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RecruitingNCT07483112Fiber-BoostUpdated Mar 19, 2026

Fiber-Boost Randomized Controlled Trial

An interventional study of High-fiber diet in Non-Small Cell Carcinoma of Lung, sponsored by Cantonal Hospital of St. Gallen. Recruiting at 4 sites in Switzerland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-03-19.

Sponsored by Cantonal Hospital of St. Gallen · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 5 months after the study started (first participant enrolled Oct 2025, registered Mar 2026).
  • Started Oct 2025; still recruiting 1 year 1 month later.
Phase
Not applicable
Study type
Interventional
Enrollment
42
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

In the present study 'Fiber-Boost', we investigate how a high-fiber diet affects the immunotherapy of advanced lung cancer and what effects it has on the gut microbiome (i.e., the bacteria in the gut) as well as the immune system. Study participants will be assigned to either a test group or a control group. Only patients in the test group will undergo a high-fiber diet. The study lasts 6 weeks per patient and will be conducted at 4 centers within Switzerland. A total of 42 patients are planned to be included in the study.

Read the detailed description

The activity of immune checkpoint blockade (ICB) mechanistically depends on the host microbiome and is manipulable through diet. In this study termed Fiber-Boost, we propose a multicenter trial of a supplement-based high-fiber diet (HFD) in non-small cell lung cancer (NSCLC) treated with first-line ICB monotherapy. Using a randomized, controlled design, we mechanistically explore the role of dietary fibers in cancer immunotherapy. Circulating tumor DNA (ctDNA) quantification as well as a rich pipeline of companion microbiome and immune profiling technologies will improve the understanding of the diet-microbiome-immune axis in therapeutic anticancer immunity and treatment response. The overarching goal is to elucidate novel therapeutic strategies for ICB sensitization in NSCLC using microbiome-centered, non-pharmaceutical interventions. Sex and gender dimensions are biologically not sufficiently relevant for the current study to merit corresponding stratification or analyses.

02

Conditions studied

  • Non-Small Cell Carcinoma of Lung

Keywords

  • non-small cell lung cancer
  • immunotherapy
  • high-fiber diet
  • microbiome
03

In context

Carcinoma, Non-Small-Cell Lung

7,620 studies on the registry are indexed under Carcinoma, Non-Small-Cell Lung; 1,838 are open to participants now.

This study's planned enrollment of 42 is below the median of 62 across 6,019 interventional studies indexed under Carcinoma, Non-Small-Cell Lung.

Browse Carcinoma, Non-Small-Cell Lung studies →

Lead sponsor

Cantonal Hospital of St. Gallen is the lead sponsor of 79 studies on the registry; 9 are open to participants now.

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥18 years
  • Written according to Swiss law and ICH/GCP regulations before inclusion and prior to any trial-specific procedures
  • or cytologically confirmed NSCLC
  • Advanced or recurrent NSCLC not amenable to curative treatment
  • expression ≥50% (TPS) determined by an approved IHC test
  • No actionable genetic alterations in genes such as EGFR, ALK, ROS1, , BRAF, RET, MET, NTRK
  • palliative PD-1/PD-L1-targeted monotherapy at a 3-weekly schedule indicated per local investigator
  • Willingness and ability to undergo study interventions
  • performance status 0-2
  • Adequate organ function:
  • ≥70 g/L, count ≥50 G/L, granulocytes ≥1 G/L
  • , , AST ≤3 x
  • (Cockroft-Gault) ≥30 mL/min/1.73m²
  • Measurable or evaluable disease per 1.1
  • Patients with are eligible, provided there is no requirement for as therapy for CNS disease and no evidence of clinical progression
  • Women with use effective (two independent methods), are not currently pregnant or lactating, and agree to not become pregnant during the trial treatment and during 3 months thereafter. A negative pregnancy test in either urine or blood is required for women with child-bearing potential before trial inclusion.
  • Men who are not sterile agree to use contraceptive methods (condoms) or abstain from sexual intercourse during the trial treatment and 3 months thereafter.

Exclusion criteria

Exclusion Criteria:

-History of , unless in remission for at least 3 years before inclusion with the exception of pT1-2 prostate cancer Gleason score \<6, adequately treated cervical carcinoma in situ or localized non-melanoma skin cancer

or additive systemic ICB treatment within 6 months prior to inclusion

  • Systemic treatment with an antibiotic within 10 days of ICB treatment/HFD intervention start
  • Concomitant drugs including at a daily dose of ≥10mg prednisone equivalents, methotrexate, azathioprine, TNF-α inhibitors
  • Concurrent treatment with other experimental drugs or other anticancer therapy
  • Major surgical procedures within 14 days prior to inclusion as judged by the investigator
  • Active disease requiring systemic immunosuppressive treatment that is seen as for the use of /PD-L1-targeted monoclonal antibodies
  • Uncontrolled diabetes mellitus
  • Severe or uncontrolled cardiovascular disease
  • Any other serious underlying medical, psychiatric, psychological, familial or geographical condition, which in the judgment of the investigator may interfere with the planned staging, treatment and follow-up, affect patient compliance or place the patient at high risk from treatment-related complications
  • Had an allogeneic tissue/solid organ transplant
  • Ongoing supplementation with OptiFibre® or another fiber supplement
Terms in these criteria, in plain language(22)

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.

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.

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.

PD-1, PD-L1 and checkpoint inhibitors

PD-1, PD-L1 and CTLA-4 are proteins that act as brakes on the immune system. Checkpoint inhibitors, such as pembrolizumab or nivolumab, block them so the immune system can attack a cancer.

PD-L1 can also be measured in a tumour sample. Some scores count stained tumour cells only (TPS); others also count certain immune cells (CPS). The study names the score and the minimum it uses.

HER2

HER2 is a protein, made from the ERBB2 gene, that drives the growth of some cancers. A study may look for a level of the protein, extra copies of the gene, or a particular change in it.

In breast cancer, protein tests are read as HER2-positive, HER2-low or HER2-negative; other cancers use their own rules. Check which test result the study requires.

Line of therapy

A line of therapy is one course of treatment, which may combine several drugs. First-line is the first course given; second-line follows when that stops working or is not tolerated.

“Two prior lines” means two courses that count separately under the study’s rules — not simply two drugs. Ask the study team if you are unsure how yours are counted.

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.

Hemoglobin (Hb)

The protein in red blood cells that carries oxygen. A low level is anaemia, which can cause tiredness and breathlessness. Measured in g/dL or g/L (9 g/dL is 90 g/L).

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

RECIST

The standard rules for measuring tumours on CT or MRI scans, to tell whether a cancer is shrinking, stable or growing during treatment.

“Measurable disease per RECIST 1.1” usually means at least one tumour 10 mm or more at its longest on a CT scan, or a lymph node 15 mm or more across its short axis.

Brain metastases

Cancer deposits in the brain from a cancer that started elsewhere in the body (CNS metastases include the spinal cord).

Studies differ: some leave out any brain metastases, some accept ones treated and stable for some weeks. Check what this study allows.

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.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

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.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
42 participants (estimated)

Study arms

  • Experimental
    High-fiber diet

    Patients in this arm will receive a high-fiber diet over the period of 6 weeks.

    Dietary Supplement: High-fiber diet

  • No intervention
    No high-fiber diet

    Patients in this arm will not receive an intervention and serve as control.

Interventions

  • Dietary supplementHigh-fiber diet

    Patients in the intervention arm will receive a high-fiber diet through daily consumption of a defined amount of plant-based fibers from a commercial product.

06

What researchers measure

Primary outcomes

  1. ctDNA clearance

    Fraction of patients achieving complete ctDNA clearance at 6 weeks

    Time frame: 6 weeks

Secondary outcomes

  1. ctDNA dynamics

    ctDNA dynamics over 6 weeks

    Time frame: 3 and 6 weeks

  2. Radiological treatment response

    Objective radiological response (RECIST 1.1)

    Time frame: 6 weeks and 6 months

  3. Disease control rate

    6-months disease control rate (non-progressive disease at 6 months)

    Time frame: 6 months

  4. Microbiota dynamics

    Gut microbiota dynamics by shotgun metagenomics

    Time frame: 6 weeks

  5. Systemic immune response

    Systemic immune response dynamics by high-dimensional flow cytometry

    Time frame: 6 months

07

Study locations

1 of 4 sites recruiting
08

References and documents

Related links

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Oct 2025 (actual). Primary completion is estimated for Dec 2027, 26 months after the start.

Of 343 non-industry interventional studies with no phase under Carcinoma, Non-Small-Cell Lung, half reached primary completion within 52 months of starting (the median), counting those still running; a quarter within 28 and three quarters within 98. This study's planned 26 months is below that.

Counting every sponsor, half of 359 studies reached it within 51 months; a quarter within 26 and three quarters within 97.

How these figures are worked out, and which studies are left out of them.

Registered
Mar 16, 2026
First posted
Mar 19, 2026
StartActual
Oct 7, 2025
Primary completionEst.
Dec 31, 2027
CompletionEst.
Dec 31, 2027
Last update
Mar 19, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Mar 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07483112
Lead sponsor
Cantonal Hospital of St. Gallen
Responsible party
Maximilian Boesch (Principal Investigator, Cantonal Hospital of St. Gallen) — Principal investigator
First posted
Mar 19, 2026
Start date
Oct 7, 2025
Primary completion
Dec 31, 2027 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
Mar 19, 2026

Study contacts

Maximilian Boesch, Ph.D.
Contact
maximilian.boesch@h-och.ch
0041714947143

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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