Ignite Creation Date:
2024-05-06 @ 8:26 PM
Last Modification Date:
2024-10-26 @ 3:27 PM
Study NCT ID:
NCT06383143
Status:
RECRUITING
Last Update Posted:
2024-07-11
First Post:
2024-04-19
Brief Title:
Promoting Diagnosis and Management of AL in Italy ProDigALIty
Sponsor:
Fondazione IRCCS Policlinico San Matteo di Pavia
Organization:
Fondazione IRCCS Policlinico San Matteo di Pavia
Study Overview
Official Title:
Promoting Diagnosis and Management of AL in Italy ProDigALIty
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:
ProDigALIty
Brief Summary:
The investigators plan to establish a dedicated network of Italian Hematologic Departments interconnected with the Amyloidosis Research and Treatment Center in Pavia to
1 Implement a biomarker-based screening strategy to promote early diagnosis of AL amyloidosis among at-risk patients including patients with monoclonal gammopathy of undetermined significance MGUS and altered free light chain ratio aFLCR and patients with smoldering multiple myeloma SMM
2 Expedite and facilitate patients referral and their enrollment in ongoing pre-clinicalclinical studies also to reflect a broader spectrum of the real-world population of patients with AL amyloidosis in Italy
3 Investigate the clinical utility of novel diagnostic technologies including light chain sequencing and N-glycosylation analysis
1 Implement a biomarker-based screening strategy to promote early diagnosis of AL amyloidosis among at-risk patients including patients with monoclonal gammopathy of undetermined significance MGUS and altered free light chain ratio aFLCR and patients with smoldering multiple myeloma SMM
2 Expedite and facilitate patients referral and their enrollment in ongoing pre-clinicalclinical studies also to reflect a broader spectrum of the real-world population of patients with AL amyloidosis in Italy
3 Investigate the clinical utility of novel diagnostic technologies including light chain sequencing and N-glycosylation analysis
Detailed Description:
AL amyloidosis AL is a rare severe protein conformational disease caused by misfolding and extracellular deposition of patients-specific monoclonal immunoglobulin light chains in form of amyloid fibrils This process can affect virtually any body site and result in potentially fatal organ dysfunction
In a significant proportion of cases AL is diagnosed late when advanced often irreversible organ involvement limits therapeutic options and greatly limits survival Thus efforts at promoting early diagnosis are urgently needed
The presence of a monoclonal protein M protein or an abnormally increased concentration of serum free LCs FLCs invariably precedes clinically overt AL amyloidosis by several years Moreover about 95 of patients with AL have an altered FLC ratio FLCR at diagnosis Yet AL is often diagnosed late also in patients with known monoclonal gammopathy under hematological follow-up Screening of at-risk patients with biomarkers of early amyloid organ involvement has been advocated but not largely implemented
Diagnosis and management of AL patients require access to sophisticated technologies and expertise available at large tertiary Amyloid Centers Yet new models of patients care are required to intercept those patients who cannot travel to distant tertiary centers in order to provide state-of-the-art care to all and to be able to analyze and describe the natural history of the disease in a contemporary real-world setting
New molecular features associated with the propensity of light chains to form amyloid are emerging but their potential clinical utility is unknown Building on 30 years-experience of the Italian Referral Center for Systemic Amyloidoses and leveraging on an already existing disease registry and a one-of-a-kind biorepository of clinically annotated biological samples the study plans to extend and corroborate the activity of the Italian Amyloidosis Network through the involvement of large Hematology Departments strategically distributed across the Country and the establishment of a structured program of patients referral and sampledata transfer
The study will be conducted as follows
Part A an active biomarker-based surveillance of pre-symptomatic signs of amyloid organ involvement in at-risk subjects patients with MGUS and aFLCR and patients with SMM will be implemented in the participating Italian Hematologic Departments This will enable the verification of the feasibility of such biomarker-based screening allow the description of baseline characteristics of at-risk patients and promote early diagnosis of AL amyloidosis
Part B newly diagnosed AL amyloidosis patients either from Part A or from patients with clinically overt AL amyloidosis evaluated in the frame of routine clinical assessments will be either referred to the Amyloidosis Research and Treatment Center in Pavia or managed locally with clinical data prospectively entering a disease registry and diagnostic leftovers from biospecimens stored in a biorepository This will aim to increase referral and increment inclusion of real-world cases of AL amyloidosis in the disease registry and linked biorepositories as well as patients enrollment in other already approved and funded pre-clinical and clinical studies on basic disease mechanisms as well as new diagnostictherapeutic approaches in AL amyloidosis
Part C exploiting data collected from patients enrolled in both part A and part B the clinical utility of clonal light chain profiling including light chain sequencing evaluation of the N-glycosylation status and artificial intelligence-based amyloidogenicity prediction will be assessed
In a significant proportion of cases AL is diagnosed late when advanced often irreversible organ involvement limits therapeutic options and greatly limits survival Thus efforts at promoting early diagnosis are urgently needed
The presence of a monoclonal protein M protein or an abnormally increased concentration of serum free LCs FLCs invariably precedes clinically overt AL amyloidosis by several years Moreover about 95 of patients with AL have an altered FLC ratio FLCR at diagnosis Yet AL is often diagnosed late also in patients with known monoclonal gammopathy under hematological follow-up Screening of at-risk patients with biomarkers of early amyloid organ involvement has been advocated but not largely implemented
Diagnosis and management of AL patients require access to sophisticated technologies and expertise available at large tertiary Amyloid Centers Yet new models of patients care are required to intercept those patients who cannot travel to distant tertiary centers in order to provide state-of-the-art care to all and to be able to analyze and describe the natural history of the disease in a contemporary real-world setting
New molecular features associated with the propensity of light chains to form amyloid are emerging but their potential clinical utility is unknown Building on 30 years-experience of the Italian Referral Center for Systemic Amyloidoses and leveraging on an already existing disease registry and a one-of-a-kind biorepository of clinically annotated biological samples the study plans to extend and corroborate the activity of the Italian Amyloidosis Network through the involvement of large Hematology Departments strategically distributed across the Country and the establishment of a structured program of patients referral and sampledata transfer
The study will be conducted as follows
Part A an active biomarker-based surveillance of pre-symptomatic signs of amyloid organ involvement in at-risk subjects patients with MGUS and aFLCR and patients with SMM will be implemented in the participating Italian Hematologic Departments This will enable the verification of the feasibility of such biomarker-based screening allow the description of baseline characteristics of at-risk patients and promote early diagnosis of AL amyloidosis
Part B newly diagnosed AL amyloidosis patients either from Part A or from patients with clinically overt AL amyloidosis evaluated in the frame of routine clinical assessments will be either referred to the Amyloidosis Research and Treatment Center in Pavia or managed locally with clinical data prospectively entering a disease registry and diagnostic leftovers from biospecimens stored in a biorepository This will aim to increase referral and increment inclusion of real-world cases of AL amyloidosis in the disease registry and linked biorepositories as well as patients enrollment in other already approved and funded pre-clinical and clinical studies on basic disease mechanisms as well as new diagnostictherapeutic approaches in AL amyloidosis
Part C exploiting data collected from patients enrolled in both part A and part B the clinical utility of clonal light chain profiling including light chain sequencing evaluation of the N-glycosylation status and artificial intelligence-based amyloidogenicity prediction will be assessed
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