Status:
RECRUITING
Role of Gut Microbiome and Fecal Transplant on Medication-Induced GI Complications in Patients With Cancer
Lead Sponsor:
M.D. Anderson Cancer Center
Collaborating Sponsors:
National Cancer Institute (NCI)
Conditions:
Clinical Stage 0 Cutaneous Melanoma AJCC v8
Clinical Stage I Cutaneous Melanoma AJCC v8
Eligibility:
All Genders
18+ years
Phase:
PHASE1
Brief Summary
This trial studies the role of the gut microbiome and effectiveness of a fecal transplant on medication-induced gastrointestinal (GI) complications in patients with melanoma or genitourinary cancer. T...
Detailed Description
PRIMARY OBJECTIVES: I. To compare the difference in stool microbiome pattern between patients who develop immune-checkpoint inhibitor (ICPI)-related colitis and patients who don't develop ICPI-relate...
Eligibility Criteria
Inclusion
- Diagnosis of any stage melanoma, Non-Small Cell Lung Cancer or genitourinary (GU) malignancies (Project 1).
- Diagnosis of any cancer type (Projects 2 and 3)
- Treatment with any ICPI agent
- Ability to understand and willingness to sign an informed consent form and rate surveys
- Life expectancy \> 4 months (Project 3)
- ICPI-related diarrhea and/or colitis of any grade with or without concurrent non- GI toxicity as the toxicity group (project 1)
- Patients with no organ toxicity as the control group (project 1)
- ICPI-related colitis and/or diarrhea of grade ≥ 2 as GI toxicity (initial episode or recurrence) receiving standard treatment of immunosuppressive agents (steroid, infliximab, vedolizumab, or ustekinumab) any time during the colitis disease course until sustained resolution of GI toxicity, or one- year time point after enrollment (Project 2)
- ICPI-related colitis and/or diarrhea of grade ≥ 2 as GI toxicity without involvement of non- GI toxicity within 45 days prior to FMT (Project 3)
- ICPI-related colitis and/or diarrhea of grade ≥ 2 within 45 days prior to FMT with ANY of the following characteristics (project 3):
- (i) refractory to treatment of steroid and two doses of non-steroidal immunosuppressants e.g. infliximab, vedolizumab or ustekinumab,
- (ii) contraindication for immunosuppressive treatment,
- (iii) recurrence after successful initial treatment,
- (iv) recurrent symptoms once steroid is tapered down/off or diarrhea/colitis symptoms are steroid dependent, or
- (v) patients with a history of refractory ICPI-related colitis and/or diarrhea to medical treatment, even if they have improved symptoms from supportive care within 45 days prior to FMT
- No concern for active concomitant GI infection for the ICPI diarrhea/colitis work up at the time of protocol therapy initiation as confirmed by stool tests or as per the treating physician based on clinical presentation (project 3)
- Patient who has been cleared for enrollment by Infectious Diseases consultant or treating physician if positive infection workup or screening tests (e.g. lifelong positive T-spot due to BCG inoculation, chronic colonization) prior to initiation of diarrhea/colitis treatment (project 3)
Exclusion
- Age younger than 18 years
- History of inflammatory bowel disease, and/or radiation enteritis or colitis with active disease status at the time of study treatment initiation
- Pregnant and breastfeeding women
- Women of child-bearing potential who have positive urine or serum pregnancy test or refuse to do pregnancy test unless last menstrual cycle was \> 1 year prior to consent and/ or clear documentation states that patient is peri- or post-menopausal or there was recent supporting objective evidence of 'no pregnancy' status (e.g. blood or imaging) within 30 days prior to date of study treatment
- Patients who develop concurrent non- GI toxicity at the time of FMT treatment (project 3)
- Patients with active bacterial or fungal infection (Project 3)
- Donors at risk for monkeypox infection and/ or exposure as determined by a questionnaire (Project 3)
- Withdrawal Criteria
- Patients may withdraw from the trial at any time
- Patients who develop GI perforation or toxic colitis that require surgery from ICPI colitis
- In project 3, if the first 30% of cases fail the fecal transplant treatment, then project 3 will be terminated
Key Trial Info
Start Date :
February 21 2021
Trial Type :
INTERVENTIONAL
Allocation :
ESTIMATED
End Date :
October 31 2025
Estimated Enrollment :
800 Patients enrolled
Trial Details
Trial ID
NCT03819296
Start Date
February 21 2021
End Date
October 31 2025
Last Update
September 16 2025
Active Locations (1)
Enter a location and click search to find clinical trials sorted by distance.
1
M D Anderson Cancer Center
Houston, Texas, United States, 77030