Scheemda

Researchers are investigating new diagnostic methods to improve personalized treatment for patients with stage III non-small cell lung cancer NSCLC. Current methods for deciding post-treatment care after surgery or chemoradiotherapy are not optimal, leading to overtreatment or undertreatment. This study is part of the GUIDE.MRD project, which aims to validate circulating tumor DNA ctDNA tests to better detect residual cancer and guide treatment decisions in NSCLC patients. The study focuses on evaluating multiple ctDNA diagnostic tests using clinical samples collected at specific time points baseline, after neoadjuvant treatment, post-surgery or chemoradiotherapy, post-adjuvant therapy, and at disease progression or study end. Participants include those receiving chemoradiotherapy followed by immunotherapy, neoadjuvant therapy followed by surgery or radiotherapy, or surgery followed by immunotherapy. Blood samples will be analyzed retrospectively to compare ctDNA test performance without influencing treatment decisions. Participants will provide plasma samples at these key time points for analysis. Researchers will measure the sensitivity, specificity, and predictive values of the ctDNA tests and assess outcomes including three-year recurrence-free survival and the timing between ctDNA detection and clinical relapse. The study also evaluates how ctDNA results relate to responses to neoadjuvant and adjuvant therapies. Participation involves sample collection and clinical monitoring over multiple years, with data helping to improve future treatment selection for stage III NSCLC.

Researchers are evaluating chemotherapy dosing strategies in older patients aged 70 years and above who have metastatic colorectal cancer and are eligible for first-line palliative chemotherapy. This phase III randomized controlled trial aims to compare upfront dose-reduced chemotherapy with standard full-dose chemotherapy, focusing on progression-free survival PFS. Patients are assessed using the Geriatric 8 G8 questionnaire to determine their risk of chemotherapy toxicity, which guides treatment assignment. The study seeks to balance treatment effectiveness with minimizing toxicity, hospital admissions, and maintaining quality of life QoL and physical functioning. Participants classified as low risk for toxicity G8 score 15 or higher are randomized to receive either doublet chemotherapy a fluoropyrimidine combined with oxaliplatin at full dose or with a 25% dose reduction upfront. Those at high risk G8 score 14 or lower or judged high risk by their oncologist receive fluoropyrimidine monotherapy either at full dose or with a 25% dose reduction. The study also allows the addition of targeted treatments like bevacizumab or EGFR inhibitors. Dose adjustments are made for patients with moderate kidney impairment. Chemotherapy is given orally or intravenously on schedules varying between every two and three weeks, depending on the regimen. Participants will be closely monitored throughout treatment, with assessments including radiological or clinical evaluations for disease progression, quality of life and physical functioning questionnaires at 1, 3, 6, and 12 months, and tracking of chemotherapy toxicity, overall survival, treatment cycles, dose changes, hospital admissions, and cumulative drug dosage. Safety and cost-effectiveness will also be evaluated over an average study duration of eight months and up to one year for some outcomes. The study plans to include 587 patients and will continue until December 2028.

Researchers are studying the gut microbiome in adults with metastasized or irresectable colorectal cancer CRC who are receiving chemotherapy. The study aims to understand how the gut microbiome changes during treatment and how these changes relate to the effects of chemotherapy. This research is important because even though treatments are improving, survival rates remain low and side effects are common, so better tools to predict treatment response are needed. Participants in this observational study will provide fecal samples at home before starting treatment and again three months after treatment begins, coinciding with their response evaluation. They will also fill out questionnaires about factors that may affect the microbiome, such as the use of antibiotics or proton pump inhibitors. Additionally, blood samples will be collected before treatment and three months later for storage and analysis. During the study, researchers will track participants response to chemotherapy and any serious side effects over two years. They will use various tests, including stool sample analysis, questionnaires, and blood tests, to gather data. The total duration of participation and follow-up extends for at least two years to help predict treatment outcomes and side effects based on microbiome changes.

Researchers are comparing robot-assisted radical prostatectomy RARP and external beam radiotherapy EBRT, sometimes combined with androgen deprivation therapy ADT, for men with high-risk non-metastatic prostate cancer. The study aims to understand differences in quality of life, functional outcomes, cost-effectiveness, progression-free survival, and distant metastasis-free survival. There is currently no clear consensus on which treatment is better, leading to variation in hospital practices. Participants will receive either RARP, which may include pelvic lymph node dissection and possibly adjuvant radiotherapy or androgen deprivation therapy, or EBRT delivered at an effective radiation dose, possibly combined with a brachytherapy boost and pelvic lymph node dissection. Positive lymph node findings will not exclude participants and may be treated with lymph node irradiation. Treatment details vary based on clinical decisions. During the study, participants will be followed for up to five years, with key assessments at three years including health-related quality of life and functional outcomes. Cost-effectiveness will also be evaluated at three years, while progression-free and distant metastasis-free survival will be tracked up to five years. The study involves regular monitoring to gather these outcomes and support shared decision-making for future patients.

Researchers are studying the effect of at-home taste steering compared to standard care on food enjoyment in patients with metastatic triple negative breast cancer, metastatic testicular cancer, or stage II-IV diffuse large B cell lymphoma who are undergoing chemotherapy. This multicentre randomized intervention trial uses a parallel cluster design across 12 hospitals in the Netherlands to prevent bias from patient contact within the same hospital. The study measures outcomes before chemotherapy begins, at the onset of taste or smell alterations, and after 6 weeks. Participants in the experimental group will use taste steering techniques at home while the control group receives usual care. Questionnaires are completed online from home, and taste and smell tests plus saliva collection are done either at home or during regular hospital visits. Both groups will have contact with their dietitian every 3 weeks. The intervention lasts 6 weeks, based on prior experience indicating the taste steering algorithm saturates after 3-4 weeks. During the study, participants will complete assessments of food enjoyment, health-related quality of life, taste and smell function, saliva secretion, and body weight. These are measured at baseline, at the time taste or smell changes occur, and after 6 weeks. Researchers will also monitor risk of malnutrition and dry mouth feeling. The total participation period covers the 6-week intervention and associated follow-up assessments.

Researchers are evaluating the impact of at-home taste and smell training compared to standard care in patients with cancer treated with tyrosine kinase inhibitors. This multicenter randomized intervention trial involves 12 hospitals in the Netherlands and aims to understand how this training affects taste function and other related outcomes over 12 weeks. The study uses a parallel cluster design to avoid bias by keeping treatment groups separate within each hospital. Participants are assigned to either perform taste and smell training at home or receive usual care without the training. Measurements are taken at baseline and after 12 weeks, including taste and smell tests, saliva collection, and online questionnaires completed at home. Dietitians contact patients every 3 weeks in both groups to support adherence and monitor progress. During the study, participants undergo assessments of taste and smell function, food enjoyment, quality of life, risk of malnutrition, dry mouth sensation, saliva secretion, and body weight. These evaluations occur at home or during regular hospital visits. The total duration for each participant is approximately 12 weeks, during which researchers track changes and safety related to the interventions.

This research aims to evaluate the value of performing an MRI scan of the brain in patients who have newly diagnosed stage IV non-oncogene addicted non-small cell lung cancer NSCLC and are fit for systemic treatment without symptoms of brain disease. The study focuses on assessing the clinical benefit of this brain imaging procedure to detect brain involvement early in this patient group. Participants will undergo an MRI scan of the brain as a screening test to identify any brain disease. This screening is conducted in patients who do not show symptoms of brain disease and have no oncogene mutations that have approved targeted treatments. The MRI scan is the main intervention in this study, with no placebo or comparison group mentioned. During the study, participants will be evaluated up to six months after the MRI to measure its clinical value. Researchers will assess the usefulness of the MRI findings in patient care. Participants will undergo standard clinical evaluations by their oncologist, and the study will monitor outcomes related to brain disease detection and patient health over this period.