Sherbrooke

Preterm birth, defined as birth before 37 weeks of gestation, occurs in about 8 percent of pregnancies in Canada and is linked to many health challenges, especially when it happens before 29 weeks. At this early stage, infants often face breathing difficulties and may require resuscitation. This trial compares resuscitation using either low 30% or high 60% oxygen levels to determine which approach results in better survival and neurodevelopmental outcomes at around 24 months of age. The study uses a cluster randomized crossover design where hospitals alternate between starting resuscitation with 30% or 60% oxygen for groups of 30 infants. Resuscitation includes standard care steps like lung expansion and ventilation support as needed. Oxygen is initially given at the assigned concentration for the first 5 minutes, then adjusted based on the infants oxygen saturation levels and heart rate over the next 5 minutes to maintain target saturation ranges. This approach aims to balance risks of too much or too little oxygen. Participants are infants born between 23 and 28 weeks gestation who receive full resuscitation at participating centers. During the study, infants have oxygen saturation monitored continuously, and adjustments to oxygen concentration are made carefully. Researchers will evaluate survival and major neurodevelopmental outcomes at 24 months corrected age, along with several safety and health measures during the neonatal intensive care stay. The trial is expected to provide important evidence to guide oxygen use during resuscitation of extremely preterm infants.

Researchers are evaluating a new imaging method called 4FMFES-PET combined with FDG-PET to improve diagnosis and management of advanced estrogen receptor-positive ER breast cancer. ER status is a key factor in guiding treatment choices, but tumors can vary in ER expression over time and across sites. This study aims to assess the full potential of 4FMFES-PET, which has shown better image quality and tumor detection than earlier tracers, in combination with FDG-PET for whole-body, non-invasive ER status evaluation in advanced breast cancer patients. Participants with advanced ER breast cancer will undergo 4FMFES-PET imaging at the start, then again at 6 and 18 months, within 4 weeks of medically prescribed FDG-PET scans. The 4FMFES tracer is given intravenously followed by PET imaging. The study will compare and complement these PET scans with conventional imaging and correlate imaging results with pathology from biopsies and with clinical outcomes like treatment response and progression-free survival. During the study, participants will have multiple PET scans to monitor ER expression and tumor activity over time. Researchers will collect pathological data and track outcomes such as time to recurrence and treatment effects. The main measurements include uptake of 4FMFES on PET scans correlated with tissue markers and clinical progress over 18 to 36 months. This approach aims to better identify patient groups who may benefit from this imaging method to guide their care.

Neuroblastoma is the most common extracranial tumor in children, occurring at a rate of about 10.2 cases per million yearly. This study is a phase II pilot trial designed to assess the use of a new imaging method, 68Ga-DOTATATE PETCT, for detecting neuroblastoma and compare it to the existing 123I-MIBG scan. Researchers aim to evaluate the feasibility and safety of 68Ga-DOTATATE and how accurately it identifies neuroblastoma lesions compared to 123I-MIBG. Participants will first undergo a 123I-MIBG scan followed by a 68Ga-DOTATATE PETCT scan a few days later. The 68Ga-DOTATATE is a radiopharmaceutical injected into the patient, and imaging is done approximately one hour post-injection, lasting about two hours. This single-arm study includes children and young adults up to 21 years old who have biopsy-proven or suspected neuroblastoma. The study monitors adverse events within 24 hours after the 68Ga-DOTATATE injection. During the study, researchers will collect clinical data from the imaging scans and participants medical records for up to two years, including demographics, treatments, medications, pathology, and laboratory tests. Outcome measurements focus on the rate of participant enrollment and any side effects from the 68Ga-DOTATATE injection, as well as lesion detection and differences between the two imaging methods. Participants health status will be followed regularly to assess the imaging techniques effectiveness and safety.

Researchers are evaluating the safety and clinical usefulness of cyclotron-produced 68Ga-PSMA-617 PET imaging in cancers that express PSMA, including prostate cancers and many other solid tumors. This open-label, non-randomized study aims to gather information on how this imaging method impacts patient management compared to current standard care. The study also seeks to promote routine use of this PET imaging in clinical settings for eligible cancer patients. Participants will receive an intravenous injection of 68Ga-PSMA-617, with the dose adjusted based on patient weight and PET scanner characteristics, up to a maximum of 370 MBq. About 60 to 90 minutes after the injection, they will undergo PETCT scanning to capture images of their tumors. These images will be reviewed by a nuclear medicine physician. The study will monitor safety, including any side effects, and assess the accuracy of the imaging by identifying false positives or negatives and unusual tracer distribution. During the study, participants will be involved in the injection and imaging procedures, followed by monitoring for adverse events and analysis of imaging results. Researchers will collect data on how the imaging influences cancer staging, treatment decisions, and follow-up care. The main outcome measured is the incidence of treatment-emergent adverse events over five years. Additional outcomes include evaluating the impact on patient management and encouraging the adoption of 68Ga-PSMA-617 PETCT as a standard diagnostic tool.

Researchers are conducting a Phase 3, randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of rilzabrutinib in adults with active Immunoglobulin G4-related disease IgG4-RD. The study aims to measure the time to the first adjudicated disease flare and assess other important outcomes such as flare-free rates, disease activity control, glucocorticoid use, and safety parameters including adverse events, laboratory tests, and electrocardiograms ECG. Participants will be assigned to one of two groups one receiving rilzabrutinib tablets and the other receiving placebo tablets, both administered orally. The treatment period lasts 52 weeks in a double-blind manner, preceded by a 4 to 6 week screening period. After treatment, there is a 2-week follow-up, with an optional open-label extension lasting up to 108 weeks. The study includes a total of 16 visits during the main period and up to 9 additional visits during the optional extension. During their participation, adults diagnosed with IgG4-RD will undergo repeated imaging procedures such as CT, MRI, PET, or ultrasound to assess disease status. Researchers will monitor disease flares, remission status, glucocorticoid dosage, clinical activity scores, laboratory values, vital signs, and ECG results. Safety monitoring continues up to week 160 to capture treatment-emergent adverse events. Overall, participation lasts up to 60 weeks, with possible extension for those continuing in the optional phase.

This research investigates treatments for metastatic castration-resistant prostate cancer mCRPC focusing on a drug called ifinatamab deruxtecan I-DXd. The study aims to assess the safety, how well participants tolerate the treatments, and appropriate dosing levels of I-DXd alone or combined with other therapies. Researchers will also monitor participants prostate specific antigen PSA levels during treatment to understand its effects. Participants are assigned to one of several treatment groups. One group receives docetaxel every three weeks for up to 10 cycles. Other groups receive I-DXd alone or combined with either opevesostat or androgen receptor pathway inhibitors such as abiraterone acetate or enzalutamide. I-DXd is given every three weeks until unacceptable side effects, disease progression, death, or withdrawal, while the other drugs continue until specific discontinuation criteria are met. Premedication is required before each I-DXd dose to prevent nausea and vomiting. Throughout the study, participants undergo various assessments including monitoring of dose-limiting toxicities, adverse events, and PSA response rates. Researchers also track objective response rates, progression-free survival, overall survival, and other clinical outcomes over up to approximately 54 months. The study involves regular evaluations to assess safety and treatment effects until study completion.

Researchers are studying new treatment options for people with high-risk non-muscle invasive bladder cancer HR NMIBC, including cases with carcinoma in situ CIS. HR NMIBC affects the lining of the bladder but has not spread to muscle or beyond. The study aims to learn if adding intismeran autogene V940 to the standard Bacillus Calmette-Guerin BCG immunotherapy can improve outcomes by helping the immune system attack the cancer more effectively. Participants are divided into groups receiving different treatments. One group Cohort A receives both intismeran autogene via intramuscular injection every 3 weeks for 9 doses and BCG instillations weekly in specific weeks over about 75 weeks. Another group receives only BCG following the same weekly schedule. A third group Cohort B receives intismeran autogene alone every 3 weeks for 9 doses. The study evaluates these treatments over several years. During the study, participants will have regular treatments and follow-up visits where researchers will monitor cancer progression, recurrence, and survival for up to approximately 5 years. Assessments include event-free survival, recurrence-free survival, overall survival, response rates, time to cystectomy, and safety outcomes such as adverse events and treatment discontinuation. The study is randomized and open-label, with detailed long-term monitoring planned.

Researchers are investigating new treatments for metastatic cervical cancer, which is cancer that has spread beyond the cervix, the lower part of the uterus. This study evaluates the safety and effectiveness of the antibody drug conjugate sacituzumab tirumotecan sac-TMT combined with pembrolizumab and bevacizumab. The goal is to find out if these treatments, given together or with some variations, help patients live longer or delay cancer progression compared to standard care. The study has two parts. In Part 1, participants receive sac-TMT, pembrolizumab, and bevacizumab together to assess safety. In Part 2, all participants first get standard induction treatment with pembrolizumab, paclitaxel, and cisplatin or carboplatin, possibly with bevacizumab. Those whose cancer does not worsen then enter maintenance treatment, where they are randomly assigned to receive either pembrolizumab alone or sac-TMT plus pembrolizumab, with optional bevacizumab. Participants are involved for up to about 20 months during maintenance treatment after up to 4 months of induction. The study monitors safety by tracking side effects and treatment discontinuations. Effectiveness is measured by progression-free survival and overall survival up to several years. Quality of life and physical functioning are also assessed through questionnaires. Treatments and evaluations occur through regular intravenous infusions and periodic monitoring visits.

Researchers are studying Sacituzumab Tirumotecan to understand its safety and tolerability when given directly into the bladder for people with intermediate-risk non-muscle invasive bladder cancer NMIBC. The study aims to find the highest dose that participants can take without serious problems and to select a dose for future research to evaluate how well the drug works. Participants receive Sacituzumab Tirumotecan administered intravesically once a week for 6 weeks. In addition to the study drug, they may use rescue medications and supportive care measures to manage side effects as needed. Rescue medications include antihistamines, steroids, antiemetics, antifungals, and pain relief agents. Supportive care may include treatments like artificial tear drops for eye-related side effects. During the study, participants will be closely monitored for any dose-limiting toxicities, adverse events, and treatment discontinuations over approximately 6 to 10 weeks. Blood samples will be taken to measure drug levels in the body. The research team will also assess treatment response up to 6 months and how long any complete response lasts over 24 months. Overall participation lasts until the primary study completion date in March 2029.

Researchers are investigating new treatments for high-risk, early-stage breast cancer, specifically targeting two types triple-negative breast cancer TNBC and hormone receptor-low positiveHER2-negative breast cancer. These cancers are characterized by low or no HER2 protein and low hormone receptor presence. The study aims to evaluate if adding sacituzumab tirumotecan sac-TMT to pembrolizumab and chemotherapy can better reduce cancer cells in tumors and lymph nodes and improve the length of time patients live without cancer progression compared to pembrolizumab with chemotherapy alone. Participants in this trial receive one of two treatment plans. One group gets sacituzumab tirumotecan intravenously every two weeks plus pembrolizumab every three weeks for 12 weeks, followed by pembrolizumab with carboplatin and paclitaxel for another 12 weeks. After 3 to 6 weeks, surgery and optional radiation therapy take place, followed by pembrolizumab for about 28 weeks. Participants with remaining disease may receive additional treatments chosen by their doctors, including olaparib, capecitabine, doxorubicin, epirubicin, or cyclophosphamide. The other group receives chemotherapy drugs carboplatin and paclitaxel with pembrolizumab initially, then pembrolizumab with cyclophosphamide and doxorubicin or epirubicin, followed by surgery, optional radiation, and pembrolizumab for about 28 weeks, with similar additional options for residual disease. During the study, participants undergo core needle biopsies, receive intravenous infusions of study drugs, and have surgery and possible radiation therapy. Researchers assess outcomes such as the percentage of participants with no detectable cancer cells at surgery pathological complete response, event-free survival up to about 92 months, and overall survival up to nearly 10 years. Quality of life and side effects are monitored through questionnaires and adverse event tracking. The study lasts several years, with various assessments throughout treatment and follow-up periods to gather comprehensive data on treatment effects and safety.