ClinicalTrials.gg
CompletedNCT00923104Updated Jul 8, 2025

An Exploratory Evaluation of Biomarkers in Blister Fluid in Healthy Volunteers and Irradiated Skin

An observational study in Breast Cancer, Healthy Volunteer and Prostate Cancer, sponsored by National Cancer Institute (NCI). Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-07-08.

Sponsored by National Cancer Institute (NCI) · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
61
Ages
18 Years and older
Sex
All
01

Study summary

Background:

  • Blister fluid contains many of the same biomarkers (substances that can be used to determine the effects of certain kinds of treatments) as blood and urine samples, particularly regarding changes in the skin.
  • The Radiation Oncology Branch and others are conducting research studies that require blood and urine samples from healthy volunteers and from patients with cancer. In addition to these samples, researchers would like to collect the fluid from blisters to examine markers of inflammation in the skin.

Objectives:

  • To compare blood, urine, and blister fluid samples of patients with cancer who are undergoing radiation therapy to that of volunteers without cancer who will not be receiving radiation therapy.
  • To gather more information about the effects of radiation therapy on the skin and body fluids of individuals.

Eligibility:

  • Patients 18 years of age and older who will be receiving radiation therapy for either breast or prostate cancer.
  • A separate group of healthy volunteers will also participate in this study.

Design:

  • Physical examination and blood samples to determine eligibility for the study.
  • Blister induction, conducted before the start of radiation treatment, at completion of radiotherapy (last day of treatment), and at a visit 12 months after the end of radiation treatment.
  • Blisters will be created through the use of a suction blister device on the hip (for patients with prostate cancer) or on the treated breast or location of removed breast (for patients with breast cancer).
  • Blisters will take approximately 30 minutes to form, and fluid will be removed with a needle and syringe.
  • Blood and urine samples will also be collected at this time.
  • Radiation treatment for breast or prostate cancer will be conducted according to standard procedures, or as directed by a separate research protocol.
  • Evaluations during the treatment period:
  • Physical examination, including vital signs and body weight checks, and pregnancy test for women who can become pregnant.
  • Blood and urine tests.
  • Disease evaluation.
  • Post-treatment evaluations:
  • Clinic visits at months 1, 3, 6, 9, and 12 after the end of radiation therapy for physical examination and disease assessment.
  • Study will end 1 year after the final radiation treatment, upon the collection of the final (third) blister fluid sample.
Read the detailed description

BACKGROUND

Blister fluid has been used to measure cytokine expression, proteomic profiles, and pharmacokinetics in a variety of disease states.

Blister fluid inside radiation treatment fields has been shown to have altered expression of cytokines and products of collagen metabolism.

Evaluation of blister fluid in normal skin inside and outside the radiation field may allow the development of a minimally invasive marker of radiation exposure or damage induced by radiation in irradiated skin.

OBJECTIVES

This protocol will evaluate the ability to determine a cytokine pattern and global changes at the protein level measured in blister fluid that correlates with radiation exposure, absorbed skin dose, or skin toxicity from patients receiving radiation.

ELIGIBILITY

Patients in whom radiotherapy is required for standard management of theirbreast or prostate cancer.

Healthy volunteers with no history of cutaneous inflammatory condition of the skin such as eczema, or psoriasis.

DESIGN

This protocol is designed to evaluate blister fluid in and out of the radiation field in patients that are receiving radiation therapy and in healthy volunteers.

Patients will undergo blister induction and blister fluid collection prior to treatment outside of the radiation field, and after completion of radiation within the radiation field.

Blisters will be induced in a non-sun exposed area and if possible in matched sites (i.e. left and right).

02

Conditions studied

  • Breast Cancer
  • Healthy Volunteer
  • Prostate Cancer

Keywords

  • Radiation
  • Blister
  • Healthy Volunteer
  • Samples
  • Natural History
  • Prostate Cancer
  • Breast Cancer
  • HV
03

In context

Breast Neoplasms

14,825 studies on the registry are indexed under Breast Neoplasms; 3,319 are open to participants now.

This study's enrollment of 61 is below the median of 184 across 3,235 observational studies indexed under Breast Neoplasms.

Browse Breast Neoplasms studies →

Lead sponsor

National Cancer Institute (NCI) is the lead sponsor of 3,556 studies on the registry; 336 are open to participants now.

Of its 411 completed or terminated interventional studies of FDA-regulated products, 373 (91%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients in whom radiotherapy is required for standard management of their breast or prostate cancer. Healthy volunteers with no history of cutaneous inflammatory condition of the skin such as eczema, or psoriasis.@@@@@@

Eligibility criteria

  • ELIGIBILITY CRITERIA

ELIGIBILITY CRITERIA FOR PATIENTS RECEIVING RADIOTHERAPY:

INCLUSION CRITERIA:

  1. Histological diagnosis: confirmed diagnosis of 1) invasive breast cancer, 2) ductal carcinoma in situ, or 3) adenocarcinoma of the prostate.
  2. Patients in whom the management of the histologic diagnosis will include radiation treatment as part of standard clinical management.
  3. Patients in whom the extent of disease is considered local or locoregional (i.e. requiring definitive radiotherapy to the breast or prostate).
  4. Patients must be older than 18 years of age.
  5. Patients must have a primary medical or surgical oncologist in the community or at NCI who is willing to collaborate with the ROB staff in the clinical management of the patient.
  6. Patients of childbearing or child- fathering potential must be willing to use a medically acceptable form of , which includes abstinence, while they are being treated with radiotherapy on this study.
  7. Patients must have an performance status of 0-2 and a greater than 12 months.

EXCLUSION CRITERIA:

  1. Patients with a history of chronic skin disease such as psoriasis, eczema, or history of keloid formation.
  2. Patients requiring concurrent use of topical
  3. Patients requiring concurrent use of glucocorticoid therapy.
  4. Patients who have received topical or systemic chemotherapy within 4 weeks of enrollment (not including hormonal agents such as antiandrogens, GnRH agonists, aromatase inhibitors, tamoxifen, and similar agents) are excluded.
  5. Patients requiring concurrent chemotherapy with radiotherapy except as noted in (Protocol section 2.3.1) are excluded.
  6. Patients with a history of lupus erythematosis, scleroderma, ataxia telengiectasia or other known to therapeutic radiation.
  7. Patients with prior radiotherapy to the site which would be used for blister induction.
  8. Patients who are pregnant because of the potential mutagenic effects of radiation on a developing fetus or newborn.
  9. Patients with unrelated systemic illness which in the judgment of the Principal Investigator (PI) would compromise the patient s ability to tolerate this therapy or are likely to interfere with the study procedures or results.
  10. Patients who are in the estimation of the PI, deemed unable or unlikely to adhere to protocol treatment.
  11. Patients with significant skin atrophy that would interfere with blister formation.
  12. Breast cancer patients in whom the site of radiotherapy includes a myocutaneous flap or skin graft.

ELIGIBILITY CRITERIA FOR HEALTHY VOLUNTEERS:

INCLUSION CRITERIA:

  1. Healthy volunteers older than 18 years of age.
  2. Ability to provide .

EXCLUSION CRITERIA:

  1. History of chronic skin disease such as psoriasis, eczema, or history of keloid formation.
  2. Concurrent use of glucocorticoid therapy.
  3. History of lupus erythematosis, scleroderma, ataxia telengiectasia or other known hypersensitivity to therapeutic radiation.
  4. Prior radiotherapy to the site which would be used for blister induction (for benign or malignant causes).
  5. Unrelated systemic illness which in the judgment of the Principal Investigator (PI) would compromise the patient s ability to tolerate blister induction or are likely to interfere with blister healing, the study procedures, or the study results.
  6. Darkly pigmented skin in whom pigmentation changes are a likely complication
  7. Significant skin atrophy that would interfere with blister formation.
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
61 participants (actual)

Groups and cohorts

  • 1/healthy volunteers

    healthy volunteers

  • 2/patients

    subjects with breast cancer, ductal carcinoma in situ, and adenocarcinoma of prostate

06

What researchers measure

Primary outcomes

  1. To determine if cytokine levels in blister fluid change following exposure of the skin to low or high dose radiation

    The primary objectives of this study are (i) to determine if cytokine levels in blister fluid change following exposure of skin to low or high dose radiation, and (ii) to compare cytokine levels in blister fluid from unirradiated skin in normal controls, breast cancer patients, and prostate cancer patients. We will examine IL-1 beta, IL6, TNF-alpha, and MMP-1 and -3 for the primary analysis. The remaining cytokines will be examined in secondary analyses.

    Time frame: study completion

  2. To compare blister fluid cytokine levels in blister fluid from unirradiated skin in normal controls, breast cancer patients, and prostate cancer patients

    The primary objectives of this study are (i) to determine if cytokine levels in blister fluid change following exposure of skin to low or high dose radiation, and (ii) to compare cytokine levels in blister fluid from unirradiated skin in normal controls, breast cancer patients, and prostate cancer patients. We will examine IL-1 beta, IL6, TNF-alpha, and MMP-1 and -3 for the primary analysis. The remaining cytokines will be examined in secondary analyses.

    Time frame: study completion

Secondary outcomes

  1. To evaluate the reproducibility of cytokine assays in simultaneously collected blister fluid samples from normal patients.

    Time frame: study completion

  2. To determine if there are differences within circulating and skin proteome and cytokine patterns between participants with cancer and healthy normal controls

    Time frame: study completion

  3. To determine if cytokine levels and changes at the proteome level measured in blister fluid correlate with absorbed radiation skin dose, acute RTOG skin toxicity (>Grade 3), or late RTOG skin toxicity (>Grade 2).

    Time frame: study completion

  4. To determine if changes in the proteome in blister fluid occur following exposure of the skin to low or high dose radiation

    Time frame: study completion

  5. To determine how proteomic pattern changes in skin correlate with circulating proteomic patterns.

    Time frame: study completion

  6. To determine how cytokine levels in skin correlate with circulating and urinary cytokine levels.

    Time frame: study completion

07

Study locations

1 site
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
08

References and documents

Publications

  • D'Auria L, Pimpinelli F, Ferraro C, D'Ambrogio G, Giacalone B, Bellocci M, Ameglio F. Relationship between theoretical molecular weight and blister fluid/serum ratio of cytokines and five other molecules evaluated in patients with bullous pemphigoid. J Biol Regul Homeost Agents. 1998 Jul-Sep;12(3):76-80. PubMed 9795835 ↗
  • Riekki R, Parikka M, Jukkola A, Salo T, Risteli J, Oikarinen A. Increased expression of collagen types I and III in human skin as a consequence of radiotherapy. Arch Dermatol Res. 2002 Jul;294(4):178-84. doi: 10.1007/s00403-002-0306-2. Epub 2002 Apr 27. PubMed 12111348 ↗
  • Sonesson B, Rosengren E, Hansson AS, Hansson C. UVB-induced inflammation gives increased d-dopachrome tautomerase activity in blister fluid which correlates with macrophage migration inhibitory factor. Exp Dermatol. 2003 Jun;12(3):278-82. doi: 10.1034/j.1600-0625.2003.120307.x. PubMed 12823441 ↗

Individual participant data

Plan to share: Yes — All IPD recorded in the medical record will be shared with intramural investigators upon request.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: Clinical data available during the study and indefinitely.

Access criteria: Clinical data will be made available via subscription to BTRIS and with the permission of the study PI.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 8, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT00923104
Responsible party
Sponsor
First posted
Jun 18, 2009
Start date
Apr 23, 2009
Primary completion
Sep 21, 2017
Completion
Sep 21, 2017
Last update
Jul 8, 2025

Study contacts

Deborah E Citrin, M.D.
principal investigator · National Cancer Institute (NCI)

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2025. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion