop sepsis within 60 days of their surgery, they will go on to be sampled as per the sepsis cohort

No intervention

Intervention Type OTHER

No intervention

Interventions

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No intervention

No intervention

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients admitted to ICU with a diagnosis of sepsis as per 'Sepsis-3' definitions with a SOFA score \[REF\] ≥2 secondary to infection from any source
* ≥18 years of age
* Written consent from patient, personal or professional consultee, or deferred consent if none of the above available at admission


* Patients undergoing elective major upper GI surgery (oesophago+/-gastrectomy) or stem cell transplant for haematological malignancy
* ≥18 years of age
* Written consent from patient

Exclusion Criteria

• Death deemed imminent by the clinical team


• Limitations in place regarding provision of treatment and/or organ support e.g., palliative patients
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Royal Marsden NHS Foundation Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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The Royal Marsden NHS Foundation Trust

London, , United Kingdom

Site Status

Countries

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United Kingdom

Facility Contacts

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Mark Brandon-Grove

Role: primary

02031865416

Other Identifiers

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CCR5669

Identifier Type: -

Identifier Source: org_study_id

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