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Role of Myostatin, Activin A and Follistatin Cachexia of ENT Cancers (MYOCACH)

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ClinicalTrials.gov Identifier: NCT03162042
Recruitment Status : Completed
First Posted : May 22, 2017
Last Update Posted : May 22, 2017
Sponsor:
Information provided by (Responsible Party):
University Hospital, Clermont-Ferrand

Study Description
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Brief Summary:
The main objective of our study was to determine the modifications of blood myostatin and activin A concentrations associated with head and neck cancers. Secondary objectives consisted in studying their influence on the occurrence of cachexia, bringing the proof of a tumoral secretion of these factors, and then determining the effect of tumor removal.

Condition or disease Intervention/treatment
Cachexia Squamous Cell Carcinoma Head and Neck Cancer Procedure: Tumor removal

Detailed Description:

Myostatin and activin A, two members of the superfamily TGF-β, have been shown to play a role on skeletal muscle mass regulation. In Humans, high plasma concentrations of activin A were observed in cancer patients, especially in cachectic subpopulations, suggesting their involvement in the development of cachexia.

55 patients were included in the study : 32 in the cancer group (only squamous cell carcinoma) and 23 in the control group. The patients underwent a complete nutritional assessment and multiple samples : blood before and 7 days after surgery, skeletal muscle biopsies, tumor biopsies. Plasma concentrations of myostatin, activin and follistatin were measured before and after tumor removal surgery. Concentrations of myostatin, activin and follistatin were also measured in an incubation medium of a tumor biopsy. Activin A and follistatin plasma concentrations were significantly increased in the cancer group (320 vs. 203 pg/ml ; p <0.001) (3593 vs 2148 pg/ml ; p <0.001), while myostatin plasma concentration was significantly decreased in this group (1542 vs. 2100 pg/ml ; p = 0.010). Surprisingly, data of the 7th postoperative day showed an increase in plasma activin A concentration (379 vs 320 pg /ml ; p <0.001) while concentrations of myostatin and follistatin were not modified. A high postoperative systemic inflammation is one hypothesis to explain these later results. Myostatin, activin A and follistatin proteins were systematically detected in the medium of tumor a 48 hour-incubation period, providing a strong proof of the tumor production of these factors by squamous cell carcinoma. The activin A/myostatin/follistatin is modified in the context of head and neck cancer. Activin A particularly seems to play a role in the occurrence of cachexia while follistatin could have a protective role for skeletal muscle mass. This system could aimed in therapeutic ways to reduce cachexia in a context of cancer in order to improve the quality of life and survival of patients.


Study Design
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Study Type : Observational
Actual Enrollment : 60 participants
Observational Model: Case-Control
Time Perspective: Prospective
Official Title: Role of Myostatin, Activin A and Follistatin Cachexia of ENT Cancers
Actual Study Start Date : November 2, 2015
Actual Primary Completion Date : February 2016
Actual Study Completion Date : May 2017
Groups and Cohorts
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Group/Cohort Intervention/treatment
Squamous cell carcinoma
55 patients were included in the study : 32 in the cancer group (only squamous cell carcinoma) and 23 in the control group.
 Procedure: Tumor removal
Surgery
Control group
55 patients were included in the study : 32 in the cancer group (only squamous cell carcinoma) and 23 in the control group.
 Procedure: Tumor removal
Surgery


Outcome Measures
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Primary Outcome Measures :
  1. Measure of plasma activin A (pg/ml) [ Time Frame: at day 1 ]
    determine the modifications of blood myostatin and activin A concentrations associated with head and neck cancers

  2. Measure of plasma follistation (pg/ml) [ Time Frame: at day 1 ]
    determine the modifications of blood myostatin and activin A concentrations associated with head and neck cancers

  3. Measure of plasma myostatin (pg/ml) [ Time Frame: at day 1 ]
    determine the modifications of blood myostatin and activin A concentrations associated with head and neck cancers


Secondary Outcome Measures :
  1. Influence on the occurrence of cachexia [ Time Frame: at day 1 ]
    Bringing the proof of a tumoral secretion of these factors, and then determining the effect of tumor removal.


Eligibility Criteria
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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
55 patients were included in the study : 32 in the cancer group (only squamous cell carcinoma) and 23 in the control group.
Criteria

Inclusion Criteria:

For case group :

  • head and neck cancer
  • squamous cell carinoma only
  • head and neck surgery chosen as treatment of cancer
  • age 18-75

For control group :

  • Neck surgery for non oncologic disease
  • age 18-75

Exclusion Criteria:

  • heart failure, respiratory failure (requiring a long-term oxygen therapy), chronic renal failure (MDRD clearance < 60 ml/min), moderate or severe chronic obstructive pulmonary disease and insulin-dependent diabeta for the two groups
  • cachexia for control group
Contacts and Locations
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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): NCT03162042


Locations
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France
CHU Clermont-Ferrand
Clermont-Ferrand, Auvergne, France, 63003
Sponsors and Collaborators
University Hospital, Clermont-Ferrand
More Information
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Responsible Party: University Hospital, Clermont-Ferrand
ClinicalTrials.gov Identifier: NCT03162042     History of Changes
Other Study ID Numbers: CHU-326
2015-A00833-46 ( Other Identifier: 2015-A00833-46 )
First Posted: May 22, 2017    Key Record Dates
Last Update Posted: May 22, 2017
Last Verified: May 2017

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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 University Hospital, Clermont-Ferrand:
Activin A
Myostatin
Follistatin
Cachexia
Squamous cell carcinoma

Additional relevant MeSH terms:
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Carcinoma, Squamous Cell
Head and Neck Neoplasms
Cachexia
Wasting Syndrome
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Squamous Cell
 Neoplasms by Site
Emaciation
Weight Loss
Body Weight Changes
Body Weight
Signs and Symptoms
Metabolic Diseases
Nutrition Disorders