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The PhOCus Trial: Implementation of Pharmacogenomic Testing in Oncology Care

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT04541381
Recruitment Status : Recruiting
First Posted : September 9, 2020
Last Update Posted : October 24, 2022
Information provided by (Responsible Party):
University of Chicago

Brief Summary:

Doctors leading this study hope to find out if giving study participants' genetic information to cancer care providers will help personalize chemotherapy dosing decisions and decrease common chemotherapy side effects. Doctors leading the study will collect genetic information from study participants using pharmacogenomics/genotyping. Pharmacogenomics is the study of how the differences in our genes can affect our unique response to medications.

This is a randomized study, which means that participants in this study will be randomly assigned (as if "by flip of a coin") to one of two different groups: a "pharmacogenomics group" or "control group".

Condition or disease Intervention/treatment Phase
Gastrointestinal Cancer Head and Neck Cancer Dihydropyrimidine Dehydrogenase Deficiency UGT1A1 Gene Mutation Breast Cancer Other: Availability of clinical decision support based on pharmacogenomic results. Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 860 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Masking Description: Blinded
Primary Purpose: Other
Official Title: The PhOCus Trial: Implementation of Pharmacogenomic Testing in Oncology Care
Actual Study Start Date : February 7, 2022
Estimated Primary Completion Date : October 1, 2027
Estimated Study Completion Date : March 31, 2028

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
No Intervention: Control Group
Participants assigned to the control group will receive standard chemotherapy without their doctors receiving any genetic information based on the participants' pharmacogenetic results. DNA (Deoxyribonucleic acid) samples for participants in this group will be stored and tested for genotyping six months later after treatment (or earlier if the participant experiences side effects).
Experimental: Pharmacogenomics Group
Participants enrolled in the pharmacogenomics group will give a DNA (deoxyribonucleic acid) sample for immediate pharmacogenomic genotyping. Once the genotyping results are in, cancer doctors caring for each participant will have immediate access to clinical decision support based on the participant's genetic results and can make dosing decisions/changes to the participant's chemotherapy prescription.
Other: Availability of clinical decision support based on pharmacogenomic results.
Availability of clinical decision support based on pharmacogenomic results. These results are designed to provide specific dosing information based on the participant's unique genetics/genomics.

Primary Outcome Measures :
  1. Dose Deviation Rate (Co-Primary Endpoint) [ Time Frame: 15 months ]
    To assess the impact of prospective pharmacogenomic testing on dose intensity deviation rate of chemotherapy during the 1st treatment cycle, comparing control vs. pharmacogenomics-guided arms.

  2. Grade 3 or Higher Toxicity (Co-Primary Endpoint) [ Time Frame: 5 years ]
    To determine the degree to which providing oncologists with comprehensive pharmacogenomic information impacts the incidence of Grade 3 or worse toxicities in subjects receiving chemotherapy. Toxicities will be assessed by Common Terminology Criteria for Adverse Events version 5.

Secondary Outcome Measures :
  1. Cumulative Chemotherapy Dose Intensity [ Time Frame: 5 years. ]
    Cumulative drug dose intensity received (function of dose and frequency of drug administration).

  2. Response Rate [ Time Frame: 5 years. ]
    Anti-cancer tumor response based on radiographic assessment (complete response, partial response, stable disease, progressive disease), by tumor type and disease setting.

  3. Progression free survival (PFS) [ Time Frame: 5 years ]
    Progression free survival (PFS) by tumor type and disease setting.

  4. Overall Survival [ Time Frame: 5 years ]
    Overall survival (OS) by tumor type and disease setting.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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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 Adult patients receiving oncology care at The University of Chicago Medical Center, and for whom treatment with a fluoropyrimidine and/or irinotecan is planned are eligible.

Individuals of all genders, races and ethnic groups are eligible for this trial. There is no bias towards race, sex, or gender in the clinical trial outlined.

Exclusion Criteria

  1. Subjects who have previously been exposed to the planned chemotherapy agent at any time (fluoropyrimidine and/or irinotecan).
  2. Subjects enrolled in an investigational trial which would preclude dose modifications of fluoropyrimidine and/or irinotecan chemotherapies.
  3. Subjects who have undergone, or are being actively considered for, bone marrow, liver or kidney transplantation.
  4. Subjects with a history of or active blood cancer (e.g., leukemia).
  5. Chronic kidney disease, as defined by glomerular filtration rate (GFR) < 30/mL/min/1.73m2, due to the risk of decreased drug excretion.
  6. Liver dysfunction, as defined by the following laboratory values, due to the risk of decreased drug metabolism: Total bilirubin more than 1.5 mg/dL, aspartate Aminotransferase (AST) and alanine transaminase (ALT) more than 2.5 X upper limit of normal*. (*AST and ALT more than 5 X upper limit of normal if hepatic metastases are present).
  7. Subjects who have previously or are currently enrolled in another institutional pharmacogenomic genotyping study, or are known to have previously undergone pharmacogenomic genotyping for the gene(s) of interest via another commercial or other means.
  8. Inability to understand and give informed consent to participate.

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): NCT04541381

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Contact: Peter H. O'Donnell, MD 773-834-0936 podonnel@medicine.bsd.uchicago.edu

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United States, Illinois
University of Chicago Medical Center Recruiting
Chicago, Illinois, United States, 60637
Contact: Peter H. O'Donnell, MD    773-834-0936    podonnel@medicine.bsd.uchicago.edu   
Sponsors and Collaborators
University of Chicago
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Principal Investigator: Peter H. O'Donnell, MD University of Chicago
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Responsible Party: University of Chicago
ClinicalTrials.gov Identifier: NCT04541381    
Other Study ID Numbers: IRB20-0462
First Posted: September 9, 2020    Key Record Dates
Last Update Posted: October 24, 2022
Last Verified: October 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Supporting Materials: Study Protocol
Informed Consent Form (ICF)

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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 of Chicago:
Additional relevant MeSH terms:
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Gastrointestinal Neoplasms
Dihydropyrimidine Dehydrogenase Deficiency
Neoplasms by Site
Digestive System Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Purine-Pyrimidine Metabolism, Inborn Errors
Metabolism, Inborn Errors
Genetic Diseases, Inborn
Metabolic Diseases