This pilot trial studies the effect of the microbiome on immune checkpoint inhibitors response in patients with melanoma by collecting stool and blood samples. Gut microbiome plays a critical role in response to immune checkpoint inhibitors. Studying the change in an individual's microbiome due to corticosteroid use may help researchers to determine whether an individual's microbiome can predict their response and toxicity to immune checkpoint inhibitors.
PRIMARY OBJECTIVE: I. To determine if the microbiome alpha-diversity is predictive of response (Response Evaluation Criteria in Solid Tumors \[RECIST\] version \[v\] 1.1) at a 12-week computed tomography (CT) scan or toxicity. SECONDARY OBJECTIVE: I. To determine the recruitment and compliance rates for longitudinal biospecimen collection, including stool, in melanoma patients. EXPLORATORY OBJECTIVE: I. To determine if individual microbes or their changes in relative abundance are predictive of response or toxicity. OUTLINE: Patients complete a Food Frequency Questionnaire (FFQ) at baseline, undergo collection of stool samples at baseline, within 2 days of starting corticosteroid treatment (if applicable), when asked for a control sample, and at 12 weeks, and undergo collection of blood samples and computed tomography (CT) at baseline and 12 weeks.
Study Type
OBSERVATIONAL
Enrollment
88
Undergo collection of blood and stool
Undergo CT
Correlative studies
Complete questionnaire
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, United States
Baseline microbiome alpha diversity in responders versus (vs) non-responders
This analysis will follow a logistic regression structure. The dependent variable, response to treatment, will be evaluated using standardized criteria (Response Evaluation Criteria in Solid Tumors \[RECIST\] version \[v\] 1.1). Each patient will be classified as "respond", "stable" or "progression'' as a categorical variable and then binarized, with "respond" or "stable" in the category "responders", and "progression" in the category "non-responders". Independent variables will be alpha-diversity. Additional covariates will be included in the model to control for differences in age, sex, body mass index (BMI), Food Frequency Questionnaire (FFQ) dietary index, and medication history.
Time frame: At 12 weeks
Baseline microbiome alpha diversity in patients prescribed corticosteroids vs those who were not prescribed corticosteroids
This analysis will follow a logistic regression structure. The dependent variable, toxicity, will be evaluated by corticosteroid prescription. Dependent variables including alpha-diversity or individual microbes will be independent variables.
Time frame: Within the 12-week treatment window
Recruitment rates for longitudinal biospecimen collection, including stool, in melanoma patients
Recruitment rates will be defined as the fraction of screened adults who are eligible and agree to participate within the Cutaneous Oncology Clinic, with an estimated recruitment of 30%. Will track the monthly collection of data and documented reasons for missing any scheduled collection dates. The recruitment rate will be used in combination with the variance of the biospecimen data in power calculations to estimate the sample size needed for future trials.
Time frame: 12 weeks
Compliance rates for longitudinal biospecimen collection, including stool, in melanoma patients
Compliance will be defined as 90% of baseline, endpoint and corticosteroid collection. Will track the monthly collection of data and documented reasons for missing any scheduled collection dates. The compliance rate will be used in combination with the variance of the biospecimen data in power calculations to estimate the sample size needed for future trials.
Time frame: 12 weeks
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