Relationship Between Immunity and Metabolism in Patients Receiving Immune Checkpoint Inhibitors for Advanced Cancer. ( RIMEC )
Recent EMA and FDA approvals have made immune checkpoint inhibitors (ICI) a standard of care in cancer treatment. ICI, used alone or as a combination are now the backbone of renal cell and lung carcinoma treatment. However, a significant proportion of patients does not respond to ICI. Thus the identification of predictive response factor is a major issue.
While factors associated with the tumour and its micro environment have been widely studied, factors associated with the patient such as metabolism could also affect the response to ICI and remain poorly studied.
The hypothesis of the investigators is that dysmetabolims, via the induction of a chronic inflammatory state could induce a defect of lymphocyte production and activation as well as a modification of the immunogenicity of tumor cells and immune cells infiltration. The consequences could be a decrease in ICI response rate as well as an increase in immune related adverse events (irAEs).
To test this hypothesis, the investigators propose a prospective bi-centric exploratory study including 60 patients treated with ICI for advanced lung or renal cell carcinoma.
The data collected will be :
Clinical (calorimetry, impedancemetry, survey of eating habits, tumour characteristics, epidemiological data),
Biologics (baseline and 3-months plasma bio banking for standard biology, inflammation markers TNF- α, IL1-6-8-11-17, TGF-ß, TWEAK, complement study C3, C4, C4d, CH50, C1q, CD46)
Primary objective is to assess the response to ICI depending on metabolic status.
Secondary objectives are to study the relationships between metabolism / cytokines profile/ complement profile and ICI response.
The investigators seek to generate hypotheses and to obtain exploratory data before submission of a Hospital Clinical Research Program whose objective will be to evaluate the impact of dysmetabolism on overall survival and to characterize immune and anatomopathological profiles (using DNA microarrays and flow cytometry techinques) of patients treated with ICI for renal cell or lung carcinoma.
Arms and Interventions
Diagnostic Test: calorimetry, impedance measurement at baseline and after 3 months of treatment
biobanking (30ml) for cytokines and complement dosages at baseline and after 3 months of treatment calorimetry and impedance measure will be collected at baseline and after 3 months of ICI treatment
Primary Outcome Measures
- response rate according to metabolic status [6 months from randomisation]
response rate after 6 months of ICI treatment (iRECIST criteria)
Secondary Outcome Measures
- 6 months progression free survival according to metabolic status [6 months from randomisation]
6 months progression free survival according to metabolic status
- 12 months overall survival according to metabolic status [12months from randomisation]
12 months overall survival according to metabolic status
- correlations between metabolism/ cytokines dosage/ complement dosage and response to ICI [12 months from randomisation]
correlations between metabolism/ cytokines dosage/ complement dosage and
- incidence of irAEs according to metabolic profile [6 months from randomisation]
incidence of irAEs according to metabolic profile
patients ≥18 years
patients receiving immune checkpoint inhibitors, used alone or as a combination with chemotherapy or tyrosine kinase inhibitor or other immune checkpoint inhibitor, for advanced renal cell or lung carcinoma.
Patient Informed and signed the consent to participate in the research
patients with history of auto immune disease
patients enrolled in an interventional study or be in the exclusion period following a previous research, if applicable
Patient not affiliated to the social security scheme or under AME
Patient under guardianship or curatorship or under legal protection
Patient unable or unwilling to give written consent
be in the exclusion period following a previous research, if applicable
Contacts and Locations
|2||AP-HP - Hôpital Européen Georges-Pompidou Paris||Paris||Île-de-France||France||75015|
Sponsors and Collaborators
- Assistance Publique - Hôpitaux de Paris
- Principal Investigator: SIMONAGGIO Audrey, MD, Hopital europeen Georges-Pompidou
Study Documents (Full-Text)None provided.
- IDRCB 2020-A02262-37