Tumor volume measurements vs diameter-based measurements (mRECIST) for response evaluation in pleural mesothelioma

ISRCTN ISRCTN12418979
DOI https://doi.org/10.1186/ISRCTN12418979
ClinicalTrials.gov (NCT) Nil known
Clinical Trials Information System (CTIS) Nil known
Protocol serial number IRBd23-265
Sponsor Antoni van Leeuwenhoek Hospital
Funder Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
Submission date
31/12/2023
Registration date
15/01/2024
Last edited
15/01/2024
Recruitment status
No longer recruiting
Overall study status
Ongoing
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Pleural mesothelioma (PM) is an aggressive type of cancer that arises from the pleural mesothelium, a thin layer covering the lungs and chest wall. The aim of this study is to investigate whether using the tumour volume makes the response evaluation more reliable compared to the current mRECIST criteria (diameter-based measurements).

Who can participate?
Patients aged 18 years and over with pleural mesothelioma

What does the study involve?
All patients will be treated by their own treating physician. However, during this study, an additional response evaluation based on tumor volume will be conducted. Treatment decisions will not be based on this evaluation.

What are the possible benefits and risks of participating?
There are no side effects nor possible benefits for the patients when participating. The researchers will gain more knowledge about the response evaluation system.

Where is the study run from?
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (Netherlands)

When is the study starting and how long is it expected to run for?
June 2023 to December 2025

Who is funding the study?
Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (Netherlands)

Who is the main contact?
Sjaak Burgers, s.burgers@nki.nl

Contact information

Ms Illaa Smesseim
Public, Scientific

Plesmanlaan 121
Amsterdam
1066 CX
Netherlands

Phone +31 (0)205129111
Email i.smesseim@nki.nl
Dr Sjaak Burgers
Principal investigator

Thoracic Oncology / Plesmanlaan 121
Amsterdam
1066 CX
Netherlands

Phone +31 (0)644137161
Email s.burgers@nki.nl

Study information

Primary study designObservational
Study designProspective blinded comparative non-inferiority single-centre feasibility study
Secondary study designFeasibility study
Study type Participant information sheet
Scientific titleCOMET trial: Comparison of pleural mesothelioma evaluation using volume measurements with an artificial intelligence program to the mRECIST v1.1 criteria, a prospective trial
Study acronymCOMET
Study objectivesARTIMES yields an equal or higher interobserver agreement between different radiologists compared to mRECIST v1.1.
Ethics approval(s)

Approved 04/12/2023, Institutional Review Board (IRB) The Netherlands Cancer Institute (Plesmanlaan 121, Amsterdam, 1066 CX, Netherlands; +31 (0)20 51291; IRB@nki.nl), ref: IRBd23-265

Health condition(s) or problem(s) studiedPleural mesothelioma
InterventionThis is a prospective blinded comparative non-inferiority single-center feasibility study. Three radiologists will review every CT scan of adult patients with pleural mesothelioma referred to the tertiary center according to the mRECIST v1.1 and ARTIMES. Confirmation bias could occur if a radiologist assigns progressive disease (PD) following mRECIST v1.1 and is afterwards segmenting extra volume to ensure a PD for ARTIMES as well. To reduce this bias, the same CT scan needs to be reviewed for mRECIST and ARTIMES on different days with a washout of at least 4 weeks. The sequence in which both methods are used will be random. Reviewers will be blinded for their own results and for the results of the other reviewers.
Intervention typeOther
Primary outcome measure(s)

The interobserver agreement among experts employing the ARTIMES criteria and the gold standard (mRECIST v1.1 criteria), measured at the end of the study using kappa

Key secondary outcome measure(s)

1. Time needed to measure response evaluation in minutes between the ARTIMES vs mRECIST v1.1 criteria, measured in minutes for every scan at every evaluation point
2. Time until partial response (PR) and progressive disease (PD) in days between the ARTIMES vs mRECIST v1.1 criteria, measured in days at every evaluation point
3. The response evaluation of the treating physician with the ARTIMES criteria and the mRECIST v1.1. criteria per evaluation point, compared at every evaluation point
4. The performance of the AI in segmenting pleural mesothelioma tumour volume vs the final segmentation of the reviewers, compared at every evaluation point

Completion date31/12/2025

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexAll
Target sample size at registration52
Key inclusion criteria1. Histology or cytology-proven non-resectable pleural mesothelioma
2. Age ≥18 years
3. Availability of a baseline CT thorax with contrast before the start of new systemic treatment with a slice increment of ≤3 mm on the CT scan
4. Availability of at least one follow-up scan (the lungs must be fully contained in the image)
Key exclusion criteria1. CT scans with lungs not fully imaged
2. No histology-proven pleural mesothelioma
Date of first enrolment01/12/2023
Date of final enrolment01/01/2025

Locations

Countries of recruitment

  • Netherlands

Study participating centre

Antoni van Leeuwenhoek hospital / NKI
Plesmanlaan 121
Amsterdam
1066 CX
Netherlands

Results and Publications

Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
IPD sharing planThe data will be stored for at least 20 years and as long as proven useful for scientific research.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Participant information sheet Participant information sheet 11/11/2025 11/11/2025 No Yes

Editorial Notes

15/01/2024: Study's existence confirmed by the Institutional Review Board (IRB) The Netherlands Cancer Institute.