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Coproporphyrine Isomers and Methotrexate Elimination (COMETH)

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Assistance Publique - Hôpitaux de Paris
ClinicalTrials.gov Identifier:
NCT00822432
First received: January 13, 2009
Last updated: July 30, 2012
Last verified: January 2009

January 13, 2009
July 30, 2012
October 2007
August 2011   (final data collection date for primary outcome measure)
MTX concentrations [ Time Frame: at the end of MTX infusion and every 24-hours until concentrations reach 0,2µM. ] [ Designated as safety issue: Yes ]
Same as current
Complete list of historical versions of study NCT00822432 on ClinicalTrials.gov Archive Site
  • The UCP I/(I+III) ratio [ Time Frame: before and at the end of MTX infusion and at the end of hospitalisation. ] [ Designated as safety issue: Yes ]
  • Five polymorphisms of the ABCC2 gene (-24C/T, 1249G/A, 3563T/A, 4544G/A) [ Time Frame: during the study ] [ Designated as safety issue: Yes ]
  • Blood cells count . [ Time Frame: before MTX infusion and at the end of hospitalisation ] [ Designated as safety issue: Yes ]
  • Renal function [ Time Frame: before MTX infusion and at the end of hospitalisation ] [ Designated as safety issue: Yes ]
Same as current
Not Provided
Not Provided
 
Coproporphyrine Isomers and Methotrexate Elimination
Urinary Ratio of the Coproporphyrins Isomers I and III and Its Relationships With Methotrexate Elimination in Patients With a Lymphoid Malignancy

High dose methotrexate (MTX) is responsible of severe toxicity in patients in whom elimination from plasma is delayed. Factors responsible for MTX accumulation are partly known but some patients still experience toxicity despite adequate measures being taken. Our hypothesis is that renal tubular secretion may be impaired in these patients. This study aims at evaluating the performance of the UCP ratio (urinary ratio of coproporphyrins), a putative biomarker of tubular secretion, in predicting delayed MTX elimination.

MTX is a substrate of MRP2, a renal tubular transporter encoded by the ABCC2 gene. It has been shown that single nucleotide polymorphisms (SNPs) on the ABCC2 gene are associated with impairment of MTX elimination. Mutations on the ABCC2 gene are also responsible for the Dubin-Johnson syndrome, characterised by the absence of a functional MRP2 protein. Apart from hyperbilirubinaemia, the main biological perturbation observed in this disease is a typical increase of the urinary ratio of coproporphyrins I (I+ III) (UCP ratio). Our hypothesis is that the UCP ratio could be used as a biomarker of MRP2's activity, thus predicting MTX elimination. One hundred patients treated with high dose MTX will be recruited in this prospective study. Their UCP ratio will be measured before and after MTX administration and correlated with MTX clearance. A genetic analysis will be conducted to study the five more frequents SNPs of ABCC2 in each patient.

Observational
Time Perspective: Cross-Sectional
Not Provided
Retention:   Samples With DNA
Description:

blood

Non-Probability Sample
  • Patients aged more than 18 y, hospitalized in the neurology or in the haematology department at PSP hospital of Paris or in the haematology department at CHU of Tours
  • Who should receive high-dose methotrexate (> 1 g/m2) for one of the following conditions : Central Nervous System Neoplasms; Lymphoma, Large B-Cell, Diffuse; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma or Burkitt lymphoma
  • Central Nervous System Neoplasms
  • Lymphoma, Large B-Cell, Diffuse
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
  • Burkitt Lymphoma
Not Provided
1
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
85
August 2011
August 2011   (final data collection date for primary outcome measure)

Inclusion criteria :

  • Patients receiving HDMTX (≥1g/m2) for a primitive cerebral lymphoma, a large cell lymphoma, a lymphoblastic lymphoma, a Burkitt's lymphoma or an acute lymphoblastic leukaemia,
  • over 18 years old,
  • Signed informed consent.
  • Affiliated to a medical assurance.
  • Able to respect the protocol.
  • Effective contraception for women.

Exclusion criteria :

  • renal failure,
  • liver failure,
  • hepatic cytolysis,
  • chronic respiratory deficiency,
  • pregnancy,
  • breast-feeding,
  • Concomitant medication: phenytoin, probenecid, trimethoprim, phenylbutazone, salicylates, non steroid anti-inflammatory, yellow fever vaccine.
  • Patient included in another study in the four weeks preceding his inclusion.
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
France
 
NCT00822432
P061005
Yes
Assistance Publique - Hôpitaux de Paris
Assistance Publique - Hôpitaux de Paris
Not Provided
Principal Investigator: Chantal Le Guellec, PharmD, PhD CHRU of Tours
Assistance Publique - Hôpitaux de Paris
January 2009

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP