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Active Surveillance of Papillary Thyroid Microcarcinoma (PMCAS)

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ClinicalTrials.gov Identifier: NCT02609685
Recruitment Status : Recruiting
First Posted : November 20, 2015
Last Update Posted : July 7, 2022
Information provided by (Responsible Party):
Allen Ho, Cedars-Sinai Medical Center

Brief Summary:
The purpose of this study is to better understand the outcomes of active surveillance (observation) instead of immediate surgery, which is the current standard of care for papillary thyroid microcarcinoma (PTMC). Patients with a 1.5 cm or smaller thyroid nodule(s) with papillary thyroid carcinoma will be eligible for the study.

Condition or disease Intervention/treatment Phase
Papillary Thyroid Microcarcinoma Other: Active Surveillance Not Applicable

Detailed Description:

The incidence of thyroid cancer has more than doubled in the last 30 years in the United States, Europe, Canada, and South America. Since nearly 50% of this increase is attributable to papillary thyroid microcarcinomas (PTMC), it appears that greater detection and diagnosis of previously subclinical disease is a major factor driving this dramatic rise.

The primary objective is to estimate the rate of disease progression (growth of primary tumor or development of loco-regional/distant metastases) over a 3, 5, and 10-year period in a series of PTMC patients followed with active surveillance in the United States.

Patients who opt for immediate surgery can participate in a sub-study looking at quality of life and anxiety measures as compared to those patients who enroll in the active surveillance main study. Patients who enroll in active surveillance can choose to have surgery at any time that they and their treating physician feel that it is in their best interest.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 216 participants
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Other
Official Title: Active Surveillance of Papillary Thyroid Microcarcinoma
Actual Study Start Date : May 13, 2016
Estimated Primary Completion Date : December 2030
Estimated Study Completion Date : December 2030

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Thyroid Diseases
Drug Information available for: Thyroid

Arm Intervention/treatment
Active Surveillance
Active surveillance instead of standard of care immediate surgery. Patients will be closely monitored every six months until disease is stable for a two-year period and then annually thereafter.
Other: Active Surveillance
Subjects will be actively observed for disease progression (condition worsens) instead of receiving immediate surgery, considered standard of care.

No Intervention: Immediate Surgery
Patients who choose to get surgery immediately after diagnosis may choose to enroll in a questionnaire sub-study that will compare quality of life and anxiety scores to patients who enroll in the active surveillance study. This is considered "no intervention" because the protocol is not directing treatment. Surgery is the standard treatment for papillary thyroid microcarcinoma.

Primary Outcome Measures :
  1. Rate of disease progression [ Time Frame: From time of diagnosis up to10 years of follow-up ]

Secondary Outcome Measures :
  1. Percentage of subjects that will elect surgery despite absence of clinical progression [ Time Frame: From time of diagnosis up to 10 years of follow-up ]
  2. Impact of TSH suppression on thyroid nodule growth (in cm) as measured by ultrasound [ Time Frame: Five years ]
  3. Identify the clinicopathologic features associated with disease progression in papillary thyroid microcarcinoma patients followed with active surveillance [ Time Frame: Five years ]
  4. Identify the genetic factors associated with an increased risk of disease progression [ Time Frame: Five years ]
    At any time subjects who have enrolled in the active surveillance study can opt to have surgery. Data will be taken from diagnosis to just after surgery.

  5. Quality of life score as measured by City of Hope Quality of Life Scale [ Time Frame: Up to five years ]
  6. Anxiety score as measured by Memorial Anxiety Scale [ Time Frame: Up to five years ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Pathologically confirmed Bethesda V or VI thyroid nodules with papillary thyroid carcinoma or high clinical suspicion, or pathologically confirmed Bethesda III or IV nodules with BRAF mutation.
  • 2.0 cm or smaller nodules by ultrasonographic criteria
  • Ability to understand and the willingness to sign a written informed consent and HIPAA Authorization form
  • Must be able to read and write English fluently to participate in the questionnaire portion of the study

Exclusion Criteria:

  • High-grade or poorly differentiated PTC variants
  • Central or lateral neck lymphadenopathy suspicious for PTC
  • Unfavorable nodule location (e.g. Near dorsal surface (by recurrent laryngeal nerve); Adjacent to trachea (risk of cartilage invasion)
  • History of radiation to neck

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 ClinicalTrials.gov identifier (NCT number): NCT02609685

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Contact: Allen Ho, MD 310-423-1220 Allen.Ho@cshs.org

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United States, California
Cedars-Sinai Medical Center Recruiting
Los Angeles, California, United States, 90048
Contact: Allen Ho, MD    310-423-1220    Allen.Ho@cshs.org   
Principal Investigator: Allen Ho, MD         
Sponsors and Collaborators
Cedars-Sinai Medical Center
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Principal Investigator: Allen Ho, MD Cedars-Sinal Medical Center
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: Allen Ho, Director, Head and Neck Cancer Program and Co-Director, Thyroid Cancer Program, Cedars-Sinai Medical Center
ClinicalTrials.gov Identifier: NCT02609685    
Other Study ID Numbers: IIT2014-13-Ho-PMCAS
First Posted: November 20, 2015    Key Record Dates
Last Update Posted: July 7, 2022
Last Verified: July 2022
Keywords provided by Allen Ho, Cedars-Sinai Medical Center:
Thyroid cancer
Active surveillance
Additional relevant MeSH terms:
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Carcinoma, Papillary
Thyroid Neoplasms
Thyroid Diseases
Endocrine System Diseases
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms, Squamous Cell
Endocrine Gland Neoplasms
Neoplasms by Site
Head and Neck Neoplasms