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Circulating Tumor Cells in Lung Cancer Screening (AIR)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02500693
Recruitment Status : Unknown
Verified January 2018 by Centre Hospitalier Universitaire de Nice.
Recruitment status was:  Active, not recruiting
First Posted : July 16, 2015
Last Update Posted : January 9, 2018
Information provided by (Responsible Party):
Centre Hospitalier Universitaire de Nice

Brief Summary:

This trial is intended to evaluate the value of circulating tumor cells (CTC), in combination with unenhanced (without injection of contrast media) low dose (to limit the effective radiation dose below 1,5 mSv) chest computed tomography (LDCT) in the screening of Lung cancer (LC).

LDCT screening was shown to reduce LC mortality in smokers and ex-smokers, older than 55 years, with a history of more than 30 pack-years. LDCT however shows a close to 30% rate of false positive that require repeat follow-up and also invasive investigations, but also false negatives with metastatic LC being discovered between screening rounds.

Migration of circulating tumor cells (CTC) is an early event of carcinogenesis and characterizes aggressive cancers. We recently showed that CTC can be detected with the ISET technique in a population at high risk for LC, i.e. COPD patients before LC was detectable on LDCT.

The study will focus on patients at very high risk for lung cancer i.e. smokers and ex-smokers suffering Chronic Obstructive Pulmonary Disease (COPD).

The study will enroll 600 participants who will undergo three rounds of screening at one year intervals, each round combining search for CTC on a blood sample and LDCT. Each participant will be followed for at least one year after the last screening round

Condition or disease Intervention/treatment Phase
Lung Neoplasms Pulmonary Disease, Chronic Obstructive Biological: Isolation of circulating tumor cells (CTC) from veinous blood Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 600 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: Circulating Tumor Cells and Early Diagnosis of Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease
Actual Study Start Date : October 30, 2015
Estimated Primary Completion Date : September 2019
Estimated Study Completion Date : December 2019

Resource links provided by the National Library of Medicine

MedlinePlus related topics: COPD

Arm Intervention/treatment
Experimental: Screening Biological: Isolation of circulating tumor cells (CTC) from veinous blood
Thirty ml of peripheral blood will be collected in buffered EDTA, maintained at 4°C, and processed within 1 hour for filtration. After blood filtration, the membrane will be gently washed with PBS, disassembled from the filtration module, and allowed to air-dry. The determination of CTC number present on filters will be carried out by combining four color immunofluorescent (anti-pancytokeratins/anti-vimentin/DAPI/anti-CD45) staining and cytomorphological examination after Diff-quick and Mayer Hemalun staining in three spots per patient sample. Imaging of immunofluorescent and cytological staining will be performed at x20 magnification using the automated Ariol system. CTCs are identified by relocating images of immunofluorescent and cytological staining.

Primary Outcome Measures :
  1. Rate of detection of circulating tumor cells in patients who will have a LC detected during the study [ Time Frame: 3 years ]

Secondary Outcome Measures :
  1. Rate of detection of CTC in the whole study population [ Time Frame: once a year for 3 years ]
  2. Circulating tumor cells [ Time Frame: once a year for 3 years ]
    Predictive value of CTC detection for the diagnosis of LC in patients identified as having a pulmonary nodule.

  3. Time span between detection of CTC and detection of lung cancer with LDCT and vice versa [ Time Frame: once a year for 3 years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   55 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Age 55 years or more
  • 30 or more pack-years of cigarette smoking history
  • Former smokers: quit smoking within the previous 15 years
  • Signed informed consent form
  • Presence of COPD
  • Affiliation to the French social security system

Exclusion Criteria:

  • Chest CT examination in the 12 months prior to eligibility assessment(1)
  • Treatment for, or evidence of, any cancer other than skin basocellular carcinoma in the 5 years prior to eligibility assessment
  • Pneumonia or acute respiratory infection treated with antibiotics in the 12 weeks prior to eligibility assessment
  • Unexplained weight loss of more than 15 10%pounds in the 12 months prior to eligibility assessment
  • Recent hemoptysis
  • History of lung volume reduction with coils, glue or valves°
  • Metallic implants or devices in the chest or back, such as pacemakers or Harrington fixation rods
  • Participation in another cancer screening trial
  • Participation in a cancer prevention study, other than a smoking cessation study
  • Vulnerable persons: adults under guardianship, adults under trusteeship or persons deprived of their liberty, patients under 18 years old
  • Medical and/or psychiatric problems of sufficient severity to limit full compliance with the study or expose patients to undue risk

    1. Many COPD patients will have had a previous chest CT examination. This has become common in medical practice, especially in patients with chronic lung diseases such as COPD patients. Including such patients would introduce huge bias in the study by artificially focusing on rapidly growing cancers. Redoing a CT in a screening intend in a patient who recently underwent this investigation would also unnecessarily enhance irradiation in these patients. It should be note that in the NLST trial "previous chest CT (≤ 18 months)" was a key exclusion criterion [NLST Radiology 2011].

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02500693

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Sponsors and Collaborators
Centre Hospitalier Universitaire de Nice
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Principal Investigator: Charles-Hugo MARQUETTE, Pr Centre Hospitalier Universitaire de Nice
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Centre Hospitalier Universitaire de Nice Identifier: NCT02500693    
Other Study ID Numbers: 15-PP-08
First Posted: July 16, 2015    Key Record Dates
Last Update Posted: January 9, 2018
Last Verified: January 2018

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Centre Hospitalier Universitaire de Nice:
Lung Cancer, Screening, COPD
Additional relevant MeSH terms:
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Lung Neoplasms
Neoplastic Cells, Circulating
Lung Diseases
Pulmonary Disease, Chronic Obstructive
Respiratory Tract Neoplasms
Thoracic Neoplasms
Neoplasms by Site
Respiratory Tract Diseases
Pathologic Processes
Lung Diseases, Obstructive
Neoplasm Metastasis
Neoplastic Processes