<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03773718</url>
  </required_header>
  <id_info>
    <org_study_id>0925-0586</org_study_id>
    <nct_id>NCT03773718</nct_id>
  </id_info>
  <brief_title>Metabolic Syndrome in Childhood Cancer Survivors</brief_title>
  <official_title>Study of the Pathogenic Mechanisms of Metabolic Syndrome at the Background of Genetically Determined Insulin Resistance in Childhood Cancer Survivors</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Federal Research Institute of Pediatric Hematology, Oncology and Immunology</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Federal Research Institute of Pediatric Hematology, Oncology and Immunology</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The research is devoted to studying the features of the metabolic syndrome in cancer&#xD;
      survivors in childhood is supposed to answer the following questions:&#xD;
&#xD;
        -  How can metabolic syndrome be diagnosed in the Russian population of survivors of acute&#xD;
           lymphoblastic leukemia and non-Hodgkin's lymphomas?&#xD;
&#xD;
        -  What are the features of the clinical symptoms of metabolic syndrome in this category of&#xD;
           patients?&#xD;
&#xD;
        -  Which genetic mutations are found in cancer survivors of patients with metabolic&#xD;
           syndrome; Which of these mutations can be considered as protective or vice versa&#xD;
           predisposing to the development of metabolic syndromes? Is the metabolic syndrome&#xD;
           associated with an increased frequency of toxic complications of therapy during the&#xD;
           intensive stages?&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Brief Overview:&#xD;
&#xD;
      The remarkable progress in developing curative therapy for childhood cancer over the last 4&#xD;
      to 5 decades has increased awareness of the serious cancer treatment-related late effects&#xD;
      experienced by long-term survivors such as premature mortality early deaths, second primary&#xD;
      cancers, organ dysfunction (heart, lung, endocrine system), fertility impairment, cognitive&#xD;
      deficits, and reduced quality of life. Endocrine disorders, which occur in 30% to 70% of&#xD;
      childhood cancer survivors, are among the most frequent late effects of anticancer therapy.&#xD;
      Survivors treated with radiation and alkylating agent chemotherapy for hematological&#xD;
      malignancies and CNS tumors are at a particularly high risk for endocrine dysfunction.&#xD;
&#xD;
      Most anticancer drugs act directly or indirectly by modifying intracellular metabolism.&#xD;
      Therefore, high frequency of acute and late cancer treatment-related organ toxicity can&#xD;
      result in metabolic disorders. For example, steroid-induced hypercortism blocks glycolysis&#xD;
      and results in insulin resistance of tissues. Insulin resistance is associated with earlier&#xD;
      manifestation of diabetes mellitus, obesity etc. The clinical sequelae of metabolic syndrome&#xD;
      developing in childhood cancer survivors may include insulin resistance, fasting&#xD;
      hyperglycemia, endothelial failure, obesity, dyslipidemia, hypertension, chronic fatigue&#xD;
      syndrome, motor and behavioral disorders.&#xD;
&#xD;
      Modern genetics make it possible to create a basis for a personalized approach to the&#xD;
      prevention of early and late toxic effects caused by anticancer therapy and the&#xD;
      rehabilitation of the childhood cancer survivors.&#xD;
&#xD;
      Objectives:&#xD;
&#xD;
      Specific Aim 1. Evaluate the frequency and clinical features of the metabolic syndrome in&#xD;
      childhood cancer survivors.&#xD;
&#xD;
      Hypothesis 1A: Components of the metabolic syndrome are realizing in children and adolescents&#xD;
      at all stages of therapy of leukemia and lymphomas, can influence the development of&#xD;
      complications and late toxic effects.&#xD;
&#xD;
      Hypothesis 1B: Initial health conditions (abnormal IBM, family history, comorbid diseases);&#xD;
      drug's toxicity could influence to the appearance of early manifestation of metabolic&#xD;
      syndrome.&#xD;
&#xD;
      Specific Aim 2: Evaluate the contribution of functional polymorphisms in candidate genes to&#xD;
      metabolic syndrome outcomes among childhood cancer patients.&#xD;
&#xD;
      Hypothesis 2A: Genetic polymorphisms involved in the regulation of the insulin resistance and&#xD;
      cancer medications during treatment contribute to the development of metabolic syndrome in&#xD;
      childhood cancer survivors.&#xD;
&#xD;
      Specific Aim 3: Assess the extent to which genetic predictors, doses of drugs, risk factors&#xD;
      improve the discriminatory performance of standard clinical prediction models for metabolic&#xD;
      syndrome outcomes among childhood cancer survivors.&#xD;
&#xD;
      Hypothesis 3 A: Development of metabolic syndrome in cancer patients depends of genetic&#xD;
      determinants and toxic effects of antitumor therapy.&#xD;
&#xD;
      Secondary Aim 1: Assess the definition of metabolic syndrome in cohort of patients of&#xD;
      leukemia and lymphoma and survivors.&#xD;
&#xD;
      Hypothesis 1A: Episodes of triglyceridemic, insulin resistance (Hyperglycemia, HOMA&gt;2,7,&#xD;
      Steroid Diabetes) during the treatment could be the base evidence marker of Metabolic&#xD;
      Syndrome in patients treated by antitumor therapy.&#xD;
&#xD;
      Hypothesis 1 B: Endothelial dysfunction as a clinical component of metabolic syndrome is&#xD;
      responsible for cardiovascular abnormalities in cancer survivors.&#xD;
&#xD;
      Exploratory Aim 1: Assess the association of biomarkers and genetic predictors among&#xD;
      childhood cancer survivors with therapeutic exposures (chemotherapy and/or radiation therapy)&#xD;
      and metabolic syndrome.&#xD;
&#xD;
      Evaluation:&#xD;
&#xD;
      Eligible persons who consent to participate in this trial will be asked to do the following:&#xD;
&#xD;
        -  Vital sign measurement including resting heart rate, blood pressure, height, and weight.&#xD;
&#xD;
        -  A total of 12 mL of blood will be collected in 3 test tubes. Biomarker analysis will be&#xD;
           completed by Laboratory of Dmitry Rogachev National Medical Research Center.&#xD;
&#xD;
        -  A Total of 4 mL of blood in 1 test tube will be used for genotyping for the presence of&#xD;
           polymorphic variants in genes involved in the biotransformation of xenobiotics, insulin&#xD;
           resistance and carbohydrate metabolism in the biomolecular laboratory of Dmitry Rogachev&#xD;
           National Medical Research Center.&#xD;
&#xD;
        -  An echocardiogram and ultrasound will be performed to assess cardiac function.&#xD;
&#xD;
        -  CAVI and ABI pulse wave velocity will be non-invasively measured by using the SphygmoCor&#xD;
           VaSera VS-1500N. Arterial pressure waveforms will be recorded with a strain gauge&#xD;
           pressure sensor placed lightly over the radial artery before and after &quot;6-minutes&#xD;
           physical activity&quot;.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Actual">November 20, 2018</start_date>
  <completion_date type="Anticipated">December 20, 2022</completion_date>
  <primary_completion_date type="Anticipated">September 20, 2021</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Cohort</observational_model>
    <time_perspective>Prospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>The frequency of metabolic syndrome</measure>
    <time_frame>12 months</time_frame>
    <description>The frequency of diagnosed metabolic syndrome in the cohort of children and adolescents with leukemia and lymphomas</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Genetic risk</measure>
    <time_frame>12 months</time_frame>
    <description>The detection of NSP associated with metabolic syndrome in children and adolescents after childhood cancer.</description>
  </secondary_outcome>
  <number_of_groups>1</number_of_groups>
  <enrollment type="Anticipated">400</enrollment>
  <condition>Metabolic Syndrome</condition>
  <arm_group>
    <arm_group_label>Russkoe pole</arm_group_label>
    <description>400 patients</description>
  </arm_group>
  <eligibility>
    <study_pop>
      <textblock>
        Participants for this study will be patients of &quot;Russkoe Pole&quot; cohort, the study designed&#xD;
        to evaluate health among children and adolescents survivors of childhood leukemia and&#xD;
        lymphoma as they age. Participants in RPC undergo risk-based medical screening according to&#xD;
        the Standards of Medical Insurance for rehabilitation of Cancer treated patients.&#xD;
&#xD;
        To be eligible for RPC, cancer survivors must has been treated at Russian children oncology&#xD;
        clinics by MB-ALL/ BFM-NHL and be 17 years of age or younger, and at least 6 months from&#xD;
        the completion of the therapy. All the patients will has exhaustively full epicrisis of&#xD;
        medical history with cumulative doses of medications. coz RPC is a retrospective cohort&#xD;
        study with ongoing recruitment (additional survivors become eligible over time).&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Cancer survivors:&#xD;
&#xD;
          -  Treatment with chemotherapy and/or radiation therapy for a primary ALL/NHL diagnosed&#xD;
             prior to age 17 years.&#xD;
&#xD;
          -  ≤ 15 years of age at the time of enrollment.&#xD;
&#xD;
          -  No cytostatic drugs uptake during the study.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Diagnosis of diabetes mellitus types 1 or 2 types before antitumor therapy&#xD;
&#xD;
          -  Active oncological disease&#xD;
&#xD;
          -  History of allogeneic hematopoietic cell transplant&#xD;
&#xD;
          -  The renouncement of participation from the patient or legally authorized&#xD;
             representative&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>5 Years</minimum_age>
    <maximum_age>15 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Melissa M. Hudson, MD</last_name>
    <role>Study Chair</role>
    <affiliation>St. Jude Children's Research Hospital Memphis, TN 38105</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Elena V. Zhukovskaya, MD</last_name>
    <phone>+79154145145</phone>
    <email>elena_zhukovskay@mail.ru</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Tatiana V. Nasedkina, PhD</last_name>
    <phone>+79169092440</phone>
    <email>tanased06@rambler.ru</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology</name>
      <address>
        <city>Moscow</city>
        <zip>117997</zip>
        <country>Russian Federation</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Alexander F Karelin, PhD</last_name>
      <phone>+74952876570</phone>
      <email>alexandr.karelin@gmail.com</email>
    </contact>
    <investigator>
      <last_name>Anna E Gavrilova, PhD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Russian Federation</country>
  </location_countries>
  <verification_date>December 2018</verification_date>
  <study_first_submitted>December 7, 2018</study_first_submitted>
  <study_first_submitted_qc>December 10, 2018</study_first_submitted_qc>
  <study_first_posted type="Actual">December 12, 2018</study_first_posted>
  <last_update_submitted>December 19, 2018</last_update_submitted>
  <last_update_submitted_qc>December 19, 2018</last_update_submitted_qc>
  <last_update_posted type="Actual">December 20, 2018</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>metabolic syndrome</keyword>
  <keyword>children</keyword>
  <keyword>cancer</keyword>
  <keyword>survivors</keyword>
  <keyword>genetic</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Metabolic Syndrome</mesh_term>
    <mesh_term>Syndrome</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <provided_document_section>
    <provided_document>
      <document_type>Study Protocol</document_type>
      <document_has_protocol>Yes</document_has_protocol>
      <document_has_icf>No</document_has_icf>
      <document_has_sap>No</document_has_sap>
      <document_date>October 12, 2018</document_date>
      <document_url>https://ClinicalTrials.gov/ProvidedDocs/18/NCT03773718/Prot_001.pdf</document_url>
    </provided_document>
  </provided_document_section>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03773718
org study id: 0925-0586
nct id: NCT03773718
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The research is devoted to studying the features of the metabolic syndrome in cancer
      survivors in childhood is supposed to answer the following questions:

        -  How can metabolic syndrome be diagnosed in the Russian population of survivors of acute
           lymphoblastic leukemia and non-Hodgkin's lymphomas?

        -  What are the features of the clinical symptoms of metabolic syndrome in this category of
           patients?

        -  Which genetic mutations are found in cancer survivors of patients with metabolic
           syndrome; Which of these mutations can be considered as protective or vice versa
           predisposing to the development of metabolic syndromes? Is the metabolic syndrome
           associated with an increased frequency of toxic complications of therapy during the
           intensive stages?
Brief Overview:

      The remarkable progress in developing curative therapy for childhood cancer over the last 4
      to 5 decades has increased awareness of the serious cancer treatment-related late effects
      experienced by long-term survivors such as premature mortality early deaths, second primary
      cancers, organ dysfunction (heart, lung, endocrine system), fertility impairment, cognitive
      deficits, and reduced quality of life. Endocrine disorders, which occur in 30% to 70% of
      childhood cancer survivors, are among the most frequent late effects of anticancer therapy.
      Survivors treated with radiation and alkylating agent chemotherapy for hematological
      malignancies and CNS tumors are at a particularly high risk for endocrine dysfunction.

      Most anticancer drugs act directly or indirectly by modifying intracellular metabolism.
      Therefore, high frequency of acute and late cancer treatment-related organ toxicity can
      result in metabolic disorders. For example, steroid-induced hypercortism blocks glycolysis
      and results in insulin resistance of tissues. Insulin resistance is associated with earlier
      manifestation of diabetes mellitus, obesity etc. The clinical sequelae of metabolic syndrome
      developing in childhood cancer survivors may include insulin resistance, fasting
      hyperglycemia, endothelial failure, obesity, dyslipidemia, hypertension, chronic fatigue
      syndrome, motor and behavioral disorders.

      Modern genetics make it possible to create a basis for a personalized approach to the
      prevention of early and late toxic effects caused by anticancer therapy and the
      rehabilitation of the childhood cancer survivors.

      Objectives:

      Specific Aim 1. Evaluate the frequency and clinical features of the metabolic syndrome in
      childhood cancer survivors.

      Hypothesis 1A: Components of the metabolic syndrome are realizing in children and adolescents
      at all stages of therapy of leukemia and lymphomas, can influence the development of
      complications and late toxic effects.

      Hypothesis 1B: Initial health conditions (abnormal IBM, family history, comorbid diseases);
      drug's toxicity could influence to the appearance of early manifestation of metabolic
      syndrome.

      Specific Aim 2: Evaluate the contribution of functional polymorphisms in candidate genes to
      metabolic syndrome outcomes among childhood cancer patients.

      Hypothesis 2A: Genetic polymorphisms involved in the regulation of the insulin resistance and
      cancer medications during treatment contribute to the development of metabolic syndrome in
      childhood cancer survivors.

      Specific Aim 3: Assess the extent to which genetic predictors, doses of drugs, risk factors
      improve the discriminatory performance of standard clinical prediction models for metabolic
      syndrome outcomes among childhood cancer survivors.

      Hypothesis 3 A: Development of metabolic syndrome in cancer patients depends of genetic
      determinants and toxic effects of antitumor therapy.

      Secondary Aim 1: Assess the definition of metabolic syndrome in cohort of patients of
      leukemia and lymphoma and survivors.

      Hypothesis 1A: Episodes of triglyceridemic, insulin resistance (Hyperglycemia, HOMA>2,7,
      Steroid Diabetes) during the treatment could be the base evidence marker of Metabolic
      Syndrome in patients treated by antitumor therapy.

      Hypothesis 1 B: Endothelial dysfunction as a clinical component of metabolic syndrome is
      responsible for cardiovascular abnormalities in cancer survivors.

      Exploratory Aim 1: Assess the association of biomarkers and genetic predictors among
      childhood cancer survivors with therapeutic exposures (chemotherapy and/or radiation therapy)
      and metabolic syndrome.

      Evaluation:

      Eligible persons who consent to participate in this trial will be asked to do the following:

        -  Vital sign measurement including resting heart rate, blood pressure, height, and weight.

        -  A total of 12 mL of blood will be collected in 3 test tubes. Biomarker analysis will be
           completed by Laboratory of Dmitry Rogachev National Medical Research Center.

        -  A Total of 4 mL of blood in 1 test tube will be used for genotyping for the presence of
           polymorphic variants in genes involved in the biotransformation of xenobiotics, insulin
           resistance and carbohydrate metabolism in the biomolecular laboratory of Dmitry Rogachev
           National Medical Research Center.

        -  An echocardiogram and ultrasound will be performed to assess cardiac function.

        -  CAVI and ABI pulse wave velocity will be non-invasively measured by using the SphygmoCor
           VaSera VS-1500N. Arterial pressure waveforms will be recorded with a strain gauge
           pressure sensor placed lightly over the radial artery before and after "6-minutes
           physical activity".
observational model: Cohort
time perspective: Prospective
measure: The frequency of metabolic syndrome
time frame: 12 months
description: The frequency of diagnosed metabolic syndrome in the cohort of children and adolescents with leukemia and lymphomas
measure: Genetic risk
time frame: 12 months
description: The detection of NSP associated with metabolic syndrome in children and adolescents after childhood cancer.
arm group label: Russkoe pole
description: 400 patients
study pop: 
sampling method: Probability Sample
criteria: 
gender: All
minimum age: 5 Years
maximum age: 15 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Melissa M. Hudson, MD
role: Study Chair
affiliation: St. Jude Children's Research Hospital Memphis, TN 38105
last name: Elena V. Zhukovskaya, MD
phone: +79154145145
email: elena_zhukovskay@mail.ru
last name: Tatiana V. Nasedkina, PhD
phone: +79169092440
email: tanased06@rambler.ru
facility: 
status: Recruiting
contact: 
investigator: 
country: Russian Federation
responsible party type: Sponsor
mesh term: Metabolic Syndrome
mesh term: Syndrome
sharing ipd: Undecided
provided document: 