Ignite Creation Date:
2024-05-06 @ 7:39 PM
Last Modification Date:
2024-10-26 @ 3:11 PM
Study NCT ID:
NCT06084234
Status:
RECRUITING
Last Update Posted:
2024-03-29
First Post:
2023-10-10
Brief Title:
National Liver Cancer Screening Trial
Sponsor:
University of Texas Southwestern Medical Center
Organization:
University of Texas Southwestern Medical Center
Study Overview
Official Title:
National Liver Cancer Screening Trial
Status:
RECRUITING
Status Verified Date:
2024-07
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
TRACER
Brief Summary:
The National Liver Cancer Screening Trial is an adaptive randomized phase IV Trial comparing ultrasound-based versus biomarker-based screening in 5500 patients with cirrhosis from any etiology or patients with chronic hepatitis B infection Eligible patients will be randomized in a 11 fashion to Arm A using semi-annual ultrasound and AFP-based screening or Arm B using semi-annual screening using GALAD alone Randomization will be stratified by sex enrolling site Child Pugh class A vs B and HCC etiology viral vs non-viral Patients will be recruited from 15 sites mix of tertiary care and large community health systems over a 3-year period and the primary endpoint of the phase IV trial reduction in late-stage HCC will be assessed after 55 years
Detailed Description:
The TRACER phase IV biomarker study is a randomized trial comparing ultrasound-based screening versus a biomarker-based strategy in patients with cirrhosis In brief 5500 patients with cirrhosis from any etiology would be randomized in a 11 fashion to Arm A offering semi-annual ultrasound - AFP-based screening or Arm B offering semi-annual biomarker-based screening Randomization will be stratified by site Child Pugh class A vs B liver disease etiology viral non-viral and non-cirrhotic HBV infection and sex Patients will be recruited from 15 sites mix of tertiary care and large community health systems over a 3-year period and reduction in the proportion of late-stage HCC will be assessed at the end of Year 55 If the results are promising study team will continue extended follow-up and compare the incidence of late-stage HCC between the two arms at Year 8 and reduction in HCC mortality during long term follow up
Study team will include adult patients age 18 years with Child Pugh class A or B cirrhosis of any etiology or non-cirrhotic chronic hepatitis B virus infection with PAGE-B score 9 Study team will exclude patients post liver transplantation patients with Child Pugh C cirrhosis patients with significant comorbidity and limited life expectancy and those with history of other malignancy except non-melanoma skin cancer or indolent tumors within 3 years prior to enrollment given lack of screening recommendations in those patient populations Study team will also exclude patients with suspicious liver masses at baseline as well as those with a solid lesion 1 cm on ultrasound or AFP 20 ngmL without diagnostic evaluation to exclude HCC Study team will also exclude patients in whom the provider plans to follow the patient with CT or MRI-based surveillance GALAD is not recommended in patients with pregnancy or active warfarin use given known impact on biomarker performance so these patients will be excluded
At enrollment study team will record patient demographics and clinical characteristics using a combination of electronic medical records and patient questionnaires Patients will then be offered semi-annual surveillance as defined by their study arm ultrasound and AFP for patients in Arm A and the biomarker GALAD for patients in Arm B Repeat surveillance tests will be offered every six months per assigned arm for patients with normal surveillance results Diagnostic evaluation with multi-phasic CT or contrast-enhanced MRI will be recommended for any patients with abnormal screening results Patients with normal diagnostic testing ie false positive result will be recommended to return to their assigned surveillance arm Standardized criteria from the AASLD and LI-RADS will be used to define incident HCC Study team will use a set of validated surveys eg Psychological Consequences Questionnaire Decision Regret scale FACIT-COST to measure secondary outcomes of interest including psychological and financial harms
Study team will include adult patients age 18 years with Child Pugh class A or B cirrhosis of any etiology or non-cirrhotic chronic hepatitis B virus infection with PAGE-B score 9 Study team will exclude patients post liver transplantation patients with Child Pugh C cirrhosis patients with significant comorbidity and limited life expectancy and those with history of other malignancy except non-melanoma skin cancer or indolent tumors within 3 years prior to enrollment given lack of screening recommendations in those patient populations Study team will also exclude patients with suspicious liver masses at baseline as well as those with a solid lesion 1 cm on ultrasound or AFP 20 ngmL without diagnostic evaluation to exclude HCC Study team will also exclude patients in whom the provider plans to follow the patient with CT or MRI-based surveillance GALAD is not recommended in patients with pregnancy or active warfarin use given known impact on biomarker performance so these patients will be excluded
At enrollment study team will record patient demographics and clinical characteristics using a combination of electronic medical records and patient questionnaires Patients will then be offered semi-annual surveillance as defined by their study arm ultrasound and AFP for patients in Arm A and the biomarker GALAD for patients in Arm B Repeat surveillance tests will be offered every six months per assigned arm for patients with normal surveillance results Diagnostic evaluation with multi-phasic CT or contrast-enhanced MRI will be recommended for any patients with abnormal screening results Patients with normal diagnostic testing ie false positive result will be recommended to return to their assigned surveillance arm Standardized criteria from the AASLD and LI-RADS will be used to define incident HCC Study team will use a set of validated surveys eg Psychological Consequences Questionnaire Decision Regret scale FACIT-COST to measure secondary outcomes of interest including psychological and financial harms
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| 2U24CA086368-22 | NIH | None | httpsreporternihgovquickSearch2U24CA086368-22 |