Northampton

Researchers are evaluating whether reducing the frequency of pembrolizumab treatment after six months of standard therapy is safe and effective for patients with advanced non-small cell lung cancer (NSCLC). Pembrolizumab, an immunotherapy targeting the PD-1 receptor on T cells, has improved outcomes for this condition. Because pembrolizumab remains bound to its target for a long time and dosing frequency may not affect outcomes, this study aims to find out if less frequent dosing can maintain effectiveness while reducing overtreatment and side effects. This phase III study also considers potential benefits like cost savings and improved quality of life due to fewer hospital visits. Participants who have completed six months of pembrolizumab treatment without disease progression and are continuing therapy will be randomly assigned to receive pembrolizumab at the standard six-week interval or at a reduced frequency of 12 weeks. If early results show that the 12-week schedule is not less effective, later participants may be randomized to even longer intervals of 9, 15, or 18 weeks. Pembrolizumab is given intravenously at 400 mg per dose. Patients whose disease progresses on a reduced frequency schedule may return to the standard six-week treatment. During the study, researchers will monitor overall survival at two years after randomization. Participants will undergo regular assessments to track disease status, treatment tolerability, and overall health. The study aims to confirm that less frequent dosing does not reduce survival while potentially improving patient experience. The trial is open to adults aged 18 and older with advanced NSCLC who have already completed six months of pembrolizumab therapy and intend to continue treatment.

Researchers are studying the safety and effects of an investigational medicine called PF-08653944 in adults who are overweight or have obesity along with type 2 diabetes. This condition involves carrying too much body weight and having high blood sugar levels. The study is a phase 3, multi-center, randomized placebo-controlled trial that aims to evaluate the medicine's ability to help with weight loss and monitor its safety. Participants will receive either the study medicine or a placebo by weekly injections under the skin in the belly area. About two-thirds of participants will get the study medicine, while one-third will receive the placebo. Participants will be trained to administer the injections themselves at home. The study will last about 21 months and includes up to 14 visits to the study site and 5 phone calls. During the study, participants will be closely monitored through visits and phone contacts. Researchers will measure changes in body weight from the start to week 64 to evaluate effectiveness. The study will also include assessments of safety and treatment effects over the entire duration. Participants need to perform finger-stick glucose monitoring as required and follow the study procedures throughout the trial.

Researchers are evaluating the safety and effectiveness of advanced external beam radiotherapy called stereotactic body radiotherapy (SBRT) in men with high risk localized prostate cancer. This cancer is limited to the prostate but has a high chance of growing quickly or spreading. The study compares SBRT given to the prostate alone versus SBRT given to both the prostate and surrounding lymph nodes. It is a Phase III trial involving 1128 participants to see which treatment option is better and safer over at least three and a half years of follow-up. Participants receive radiotherapy in 5 visits over two weeks. Half of the men will have SBRT targeted only to the prostate, while the other half will have it directed to both the prostate and pelvic lymph nodes. The treatments are delivered at NHS radiotherapy centers experienced with SBRT and pelvic node radiotherapy. Quality assurance ensures the treatments are administered properly. During the study, men will undergo scans including multi-parametric MRI and various types of PET-CT or MRI to stage their cancer before treatment. Researchers will monitor side effects and cancer outcomes to assess safety and effectiveness. The main outcome measured is the time until biochemical or clinical failure, with a minimum follow-up of 3.5 years after randomization. Participants will be closely followed for side effects and cancer control throughout the study period.

This is a Phase III open-label study to assess if camizestrant improves outcomes compared to standard adjuvant endocrine therapy for patients with ER+/HER2- early breast cancer with intermediate-high or high risk for disease recurrence who completed definitive locoregional therapy (with or without chemotherapy). The planned duration of treatment in either arm of the study is 7 years. Eligible patients must have intermediate-high or high risk of recurrence as defined by specified clinical and biologic criteria. Concurrent use of abemaciclib is permitted in both arms. The primary endpoint of the study is Invasive breast cancer-free survival (IBCFS) and main secondary endpoints include Invasive disease-free survival (IDFS), Distant relapse-free survival (DRFS), Overall survival (OS), Safety and Clinical Outcome Assessments (COAs). Patients will be followed for 10 years from randomization of the last patient.

This research aims to understand the genetic factors that contribute to the risk of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). GCA is a serious inflammatory disease affecting blood vessels, mainly in people over 50, which can cause severe complications like vision loss or stroke if untreated. PMR causes pain and stiffness in the limbs with signs of inflammation. The study involves both patients recently suspected of having GCA and those with confirmed diagnoses from the past. It seeks to provide new insights into disease causes and improve diagnosis and treatment approaches. Participants are observed in a multi-center study collecting clinical and genetic data. The study includes both prospective patients with suspected GCA and retrospective patients with confirmed GCA or PMR diagnoses. Some retrospective participants receiving tocilizumab for recurring or difficult-to-treat GCA are also included in a safety monitoring registry. Data collected include clinical features, imaging, tissue and blood samples, and advanced genetic testing. The study also follows patients over time to assess disease impact, quality of life, and long-term outcomes. During the study, participants provide medical information, biological samples, and complete questionnaires about their symptoms and quality of life. Researchers monitor disease activity and treatment effects, especially among those starting certain immune-modifying drugs. The main measurements focus on genetic susceptibility at the study start, with ongoing evaluation of diagnosis, prognosis, and disease progression. The study is designed to improve understanding and management of GCA and PMR over time.

Researchers are evaluating the efficacy and safety of once-weekly injectable MET097 in adults who have obesity or are overweight with related weight complications, but who do not have type 2 diabetes. This phase 3, multi-center randomized controlled trial aims to understand how well MET097 works and how safe it is over a long period. The study will last 84 weeks, with the primary effectiveness measured after 64 weeks of treatment. Participants will receive either MET097 or a placebo, both given once a week by subcutaneous injection. The study compares these two groups to assess the impact of MET097 on weight and related health issues. The treatment period is followed by continued monitoring to evaluate longer-term effects up to 84 weeks. During the study, participants' body weight changes will be carefully tracked from the start through week 64, which is the main outcome measure. Additional health assessments will occur through the 84-week duration to monitor safety and overall responses. Participants will be supported and monitored regularly to assess the medication's impact and any side effects throughout the trial.

Researchers are conducting Enroll-HD, a large, long-term observational study involving individuals affected by Huntington's Disease (HD), those at risk, and control participants. This study combines data from previous registries in Europe, North America, Australasia, and now includes Latin America. It aims to build a comprehensive database of clinical information and biological samples to support research on disease progression, prognosis, and clinical characteristics, as well as to establish clear endpoints for future interventional studies. Enroll-HD collects detailed clinical and genetic information along with blood samples from participants categorized as carriers of the HD gene mutation, controls without the mutation, and family or community controls. The study enrolls participants from over 150 sites in 23 countries and conducts annual assessments without a set end date. Participant groups include those with manifest HD symptoms, pre-manifest carriers, relatives with unknown genotype, and genotype-negative relatives. Participants undergo yearly evaluations including motor, functional, behavioral, and cognitive assessments using standardized scales such as the Unified Huntington's Disease Rating Scale and the Problem Behaviors Assessment-Short. Researchers track changes over an average of one year or longer through this ongoing registry. Data collected supports multiple research efforts and is accessible to qualified researchers worldwide.

Researchers are evaluating two surgical approaches for patients with low risk differentiated thyroid cancer in this multi-center, randomized, phase III study. The study aims to determine if hemithyroidectomy, which removes part of the thyroid, is an acceptable and cost-effective alternative to total thyroidectomy, which removes the entire thyroid. Patients are identified through oncology multidisciplinary team meetings and divided into two groups based on their treatment history and diagnosis method. Patients in Group 1 have already had a hemithyroidectomy for thyroid problems and are then diagnosed with low risk differentiated thyroid cancer. They will be randomized to either surveillance only or a second surgery to remove the rest of the thyroid gland (two-stage total thyroidectomy). Group 2 patients are diagnosed by cytology with low risk cancer and have not yet had surgery; they will be randomized to either hemithyroidectomy or a single-stage total thyroidectomy. The study plans to recruit 456 patients who will be followed after surgery and then every 12 months for 6 years. During the study, participants will undergo regular assessments to monitor for any signs or symptoms of cancer recurrence, with a primary outcome measure of the 3-year recurrence rate after surgery. Follow-up visits will include clinical evaluations to check for cancer return or progression. Researchers will also observe overall patient outcomes and safety throughout the 6-year follow-up period.

Major Depressive Disorder (MDD) is a common and disabling condition often treated with antidepressants or talking therapies, but many patients remain unwell after these treatments. This research aims to evaluate whether a new brain stimulation method called transcranial direct current stimulation (tDCS), used at home, can be an effective treatment for adults with MDD. The study is designed as a multi-center randomized controlled trial to assess the clinical and cost-effectiveness of home-based tDCS combined with usual care compared to usual care alone. Participants will be randomly assigned to one of two groups: one receiving their usual treatment for depression, which may include psychotherapy and/or medication, and the other receiving usual treatment plus tDCS. Those in the tDCS group will use a headset device that delivers mild electrical stimulation to specific areas of the brain. The treatment involves 36 sessions over 10 weeks, starting with five sessions per week for three weeks, then three sessions per week for seven weeks. Each session lasts 30 minutes with a gradual increase and decrease in stimulation at the start and end. Throughout the study, participants will be assessed on their depression symptoms using a clinical rating scale at 10 weeks and again at 6 months. After the 6-month follow-up, all participants may choose to use the tDCS device for an additional 3 months. Researchers will also evaluate anxiety, remission, quality of life, and treatment acceptability. The study will involve regular monitoring of participants and their care providers, with a total participation time of up to 9 months from treatment start to final follow-up.

Researchers are evaluating the use of biparametric MRI (bpMRI) and image-fusion targeted biopsies to detect prostate cancer in men at risk. The study aims to determine if bpMRI can be recommended as an alternative to the longer multiparametric MRI (mpMRI) for identifying clinically significant prostate cancers. It also compares image-fusion targeted biopsy with visual-registration targeted biopsy to see which method better detects significant prostate cancer in patients with suspicious MRI findings. Participants will undergo one of two types of MRI scans: a longer 30-40 minute MRI that uses a contrast dye called gadolinium (commonly used in the NHS), or a shorter MRI without contrast. If the MRI shows suspicious areas, participants may then have a prostate biopsy. Biopsies are performed either by visual registration, where the biopsy needle placement is guided by the operator’s judgment using MRI and ultrasound images, or by image fusion, where MRI images are overlaid on live ultrasound using software to guide the biopsy needle more precisely. During the study, patient scans and biopsy results will be closely monitored and analyzed to measure how many clinically significant cancers are detected within 12 weeks of enrollment. Researchers will collect MRI images, perform biopsies if indicated, and evaluate the biopsy samples under a microscope. The study includes safety monitoring and aims to inform future NHS practices for prostate cancer diagnosis. Male participants aged 18 and older who are referred for prostate MRI due to abnormal exams or elevated PSA levels are eligible to join.