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Trial registered on ANZCTR
Registration number
ACTRN12616000876493
Ethics application status
Approved
Date submitted
29/06/2016
Date registered
5/07/2016
Date last updated
30/01/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Actinic Keratosis and Squamous Cell Carcinoma Cross-sectional Microbiome study in Transplant Recipients
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Scientific title
A cross-sectional study to determine whether certain microbiome on the skin influence the progression of sun-damaged skin to skin cancer in immune-supressed transplant recipients.
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Secondary ID [1]
289518
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None
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Universal Trial Number (UTN)
U1111-1184-5666
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Trial acronym
n/a
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Squamous Cell Carcinoma
299227
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Actinic Keratosis
299228
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Condition category
Condition code
Skin
299236
299236
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0
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Dermatological conditions
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Cancer
299360
299360
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0
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Non melanoma skin cancer
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Participants will be recruited during routine follow up visits concerning previous renal/liver transplant.
Participation involves one visit with the study team where a full skin check will be performed. Swabs will be taken from standardised control sites of sun-damaged skin on the patients forearm, Squamous cell carcinomas (SCCs), peri-lesional skin to SCCs and actinic keratoses (AKs). The swabbing technique has been tested in previous pilot studies and involves using sterile swabs moistened in saline, to rub over the surface of the lesion/skin. Swabs are then stored in tubes for later DNA extraction and culturing.
All suspected SCCs will be recommended for routine excision and histology. We will request a copy of the subsequent pathology report to confirm SCC diagnosis. The member of the study team will also record information on demographic, and relevant medical history from the patient, as listed below. Clinical non-identifiable photographs of patient’s forearms and any SCCs will be taken.
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Intervention code [1]
295115
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Early Detection / Screening
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Comparator / control treatment
no control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Primary outcome is the identification of microbial communities present on different lesions of the skin. Microbiome identification will be performed by extracting DNA from swabs collected of patient lesions, then sequenced using standard laboratory procedures.
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Assessment method [1]
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Timepoint [1]
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baseline - after swab collection.
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Secondary outcome [1]
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To support the primary outcome, we will also seek to identify microbiome from swabs using bacterial and yeast/fungi culture and isolation techniques.
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Assessment method [1]
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Timepoint [1]
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baseline - after swab collection.
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Eligibility
Key inclusion criteria
All participants in the study will need to have been immune-suppressed for over 1 year as a result of a kidney or liver transplant, prior to enrolling in the study. They will also need to be over the age of 40 years old. Participants are divided into three specific groups based on whether they have current SCCs (anywhere on the body) or AKs (on either forearm).
There will be 3 distinct groups recruited;
1. Renal/liver transplant recipients with over 1 year of immune-suppression, with no AKs
2. Renal/liver transplant recipients with over 1 year of immune-suppression, with at least 2 AKs on one forearm.
3. Renal/liver transplant recipients with over 1 year of immune-suppression, with one SCC located anywhere on the body.
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Minimum age
40
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria: Topical medicated creams to the area being sampled i.e. 5-fluorouracil, imiquimod, diclofenac sodium, ingenol mebutate, PDT, corticosteroid. Topical keratolytics.
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Once DNA is extracted, amplified and sequenced, then bioinformatics and biostatistical analysis will be able to identify any microbial populations associated with squamous cell carcinoma, actinic keratosis and sun-damaged skin.
This is an exploratory observational study, no formal sample size calculation was performed.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/08/2016
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Actual
9/09/2016
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Date of last participant enrolment
Anticipated
1/08/2017
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Actual
2/11/2017
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Date of last data collection
Anticipated
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Actual
2/11/2017
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Sample size
Target
300
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Accrual to date
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Final
32
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment postcode(s) [1]
13437
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4102 - Woolloongabba
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council (NHMRC)
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Address [1]
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GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of Queensland
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Address
TRI, 37 Kent Street
Woolloongabba QLD 4102
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
292723
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Metro South Health HREC
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Ethics committee address [1]
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TRI, Level 7, 37 Kent Street Woolloongabba QLD 4102
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
295314
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18/05/2016
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Approval date [1]
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23/06/2016
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Ethics approval number [1]
295314
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HREC/16/QPAH/364
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Summary
Brief summary
We have conducted pilot research in the significance of skin microorganisms in the conversion of AK to squamous cell carcinoma (SCC) in healthy volunteers and wish to compare these data to transplant recipients. Transplant patients, who are required to take immune-supressing drugs, are at a much higher risk of skin cancers than people in the general population. There is a necessity to study the relevance of the skin microbiome in transplant recipients as they are more vulnerable to the conversion of AK to SCC. We seek to compare the microbiome of transplant patients who have been immune-supressed for over 1 year, who have no AKs, many AKs, and those with suspected SCCs. The microbiome will be examined by taking skin swabs from participants and analysed by DNA extraction and microbe culture and isolation. In the case of suspected SCCs, patients will undergo routine care for their recommended removal, and the study team will request a copy of the subsequent pathology report to confirm SCC diagnosis. Who is it for? All participants in the study will need to have been immune-suppressed for over 1 year as a result of a kidney or liver transplant, prior to enrolling in the study. They will also need to be over the age of 40 years old. Participants are divided into three specific groups based on whether they have current SCCs (anywhere on the body) or AKs (on either forearm). Study details: Participants will be recruited during their routine follow up visits with the renal/liver transplant services at Princess Alexandra Hospital. If they consent to take part in the study, the study visit can occur after their follow up visit, or scheduled for a later date. Swabs will be taken from standardised control sites of sun-damaged skin on the patients forearm, SCCs, peri-lesional skin to SCCs and AKs. The swabbing technique has been tested in previous pilot studies. All suspected SCCs will be recommended for routine excision and histology. We will request a copy of the subsequent pathology report to confirm SCC diagnosis. The member of the study team will also record information on demographic, and relevant medical history from the patient. Clinical non-identifiable photographs of patient’s forearms and any SCCs will be taken.
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Trial website
n/a
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Trial related presentations / publications
n/a
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Public notes
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Contacts
Principal investigator
Name
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Prof H. Peter Soyer
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Address
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Dermatology Research Centre, School of Medicine, The University of Queensland
TRI, 37 Kent Street, Woolloongabba QLD 4102
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Country
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Australia
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Phone
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+61 7 3443 8017
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Fax
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+61 7 3443 7779
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Email
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[email protected]
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Contact person for public queries
Name
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Clare Primiero
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Address
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Dermatology Research Centre, School of Medicine, The University of Queensland
TRI, 37 Kent Street, Woolloongabba QLD 4102
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Country
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Australia
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Phone
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+61 7 3443 7496
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Fax
66843
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+61 7 3443 7779
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Email
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[email protected]
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Contact person for scientific queries
Name
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Clare Primiero
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Address
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Dermatology Research Centre, School of Medicine, The University of Queensland
TRI, 37 Kent Street, Woolloongabba QLD 4102
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Country
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Australia
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Phone
66844
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+61 7 3443 7496
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Fax
66844
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+61 7 3443 7779
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Email
66844
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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