Rapid screening of cheek cells to distinguish cancer using light

ISRCTN ISRCTN18176235
DOI https://doi.org/10.1186/ISRCTN18176235
IRAS number 257831
Secondary identifying numbers IRAS 257831, CPMS 41596
Submission date
09/09/2022
Registration date
21/10/2022
Last edited
28/02/2024
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Respiratory
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Non-small cell lung cancer (NSCLC) is the UK’s leading cause of cancer deaths. Early diagnosis of lung cancer is key to improving survival rates. Most patients aren’t diagnosed until stage 4, when a cure is often not possible. Sierra Medical are developing a new and unique non-invasive screening test to detect NSCLC from a simple cheek swab with extremely high accuracy. To get the technology approved for use in hospitals, they need to conduct a series of clinical trials. This is the first clinical trial required to gain approval.

Who can participate?
1. Non-smokers with no history of lung disease
2. Current or ex-smokers with no history of lung disease
3. Current or ex-smokers with confirmed COPD
4. Current or ex-smokers with lung cancer (NSCLC only)
5. Smokers and non-smokers with other types of lung cancer
All aged 18 years and over

What does the study involve?
Participants will be seen in a research clinic where medical history will be obtained, lung function tests are performed and two cheek swabs are taken. These swabs will be analysed to demonstrate that there is a difference between cells from patients with and without lung cancer.

What are the possible benefits and risks of participating?
There will be no immediate benefit to the participant. However, if the study is successful participants will contribute to developing a lung cancer screening test that will enable earlier detection of lung cancer which will provide better outcomes to future lung cancer patients. The participant will be paid £10 to cover time and travel. There are very few risks associated with participation in the study, however, the participant may experience temporary irritation to the inside of their cheek where they were swabbed and/or temporary dizziness from forced exhalation during the lung function test (spirometry). Both side effects are rare and temporary.

Where is the study run from?
Queen Alexander Hospital (UK)

When is the study starting and how long is it expected to run for?
March 2019 to June 2024

Who is funding the study?
1. Innovate UK
2. Sierra Medical Ltd (UK)

Who is the main contact?
Thomas.macdonald@porthosp.nhs.uk

Contact information

Prof Anoop Chauhan
Principal Investigator

Portsmouth Hospitals NHS Trust
Queen Alexandra Hospital
Southwick Hill Road
Cosham
PO6 3LY
United Kingdom

Phone +44 (0)2392286000
Email anoop.chauhan@porthosp.nhs.uk

Study information

Study designObservational study
Primary study designObservational
Secondary study design
Study setting(s)Hospital
Study typeScreening
Participant information sheet Not available in web format, please use the contact details to request a participant information sheet
Scientific titleInfrared analysis of buccal cell swabs as a novel non-invasive screening test for lung cancer in individuals exposed to carcinogens
Study acronymRADiCAL
Study objectivesInfrared (IR) fingerprints collected using lab-based IR micro-spectroscopy of individual human buccal mucosa cells can be used to differentiate between smokers with non-small cell lung cancer (NSCLC) and smokers/non-smokers without NSCLC with sufficient accuracy to be used as an initial screening test for lung cancer.
Ethics approval(s)Approved 20/03/2019, South Central - Berkshire Research Ethics Committee (Bristol REC Centre, Whitefriars, Level 3, Block B Lewins Mead, Bristol, BS1 2NT, UK; +44 (0)20 7104 8057; berkshire.rec@hra.nhs.uk), ref: 19/SC/0100
Health condition(s) or problem(s) studiedChronic obstructive pulmonary disease (COPD) and/or non-small cell lung cancer
InterventionPatients will attend one study visit where the following will be obtained/performed:
1. Informed consent
2. Specific medical history
3. Brief medical history
4. Smoking history
5. Assessment of food and other potential contaminates
6. Collection of cheek swabs
7. Lung function test (spirometry)
8. Confirm eligibility
9. Record adverse events
10. Acceptability questionnaire
Intervention typeDevice
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Sierrra AIR-DS
Primary outcome measureIndividual infrared (IR) spectra collected from each participant's cheek cells using a Fourier-transform infrared spectroscopy (FTIR) microspectrometer at a single timepoint
Secondary outcome measuresAverage IR spectra of buccal mucosa swabs measured using a benchtop ATR-FTIR spectrometer for smokers with NSCLC and smokers/non-smokers without NSCLC at a single timepoint
Overall study start date20/03/2019
Completion date30/06/2024

Eligibility

Participant type(s)Mixed
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants700
Key inclusion criteriaThere are five arms of the study. Approximately 100 participants will be recruited into the following four groups:
A. Non-smokers with no history of lung disease
B. Current or ex-smokers with no history of lung disease
C. Current or ex-smokers with confirmed COPD
D. Current or ex-smokers with lung cancer

An additional exploratory group of up to 50 participants will be recruited:
E. Smokers and non-smokers with heterogenous lung cancers or suspected lung cancer

1. Are able to understand and provide signed consent – All groups
2. Are aged 18 years or older – All groups
3. Are able to provide a cheek swab sample – All groups
4. Are a non-smoker and never used e-cigarettes – Group A only
5. Are a smoker or ex-smoker – Group B, C and D
6. Must have spirometry of FEV1/FVC ratio >0.7 - Group A and B
7. Are diagnosed with COPD and meet the GOLD criteria for COPD (post-bronchodilator airway obstruction with FEV1/FVC ratio <0.7) Group C only
8. Have (or eventually proven to have) a histologically-confirmed primary non-small cell lung cancer - Group D only
9. Have not commenced treatment for non-small cell lung carcinoma - Group D only
10. Have (or eventually have) a histologically-confirmed cancer a) other than a NSCLC (e.g. small-cell cancer, carcinoid) or b) NSCLC but have never smoked or c) NSCLC but have received treatment – Group E only
Key exclusion criteriaDoes not meet the inclusion criteria
Date of first enrolment01/05/2019
Date of final enrolment30/06/2024

Locations

Countries of recruitment

  • England
  • United Kingdom

Study participating centre

Portsmouth Hospitals NHS Trust
Queen Alexandra Hospital
Portsmouth
PO6 3LY
United Kingdom

Sponsor information

Sierra Medical
Industry

Ketton Suite
The King Centre
Main Road
Barleythorpe
Rutland
LE15 7WD
England
United Kingdom

Phone +44 (0)7903406271
Email info@sierramedical.co.uk
Website https://www.sierramedical.co.uk

Funders

Funder type

Industry

Sierra Medical

No information available

Innovate UK
Government organisation / National government
Alternative name(s)
innovateuk
Location
United Kingdom

Results and Publications

Intention to publish date05/05/2023
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot expected to be made available
Publication and dissemination planThe final clinical study report will be produced after study completion. It is intended that the results from this research will be submitted to a high-impact peer-reviewed journal, once the study is complete.
IPD sharing planThe datasets generated during and/or analysed during the current study are not expected to be made available due to commercial sensitivity

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
HRA research summary 28/06/2023 No No

Editorial Notes

28/02/2024: The following changes were made to the trial record:
1. The overall end date was changed from 31/01/2022 to 30/06/2024.
2. The recruitment end date was changed from 31/01/2022 to 30/06/2024.
3. The target number of participants was changed from 400 to 700.
4. The plain English summary was updated to reflect these changes.
01/11/2022: Internal review.
20/10/2022: Trial's existence confirmed by the South Central - Berkshire Research Ethics Committee.