Lewistown

This research aims to establish a national biorepository by collecting research data and samples from patients who experience side effects from immunotherapy treatments used in cancer care. It focuses on patients who have serious immune-related reactions, rare infections, or accelerated tumor growth after receiving immuno-oncology therapies. The goal is to help researchers better predict, prevent, and treat these side effects in the future. Participants will have tissue and blood samples collected within 72 hours after confirmation of a serious immune-related side effect and again one month later. For patients experiencing colitis, stool samples may also be collected. Alongside sample collection, medical records will be reviewed for up to one year. This study is observational and involves no experimental treatments. During the study, participants will provide biospecimens at two time points and allow access to their medical records for a year. Researchers will analyze these samples and clinical data to build a resource for future studies on immune-related adverse events. The main outcome is the establishment of this biorepository, which will be maintained for up to one year after enrollment.

The trial investigates treatments for younger patients with intermediate risk acute myeloid leukemia AML. It compares three therapy combinations cytarabine with daunorubicin, cytarabine with daunorubicin plus venetoclax, and venetoclax with azacitidine. This phase II study aims to evaluate whether adding venetoclax improves the elimination of leukemia cells compared to standard treatment, focusing on measurable residual disease MRD after remission. Participants are randomly assigned to one of three arms. Arm I receives daunorubicin intravenously on days 2-4, cytarabine intravenously on days 2-8, and venetoclax orally daily on days 1-11, with possible reinduction based on bone marrow assessment. Arm II receives azacitidine intravenously or subcutaneously on days 1-7 or 1-5 and 8-9, plus venetoclax orally daily on days 1-28 for two cycles. Arm III receives daunorubicin intravenously on days 1-3 and cytarabine intravenously on days 1-7, with possible reinduction depending on bone marrow results. Treatment continues unless disease progresses or side effects become unacceptable. During the trial, participants undergo bone marrow aspiration, blood sample collection, and heart function tests like echocardiography or MUGA scans. After treatment, follow-up visits occur at 4 weeks, then every 3 months for one year, every 6 months for the second year, and yearly afterward. Researchers assess outcomes such as undetectable MRD rates, remission rates, survival, relapse, and treatment side effects over several years.

Researchers are evaluating the effects of lenalidomide and dexamethasone with or without daratumumab in treating patients with high-risk smoldering multiple myeloma. This phase III trial aims to compare overall survival, progression-free survival, response rates, and safety between these treatments. The study also explores patient-reported quality of life, treatment adherence, minimal residual disease status, and imaging associations during therapy. Participants are randomly assigned to one of two treatment groups. The first group receives daratumumab intravenously on a detailed schedule across up to 24 courses, plus oral lenalidomide daily for 21 days and dexamethasone on specific days during the first 12 courses. The second group receives only oral lenalidomide and dexamethasone on a similar schedule for up to 24 courses. Treatment cycles repeat every 28 days unless disease progression or unacceptable side effects occur. During the study, participants complete quality-of-life questionnaires and undergo laboratory tests, including minimal residual disease assessments and PETCT imaging. Safety is closely monitored, especially infusion-related reactions and toxicity. After treatment, patients are followed for up to 15 years with periodic visits every 3 to 12 months to track long-term outcomes and survival.

Researchers are comparing two chemotherapy combinations for treating advanced, unresectable, or metastatic HER2 negative adenocarcinomas of the esophagus, gastroesophageal junction, and stomach. This phase III trial evaluates modified FOLFIRINOX fluorouracil, leucovorin calcium, oxaliplatin, and irinotecan with or without nivolumab versus modified FOLFOX fluorouracil, leucovorin calcium, and oxaliplatin with or without nivolumab. Chemotherapy drugs act to stop tumor growth by killing cells or stopping division, and immunotherapy with nivolumab may affect the immune system to hinder tumor growth and spread. Participants are randomized into two groups one receives mFOLFIRINOX plus nivolumab as clinically indicated, and the other receives mFOLFOX plus nivolumab as clinically indicated. Treatments are administered intravenously. Throughout the study, participants undergo magnetic resonance imaging MRI, computed tomography CT scans, and may provide blood samples. Nivolumab is given as needed based on clinical assessment during the trial. Participants will be monitored up to 2 years from randomization for overall survival, with secondary measures including progression-free survival, response rates, duration of response, adverse events, and patient-reported outcomes collected at baseline and during treatment cycles. Safety and tolerability are evaluated, and exploratory analyses include biomarker assessments such as PD-L1 combined positive score and cell-free DNA. The trial includes regular imaging and clinical assessments to track disease status and treatment effects.

The Master Screening and Reassessment Protocol MSRP for the NCI MyeloMATCH clinical trials focuses on patients with myeloid cancers, including acute myeloid leukemia AML and myelodysplastic syndrome MDS. The study evaluates the use of a screening tool and specific laboratory tests, including rapid genetic testing of bone marrow and blood, to better identify biomarkers that can guide treatment decisions. The goal is to improve the ability to assign participants to targeted treatment studies or to continue standard care through a Tier Advancement Pathway TAP. Participants undergo bone marrow aspiration and blood collection for biomarker testing. Based on their mutational profiles, patients may be assigned to specific treatment substudies testing therapies tailored to their cancer or placed on TAP if no targeted treatment is available. The study includes various treatment regimens involving drugs such as azacitidine, venetoclax, daunorubicin, and others administered via intravenous, oral, or subcutaneous routes. Screening also includes echocardiography or multigated acquisition scans to assess heart function. Throughout the study, participants have ongoing bone marrow biopsies and aspirations, blood sample collections, and additional imaging such as chest x-rays, PET, or CT scans as needed. Researchers monitor treatment assignment timing, treatment responses, adverse events, minimal residual disease, and patient survival. The study aims to maintain access to investigational treatments and collect specimens for translational research. The total duration varies by treatment assignment and disease progression, with continuous monitoring throughout.

Researchers are studying the relationship between low muscle mass myopenia at diagnosis and chemotherapy side effects in older adults newly diagnosed with advanced colorectal cancer. This prospective cohort study also investigates how genetic differences may influence the link between myopenia and chemotherapy toxicity, focusing on overall survival in this population receiving specific chemotherapy treatments. Participants in this observational study are older adults with metastatic colorectal cancer who are starting or recently started 5-Fluouracil 5-FU based chemotherapy, alone or combined with other drugs like oxaliplatin, irinotecan, or immunotherapy. The study groups include adults aged 60-74 years and those 75 years or older. The study tracks chemotherapy toxicities over 6 months following treatment initiation. During the study, participants will be monitored for chemotherapy toxicities graded 3 to 5 and overall survival for up to one year. Researchers will collect information through questionnaires available in English or Spanish and assess the impact of muscle mass and genetics on treatment side effects and survival. The total participation time varies, with ongoing assessments during and after chemotherapy treatment.

Researchers are evaluating how well radiation therapy works compared with observation in patients who have a newly diagnosed grade II meningioma that has been completely removed by surgery. This phase III trial aims to determine the clinical benefit of adding radiation therapy after complete tumor removal and also studies overall survival, disease-specific survival, side effects, neurocognitive function, patient-reported outcomes, and biomarker correlations. Participants are randomly assigned to one of two groups. One group undergoes observation with regular MRI scans and blood collection throughout the study. The other group receives intensity-modulated radiation therapy IMRT or proton beam radiation therapy five days a week for about 6.5 to 7 weeks, totaling 33 treatment sessions, unless disease progression or unacceptable side effects occur. Both groups continue to have MRI scans and blood tests during the study. Participants are followed for up to 10 years after treatment or observation, with visits scheduled at 3, 6, and 12 months, then every 6 months for years 2 and 3, and yearly thereafter. The study measures time without disease progression as the main outcome, along with survival rates, adverse events, cognitive function changes, and adherence to treatment protocols. Tissue and blood samples are also collected for ongoing research.

Researchers are collecting data on patients with Epidermal Growth Factor Receptor EGFR-mutant Non-Small Cell Lung Cancer NSCLC who are treated outside of a clinical trial with standard care using osimertinib alone or combined with chemotherapy. The goal is to better understand the safety and effectiveness of these treatments as they are used in routine clinical practice. This is an observational study recruiting about 250 patients per treatment group, including those receiving osimertinib alone or osimertinib plus chemotherapy. Patients are treated according to standard medical care as determined by their doctors. One group receives osimertinib by mouth once daily, while the other group receives osimertinib plus chemotherapy, with chemotherapy type chosen by the treating physician. Treatment dosing and administration follow standard guidelines. The study records planned treatments at registration and observes outcomes without altering the care given. Participants will have clinical and imaging assessments as part of their usual care, with data collected on their health and treatment progress. Researchers will measure real-world progression-free survival, overall survival, and time to stopping osimertinib for up to three years. The study follows participants over time to monitor how they respond to therapy and to gather safety information.

Researchers are evaluating different treatment approaches for patients newly diagnosed with high-risk acute myeloid leukemia AML who have not yet started treatment. This phase II trial compares the standard chemotherapy combination of cytarabine and daunorubicin to four experimental regimens that include daunorubicin and cytarabine liposome, venetoclax, and azacitidine. The goal is to see which regimen is better at reducing measurable residual disease and inducing remission in this difficult-to-treat form of AML. Participants are randomly assigned to one of five treatment groups. Each group receives a different combination of drugs standard cytarabine and daunorubicin, cytarabine and daunorubicin with venetoclax, azacitidine with venetoclax, daunorubicin and cytarabine liposome alone, or daunorubicin and cytarabine liposome with venetoclax. Treatments are given in cycles lasting 28 days, with specific dosing schedules for each drug. Some patients may receive an additional cycle depending on their response and tolerance. Before starting treatment, participants undergo echocardiography or MUGA scans to assess heart function. During the trial, participants have bone marrow aspirations and blood collections to monitor their disease and treatment effects. After completing the study treatment, participants have regular follow-up visits monthly during the first year, every two months in the second year, every three months in the third year, and then every six months until five years after treatment. Researchers measure remission rates, survival outcomes, and side effects to evaluate each treatments impact and safety over time.

Researchers are evaluating the addition of pembrolizumab immunotherapy to standard chemotherapy for patients with stage IIA, IIB, IIIA, or IIIB non-small cell lung cancer NSCLC that has been completely removed by surgery. This phase III trial aims to compare disease-free survival and overall survival among different treatment approaches, including chemotherapy alone, chemotherapy followed by pembrolizumab, and chemotherapy combined with pembrolizumab. The study also assesses quality of life and adverse event rates in these patient groups. Participants are randomly assigned to one of three groups. One group receives only chemotherapy with observation afterward. The other two groups receive chemotherapy followed by pembrolizumab or chemotherapy combined with pembrolizumab. Chemotherapy involves one of four platinum doublet regimens administered every 21 days for four cycles, depending on the physicians choice. Pembrolizumab is given intravenously over 25-40 minutes, either after chemotherapy or alongside it, repeated every 21 days or every 6 weeks for multiple cycles. Patients also undergo heart ultrasound, MRI, CT scans, and blood sample collections as part of the study. During the trial, participants have regular medical assessments including imaging and blood tests to monitor their health. Follow-up visits occur 6 weeks after treatment, then every 3 months for 2 years, every 6 months for years 2-4, and annually up to 10 years from randomization. Researchers measure disease-free survival as the main outcome, tracking the time until cancer recurrence or death. They also evaluate overall survival, side effects, drug tolerability, and patient-reported quality of life over time.