Clinical trial NCT06080009: Analysis of Molecular Biomarkers in Periocular Adnexal Tumours
Official title: Analysis of Molecular Biomarkers in Periocular Adnexal Tumours
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Sebaceous Cell Tumor of Eyelid
Lead sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Sponsor class: OTHER
First posted: 2023-10-12
Enrollment: 20
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: Single-centre interventional study on biological sample
Primary purpose: DIAGNOSTIC

Brief summary: The aim of this study is to collect sebaceous carcinomas from the Fondazione Policlinico Gemelli retrospectively and prospectively, to analyse them morphologically and immunopathologically and to correlate them with molecular genetic aspects. This study will help to clarify and develop a more effective multidisciplinary diagnostic-therapeutic pathway.

Detailed description: The purpose of this research is to prospectively and retrospectively collect sebaceous carcinomas from the Fondazione Policlinico Gemelli, examine them immunopathologically and morphologically, and establish a correlation between these characteristics and molecular genetic factors. Conducting this research will contribute to the elucidation and advancement of a multidisciplinary therapeutic-diagnostic pathway. The study will utilise surgical specimens, irrespective of the disease stage, that have been formalin-fixed and paraffin-embedded. These specimens were previously collected for clinical practise at the Ocular Oncology of Fondazione Policlinico A. Gemelli IRCCS The informed consent of the patients regarding the use of these specimens for research purposes was obtained beforehand.Each specimen will be subjected to a comprehensive microscopic examination, followed by precise subclassification in accordance with the WHO classification and immunophenotypic characterization. An exhaustive collection of conventionally standardised histopathological prognostic attributes for sebaceous carcinomas will be compiled. Following this, tissue samples are sent for single and/or multiple IHC. Tumour tissues will be subjected to automated digital quantification in conjunction with multiparametric cell line evaluation. Integrating IHC with digital automation of analysis.Exome sequencing will be performed on DNA extracted from paraffin-embedded sections in order to detect variants that are specific to tumours.

For each tumour, three to nine sections (10 micrometres in thickness) will be utilised as the DNA source. Following the identification and separation of tumour tissue from normal tissue by the pathologist, the two DNAs will be sequenced independently. A comparison will be made between variants derived from tumour and normal tissue, with contrasting results. Anticipated outcomes include 1) somatic or tumor-specific variants, which are non-existent in healthy tissue, and 2) variants that are lost during the evolution of the tumour as a result of segmental chromosomal deletion or other mechanisms that induce heterozygosity loss. During the project's prospective phase, newly developed tumours will be preserved. Furthermore, this resource will facilitate methylome analysis, which is in addition to exome analysis.

Eligibility criteria: Inclusion Criteria:

* Age 18 years or older;
* Diagnosis of sebaceous Ca of the ocular adnexa
* Ability to obtain formalin-fixed and paraffin-embedded primary and/or metastatic tumour tissue (FFPE) and healthy tissue
* Availability of primary and/or metastatic tumour tissue in paraffin-embedded or OCT (prospective part) and healthy tissue
* Written informed consent for use of data for research purposes.

Exclusion Criteria:

* Age \< 18 years;
* Lack of sufficient clinical data on selected patients.
* Lack of tumor and/or metastatic tissue in kerosene or OCT.
* Refusal to give informed consent to data processing for research purposes.

Primary outcomes:
measure: Concentration of different molecules in Microscopic and immunophenotypic analysis
timeFrame: 1 year
Secondary outcomes:
measure: Rate of somatic variants, variants with loss of heterozygosity, global mutational signature and identification of probable driver mutations
timeFrame: 1 year
measure: Rate of correlations histopathological features with tumour DNA variants and disease stage.
timeFrame: 2 years
Other outcomes:
Locations:
city: Roma
country: Italy
facility: Gustavo Savino
state: Rome
Study officials:
References:
citation: Prieto-Granada C, Rodriguez-Waitkus P. Sebaceous Carcinoma of the Eyelid. Cancer Control. 2016 Apr;23(2):126-32. doi: 10.1177/107327481602300206.
citation: Owen JL, Kibbi N, Worley B, Kelm RC, Wang JV, Barker CA, Behshad R, Bichakjian CK, Bolotin D, Bordeaux JS, Bradshaw SH, Cartee TV, Chandra S, Cho NL, Choi JN, Council ML, Demirci H, Eisen DB, Esmaeli B, Golda N, Huang CC, Ibrahim SF, Jiang SB, Kim J, Kuzel TM, Lai SY, Lawrence N, Lee EH, Leitenberger JJ, Maher IA, Mann MW, Minkis K, Mittal BB, Nehal KS, Neuhaus IM, Ozog DM, Petersen B, Rotemberg V, Samant S, Samie FH, Servaes S, Shields CL, Shin TM, Sobanko JF, Somani AK, Stebbins WG, Thomas JR, Thomas VD, Tse DT, Waldman AH, Wong MK, Xu YG, Yu SS, Zeitouni NC, Ramsay T, Reynolds KA, Poon E, Alam M. Sebaceous carcinoma: evidence-based clinical practice guidelines. Lancet Oncol. 2019 Dec;20(12):e699-e714. doi: 10.1016/S1470-2045(19)30673-4.
citation: Alfaar AS, Suckert CN, Rehak M, Girbardt C. The epidemiology of adults' eyelid malignancies in Germany between 2009 and 2015; An analysis of 42,710 patients' data. Eur J Ophthalmol. 2022 Nov 4;33(2):11206721221125018. doi: 10.1177/11206721221125018. Online ahead of print.
citation: Tryggvason G, Bayon R, Pagedar NA. Epidemiology of sebaceous carcinoma of the head and neck: implications for lymph node management. Head Neck. 2012 Dec;34(12):1765-8. doi: 10.1002/hed.22009. Epub 2012 Jan 20.
citation: Gauthier AS, Campolmi N, Tumahai P, Kantelip B, Delbosc B. Sebaceous carcinoma of the eyelid and Muir-Torre syndrome. JAMA Ophthalmol. 2014 Aug;132(8):1025-8. doi: 10.1001/jamaophthalmol.2014.1026. No abstract available.
citation: Ferreira I, Wiedemeyer K, Demetter P, Adams DJ, Arends MJ, Brenn T. Update on the pathology, genetics and somatic landscape of sebaceous tumours. Histopathology. 2020 Apr;76(5):640-649. doi: 10.1111/his.14044. Epub 2020 Mar 17.
citation: Jagan L, Zoroquiain P, Bravo-Filho V, Logan P, Qutub M, Burnier MN Jr. Sebaceous adenomas of the eyelid and Muir-Torre Syndrome. Br J Ophthalmol. 2015 Jul;99(7):909-13. doi: 10.1136/bjophthalmol-2014-305873. Epub 2015 Jan 16.
citation: Yeatts RP, Waller RR. Sebaceous carcinoma of the eyelid: pitfalls in diagnosis. Ophthalmic Plast Reconstr Surg. 1985;1(1):35-42. doi: 10.1097/00002341-198501000-00006.
citation: Orr CK, Yazdanie F, Shinder R. Current review of sebaceous cell carcinoma. Curr Opin Ophthalmol. 2018 Sep;29(5):445-450. doi: 10.1097/ICU.0000000000000505.
citation: Kumar T, Tewari P, Khanna N, Surabhi, Bharti S, Sinha R, Bhadani PP. Cytomorphology of sebaceous carcinoma of the eyelid: A short series of three cases with literature review. Diagn Cytopathol. 2022 Dec;50(12):E361-E366. doi: 10.1002/dc.25029. Epub 2022 Aug 6.
citation: Tetzlaff MT, Curry JL, Ning J, Sagiv O, Kandl TL, Peng B, Bell D, Routbort M, Hudgens CW, Ivan D, Kim TB, Chen K, Eterovic AK, Shaw K, Prieto VG, Yemelyanova A, Esmaeli B. Distinct Biological Types of Ocular Adnexal Sebaceous Carcinoma: HPV-Driven and Virus-Negative Tumors Arise through Nonoverlapping Molecular-Genetic Alterations. Clin Cancer Res. 2019 Feb 15;25(4):1280-1290. doi: 10.1158/1078-0432.CCR-18-1688. Epub 2018 Nov 12.
citation: McGrath LA, Currie ZI, Mudhar HS, Tan JHY, Salvi SM. Management of recurrent sebaceous gland carcinoma. Eye (Lond). 2020 Sep;34(9):1685-1692. doi: 10.1038/s41433-019-0756-9. Epub 2020 Jan 2.
citation: Magazin M, Dalvin LA, Salomao DR, Castner NB, Halbach C, Tooley AA. Sebaceous Carcinoma of the Eyelid: Proposed Nomenclature for Multifocal and Multicentric Disease. Ophthalmic Plast Reconstr Surg. 2023 Mar-Apr 01;39(2):117-122. doi: 10.1097/IOP.0000000000002281. Epub 2022 Oct 20.