Clinical trial NCT06701058: Active MMP-8 in Oral Fluid for the Detection of Oral and Oropharyngeal Cancer
Official title: Active MMP-8 in Oral Fluid for the Detection of Oral and Oropharyngeal Cancer
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Oropharyngeal Cancers
Biomarker in Early Diagnosis
Oral Cancer , Oral Squamous Cell Carcinoma, Oral Cavity Cancer
Periodontal Diseases
Keywords: aMMP-8
matrix
metalloproteinase
cancer
carcinoma
oral
oropharyngeal
mouthrinse
Lead sponsor: Helsinki University Central Hospital
Sponsor class: OTHER
Collaborators: name: Karolinska Institutet
name: University of Helsinki
First posted: 2024-11-22
Enrollment: 107
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The study included participants of all ages and genders. All patients were eligible regardless of other medical conditions, except for those with a history of cancer within five years prior to sampling. Cancer patients were selected from a multidisciplinary meeting, and suitable patients were contacted to assess their willingness to participate. Control participants were recruited from the otorhinolaryngology outpatient clinic, where they were being studied and/or treated for other otorhinolaryngology-related conditions

Brief summary: The goal of this observational study is to evaluate whether the active-matrix metalloproteinase-8 (aMMP-8) mouth-rinse test can help detect oral and oropharyngeal cancers. Researchers measured aMMP-8 levels in mouth-rinse samples collected from 77 cancer participants and 50 non-cancer participants in a clinical setting.

The main question this study seeks to answer:

Can the aMMP-8 mouth-rinse test accurately identify and differentiate cancer participants from non-cancer participants in real-time?

Detailed description: The goal of this prospective study is to evaluate whether the active-matrix metalloproteinase-8 (aMMP-8) mouth-rinse test can detect and differentiate 72 oral and oropharyngeal cancers from 50 control participants.

In sampling process patients were asked to pre-rinse with tap water for 30 s. After one-minute wait, they were asked to rinse their mouth 30 s with 5 mL of distilled water provided in the test kit and to spit it out in a sterile measuring cup.

The sample solution were poured into the opening of the test cassette placed on the test system (ORALyzer®) for quantitative results. After obtaining the quantitative results in 5-6 min, the cassette was promptly removed to conduct the qualitative evaluation (Periosafe®).

The expression of aMMP-8 was compared with various factors, including age, sex, smoking status, periodontitis, tumor size, nodal or distal metastases, cancer stage, histological grade, and tumor site. Statistical analysis was performed to evaluate these relationships.

Eligibility criteria: Inclusion Criteria:

* Biopsy-confirmed oral or oropharyngeal cancer identified by the following International Classification of Diseases (ICD-10) codes: C00-C06, C08-C10, C13, and C32 according to the American Joint Committee on Cancer (AJCC) 8th Edition
* Adult

Exclusion Criteria:

* In-situ cancer
* Previous cancer diagnosis within five years prior to the examination
* Use of tetracyclines at the time of sampling
* Did not follow the manufacturer's instructions prior to the mouth-rinse sample (i.e. brushing teeth before sampling)

Primary outcomes:
measure: aMMP-8 levels and status in mouth rinse-samples measured utilizing aMMP-8 Point-of-Care Test
timeFrame: Within two hours from initial sample obtained for this study
Secondary outcomes:
Other outcomes:
Locations:
city: Helsinki
country: Finland
facility: Helsinki University Central Hospital
state: Uusimaa
Study officials:
affiliation: Helsinki University Central Hospital
name: Antti Mäkitie, Prof.
role: STUDY_DIRECTOR
References:
citation: Keskin M, Rintamarttunen J, Gulcicek E, Raisanen IT, Gupta S, Tervahartiala T, Patila T, Sorsa T. A Comparative Analysis of Treatment-Related Changes in the Diagnostic Biomarker Active Metalloproteinase-8 Levels in Patients with Periodontitis. Diagnostics (Basel). 2023 Feb 27;13(5):903. doi: 10.3390/diagnostics13050903.
citation: Moilanen M, Pirila E, Grenman R, Sorsa T, Salo T. Expression and regulation of collagenase-2 (MMP-8) in head and neck squamous cell carcinomas. J Pathol. 2002 May;197(1):72-81. doi: 10.1002/path.1078.
citation: Guarnieri R, Zanza A, D'Angelo M, Di Nardo D, Del Giudice A, Mazzoni A, Reda R, Testarelli L. Correlation between Peri-Implant Marginal Bone Loss Progression and Peri-Implant Sulcular Fluid Levels of Metalloproteinase-8. J Pers Med. 2022 Jan 6;12(1):58. doi: 10.3390/jpm12010058.
citation: Tchetverikov I, Ronday HK, Van El B, Kiers GH, Verzijl N, TeKoppele JM, Huizinga TW, DeGroot J, Hanemaaijer R. MMP profile in paired serum and synovial fluid samples of patients with rheumatoid arthritis. Ann Rheum Dis. 2004 Jul;63(7):881-3. doi: 10.1136/ard.2003.013243.
citation: Weiss SJ. Tissue destruction by neutrophils. N Engl J Med. 1989 Feb 9;320(6):365-76. doi: 10.1056/NEJM198902093200606. No abstract available.
citation: Feng Y, Li Q, Chen J, Yi P, Xu X, Fan Y, Cui B, Yu Y, Li X, Du Y, Chen Q, Zhang L, Jiang J, Zhou X, Zhang P. Salivary protease spectrum biomarkers of oral cancer. Int J Oral Sci. 2019 Jan 3;11(1):7. doi: 10.1038/s41368-018-0032-z.
citation: Deng K, Pelekos G, Jin L, Tonetti MS. Diagnostic accuracy of a point-of-care aMMP-8 test in the discrimination of periodontal health and disease. J Clin Periodontol. 2021 Aug;48(8):1051-1065. doi: 10.1111/jcpe.13485. Epub 2021 Jun 10.
citation: Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig L, Lijmer JG, Moher D, Rennie D, de Vet HC, Kressel HY, Rifai N, Golub RM, Altman DG, Hooft L, Korevaar DA, Cohen JF; STARD Group. STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. BMJ. 2015 Oct 28;351:h5527. doi: 10.1136/bmj.h5527.
citation: Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK, Meyer L, Gress DM, Byrd DR, Winchester DP. The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population-based to a more "personalized" approach to cancer staging. CA Cancer J Clin. 2017 Mar;67(2):93-99. doi: 10.3322/caac.21388. Epub 2017 Jan 17.
citation: Preshaw PM, Hefti AF, Jepsen S, Etienne D, Walker C, Bradshaw MH. Subantimicrobial dose doxycycline as adjunctive treatment for periodontitis. A review. J Clin Periodontol. 2004 Sep;31(9):697-707. doi: 10.1111/j.1600-051X.2004.00558.x.
citation: Maruyama Y, Nishimoto Y, Umezawa K, Kawamata R, Ichiba Y, Tsutsumi K, Kimura M, Murakami S, Kakizawa Y, Kumagai T, Yamada T, Fukuda S. Comparison of oral metabolome profiles of stimulated saliva, unstimulated saliva, and mouth-rinsed water. Sci Rep. 2022 Jan 13;12(1):689. doi: 10.1038/s41598-021-04612-x.
citation: Drouin L, Overall CM, Sodek J. Identification of matrix metalloendoproteinase inhibitor (TIMP) in human parotid and submandibular saliva: partial purification and characterization. J Periodontal Res. 1988 Nov;23(6):370-7. doi: 10.1111/j.1600-0765.1988.tb01615.x. No abstract available.
citation: Hsiao YC, Chi LM, Chien KY, Chiang WF, Chen SF, Chuang YN, Lin SY, Wu CC, Chang YT, Chu LJ, Chen YT, Chia SL, Chien CY, Chang KP, Chang YS, Yu JS. Development of a Multiplexed Assay for Oral Cancer Candidate Biomarkers Using Peptide Immunoaffinity Enrichment and Targeted Mass Spectrometry. Mol Cell Proteomics. 2017 Oct;16(10):1829-1849. doi: 10.1074/mcp.RA117.000147. Epub 2017 Aug 18.
citation: Monea M, Pop AM. The Use of Salivary Levels of Matrix Metalloproteinases as an Adjuvant Method in the Early Diagnosis of Oral Squamous Cell Carcinoma: A Narrative Literature Review. Curr Issues Mol Biol. 2022 Dec 12;44(12):6306-6322. doi: 10.3390/cimb44120430.
citation: Sorsa T, Nwhator SO, Sakellari D, Grigoriadis A, Umeizudike KA, Brandt E, Keskin M, Tervahartiala T, Parnanen P, Gupta S, Mohindra R, Bostanci N, Buduneli N, Raisanen IT. aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases. Front Oral Health. 2022 Jun 10;3:897115. doi: 10.3389/froh.2022.897115. eCollection 2022.
citation: Costa PP, Trevisan GL, Macedo GO, Palioto DB, Souza SL, Grisi MF, Novaes AB Jr, Taba M Jr. Salivary interleukin-6, matrix metalloproteinase-8, and osteoprotegerin in patients with periodontitis and diabetes. J Periodontol. 2010 Mar;81(3):384-91. doi: 10.1902/jop.2009.090510.
citation: Johnson N, Ebersole JL, Kryscio RJ, Danaher RJ, Dawson D 3rd, Al-Sabbagh M, Miller CS. Rapid assessment of salivary MMP-8 and periodontal disease using lateral flow immunoassay. Oral Dis. 2016 Oct;22(7):681-7. doi: 10.1111/odi.12521. Epub 2016 Jul 14.
citation: Sorsa T, Alassiri S, Grigoriadis A, Raisanen IT, Parnanen P, Nwhator SO, Gieselmann DR, Sakellari D. Active MMP-8 (aMMP-8) as a Grading and Staging Biomarker in the Periodontitis Classification. Diagnostics (Basel). 2020 Jan 22;10(2):61. doi: 10.3390/diagnostics10020061.
citation: Lake BD. Histochemical detection of the enzyme deficiency in blood films in Wolman's disease. J Clin Pathol. 1971 Oct;24(7):617-20. doi: 10.1136/jcp.24.7.617.
citation: Ala-aho R, Kahari VM. Collagenases in cancer. Biochimie. 2005 Mar-Apr;87(3-4):273-86. doi: 10.1016/j.biochi.2004.12.009.
citation: Juurikka K, Butler GS, Salo T, Nyberg P, Astrom P. The Role of MMP8 in Cancer: A Systematic Review. Int J Mol Sci. 2019 Sep 11;20(18):4506. doi: 10.3390/ijms20184506.
citation: Klein T, Bischoff R. Physiology and pathophysiology of matrix metalloproteases. Amino Acids. 2011 Jul;41(2):271-90. doi: 10.1007/s00726-010-0689-x. Epub 2010 Jul 18.
citation: Dejonckheere E, Vandenbroucke RE, Libert C. Matrix metalloproteinase8 has a central role in inflammatory disorders and cancer progression. Cytokine Growth Factor Rev. 2011 Apr;22(2):73-81. doi: 10.1016/j.cytogfr.2011.02.002. Epub 2011 Mar 8.
citation: Chung PC, Chan TC. Association between periodontitis and all-cause and cancer mortality: retrospective elderly community cohort study. BMC Oral Health. 2020 Jun 9;20(1):168. doi: 10.1186/s12903-020-01156-w.
citation: Romandini M, Baima G, Antonoglou G, Bueno J, Figuero E, Sanz M. Periodontitis, Edentulism, and Risk of Mortality: A Systematic Review with Meta-analyses. J Dent Res. 2021 Jan;100(1):37-49. doi: 10.1177/0022034520952401. Epub 2020 Aug 31.
citation: Gopinath D, Kunnath Menon R, K Veettil S, George Botelho M, Johnson NW. Periodontal Diseases as Putative Risk Factors for Head and Neck Cancer: Systematic Review and Meta-Analysis. Cancers (Basel). 2020 Jul 14;12(7):1893. doi: 10.3390/cancers12071893.
citation: Komlos G, Csurgay K, Horvath F, Pelyhe L, Nemeth Z. Periodontitis as a risk for oral cancer: a case-control study. BMC Oral Health. 2021 Dec 15;21(1):640. doi: 10.1186/s12903-021-01998-y.
citation: Bourgeois D, Inquimbert C, Ottolenghi L, Carrouel F. Periodontal Pathogens as Risk Factors of Cardiovascular Diseases, Diabetes, Rheumatoid Arthritis, Cancer, and Chronic Obstructive Pulmonary Disease-Is There Cause for Consideration? Microorganisms. 2019 Oct 9;7(10):424. doi: 10.3390/microorganisms7100424.
citation: Rivera C. Essentials of oral cancer. Int J Clin Exp Pathol. 2015 Sep 1;8(9):11884-94. eCollection 2015.
citation: Bosetti C, Carioli G, Santucci C, Bertuccio P, Gallus S, Garavello W, Negri E, La Vecchia C. Global trends in oral and pharyngeal cancer incidence and mortality. Int J Cancer. 2020 Aug 15;147(4):1040-1049. doi: 10.1002/ijc.32871. Epub 2020 Jan 30.
citation: McIlwain WR, Sood AJ, Nguyen SA, Day TA. Initial symptoms in patients with HPV-positive and HPV-negative oropharyngeal cancer. JAMA Otolaryngol Head Neck Surg. 2014 May;140(5):441-7. doi: 10.1001/jamaoto.2014.141.
citation: Guneri P, Epstein JB. Late stage diagnosis of oral cancer: components and possible solutions. Oral Oncol. 2014 Dec;50(12):1131-6. doi: 10.1016/j.oraloncology.2014.09.005. Epub 2014 Sep 23.
citation: Cai M, Zheng Z, Bai Z, Ouyang K, Wu Q, Xu S, Huang L, Jiang Y, Wang L, Gao J, Pathak JL, Wu L. Overexpression of angiogenic factors and matrix metalloproteinases in the saliva of oral squamous cell carcinoma patients: potential non-invasive diagnostic and therapeutic biomarkers. BMC Cancer. 2022 May 11;22(1):530. doi: 10.1186/s12885-022-09630-0.
citation: Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.