Clinical trial NCT04164134: New Strategies to Detect Cancers in Carriers of Mutations in RB1
Official title: New Strategies to Detect Cancers in Carriers of Mutations in RB1: Blood Tests Based on Tumor-educated Platelets, or Extracellular Vesicles.
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Retinoblastoma
Secondary Primary Malignancies After Retinoblastoma
Keywords: Retinoblastoma
blood test
liquid biopsy
RB1
cancer
Secondary primary malignancies
SPM
Lead sponsor: Amsterdam UMC, location VUmc
Sponsor class: OTHER
Collaborators: name: University Hospital, Essen
name: Institut Curie
name: Ligue contre le cancer, France
First posted: 2019-11-15
Enrollment: 378
Sex: ALL
Minimum age (years): 0
Maximum age (years): 99
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: CASE_CONTROL
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Control samples for the Rb survivor group (adult) are already available at the VUMC for the platelet study; unselected volunteers from an anti-cancer campaign. Control samples (adult) for the EV study will be collected in a blooddrive at the Essen site.

Pediatric patients. For the pediatric Rb patients, blood draw is part of standard care (3mth-4y). The control blood samples of healthy children (12) will be drawn from healthy children, where the blood draw is already part of otherwise planned care (e.g. patients which are completely healthy besides having an unrelated problem for which surgery is required). Controls will be age-matched as much as possible.

Brief summary: Rationale: Individuals with a cancer predisposition due to a mutation in the paradigm tumor suppressor gene RB1, have a high risk to develop the childhood cancer retinoblastoma (Rb). Biopsies are not possible in Rb, before treatment selection. Heritable Rb patients have also a high risk to develop other types of second primary, either childhood or adult, malignancies (SPMs), notably sarcomas and melanomas. Remarkably, SPMs are now the leading cause of death in heritable-Rb-survivors. Unfortunately, there are no well-developed regular surveillance protocols for SPMs in Rb survivors available right now. Recently, new non-invasive cancer test have been developed, based on either RNA-sequencing data from platelets (ThromboSeq), or on extracellular membrane vesicles (EVs) derived from tumor cells present in blood.

Objective:

* Determine the non-cancerous baseline in adult RB1-mutation carriers (heritable-Rb-survivors).
* Contribute to the biobanking of blood and cancerous tissues from RB1-mutation carriers with SPMs.
* The development of blood-based tests, either platelet or EV-based, for the detection of (the type of) tumors in RB1-mutation carriers.

Study design: Cross-sectional multicenter trial.

Study population:

* 40 Rb patients (children),
* 40 controls (children),
* 153 Rb survivors (adults),
* 153 controls (adults),
* 10 Rb survivors with SPM (children/adults).

Main study parameters/endpoints:

* Determine the non-cancerous baseline in adult RB1-mutation carriers (heritable-Rb-survivors).
* Contribute to the biobanking of blood and cancerous tissues from RB1-mutation carriers with SPMs.

Nature and extent of the burden and risks associated with participation, benefit and group relatedness:

Two blood samples totalling 10ml blood will be collected for every participant. Additionally, a short questionnaire has to be filled in concerning their and their family's cancer history. Blood draws will be done, when participants are already present in the hospital for other appointments, and thus no extra visits are required. For all children, blood will be collected through an already present IV, and so no extra venepuncture is required. Children have to be included because Rb is a tumor only present in this patient group.


Eligibility criteria: Inclusion Criteria:

Adult (16 years and older):

* Group 1: germline mutation RB1.
* Group 2 (control): no germline mutation RB1.

Pediatric (until 6 years of age):

* Group 1: somatic or germline mutation RB1 and retinoblastoma.
* Group 2 (control): no mutation RB1.

Exclusion Criteria:

Adult (16 years and older):

* Group 1: concomitant heritable (inherited) disorder other than caused by monoallelic mutation of RB1.
* Group 2 (control): cancer or already known cancer predisposition syndrome.

Pediatric (until 6 years of age):

* Group 1: concomitant heritable (inherited) disorder other than caused by monoallelic mutation of RB1.
* Group 2: cancer or already known cancer predisposition syndrome.

Primary outcomes:
measure: RNA expression on platelets and allelic DNA balance of EVs in the blood of adult RB1 mutation carriers (Rb-survivors) and retinoblastoma patients (children).
timeFrame: blood will be taken at study inclusion, patients will be followed throughout the study, max 3 years and 9 months.
Secondary outcomes:
measure: RNA expression on platelets, allelic DNA balance of EVs in blood and genomic analysis on tumor tissue of RB1-mutation carriers diagnosed with a second primary malignancy.
timeFrame: blood will be taken at study inclusion, patients will be followed throughout the study, max 3 years and 9 months. In case of second primary tumor a second sample will be taken.
Other outcomes:
Locations:
city: Paris
country: France
facility: Institute Curie
city: Essen
country: Germany
facility: University Hospital Essen (UHE)
city: Amsterdam
country: Netherlands
facility: Amsterdam UMC, location VUmc
Study officials:
affiliation: VUMC
name: Armida Fabius
role: PRINCIPAL_INVESTIGATOR
References: