ClinicalTrials.gg
RecruitingNCT07676461ATLASUpdated Jul 7, 2026

Oral, Fecal and Intratumoral Microbiome Atlas in Colombian Patients With Advanced Solid Tumors Receiving First-Line Immunotherapy

An observational study in Gastric Cancer, Colorectal Cancer and Breast Cancer, sponsored by Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo. Recruiting at 1 site in Colombia. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-07.

Sponsored by Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo · Observational

From the registry’s dates

  • Started Jun 2026; still recruiting 5 months later.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
150
Ages
18 Years and older
Sex
All
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Study summary

This is a prospective observational cohort study conducted at Fundación CTIC in Bogotá, Colombia. It characterizes the oral, fecal and intratumoral microbiome of Colombian adults with advanced solid tumors (gastric, colorectal, breast, cervical and head-and-neck cancer) who receive first-line immunotherapy as standard of care, and compares them with healthy volunteers. Using multi-omics (HiFi metagenomics, 16S, tumor RNA-Seq and untargeted metabolomics), the study aims to identify microbial signatures associated with treatment response and survival, building the initial Colombian cohort of a Cancer Microbiome Atlas with Latin American projection.

Read the detailed description

Single-center, prospective, observational cohort study. 120 patients with advanced (stage III unresectable or IV) solid tumors candidates for first-line immunotherapy and 30 healthy controls are enrolled (total N=150). Patients provide saliva, stool and tongue-scraping samples plus archival FFPE tumor tissue at baseline (V0) and at 6 (V1) and 12 (V2) months; controls provide saliva and stool at V0 only. Microbiomes are profiled by PacBio HiFi shotgun metagenomics and full-length 16S; tumor transcriptome by RNA-Seq; and saliva/stool metabolome by GC-MS in a subcohort (n=60). Tumor response is assessed by RECIST 1.1. Microbial, transcriptomic and metabolomic features are integrated with clinical outcomes (objective response, PFS, OS) using multivariable and machine-learning models.

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Conditions studied

  • Gastric Cancer
  • Colorectal Cancer
  • Breast Cancer
  • Cervical Cancer
  • Head and Neck Cancer (H&N)

Keywords

  • Microbiome
  • Cancer
  • Immunotherapy
  • Tumor microenvironment
  • Biomarkers
  • Metagenomics
  • Transcriptomics
  • Metabolomics
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In context

Stomach Neoplasms

3,399 studies on the registry are indexed under Stomach Neoplasms; 992 are open to participants now.

This study's planned enrollment of 150 is below the median of 278 across 790 observational studies indexed under Stomach Neoplasms.

Browse Stomach Neoplasms studies →

Lead sponsor

Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo is the lead sponsor of 5 studies on the registry; 5 are open to participants now.

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

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Colombian adults with advanced solid tumors (gastric, colorectal, breast, cervical, head-and-neck) candidates for first-line immunotherapy, plus healthy adult volunteers. Single center: Fundación CTIC, Bogotá.

Eligibility criteria

Inclusion Criteria:

  • Age 18 years or older.
  • confirmed advanced (stage III unresectable or IV) gastric, colorectal, breast, cervical or head-and-neck cancer.
  • Candidate for immunotherapy per current clinical guidelines.
  • Available FFPE tumor block in institutional or reference pathology archive.
  • Able to provide saliva and stool samples at V0 and follow-up.
  • performance status within protocol limits; over 3 months.
  • Cognitive capacity to give ; signed EVA-BIOBANCO and Atlas consents.

Inclusion Criteria (healthy controls)

  • No prior cancer diagnosis.
  • No active disease; no inflammatory bowel disease.
  • No antibiotics, invasive dental treatment, or in the prior 3 months; no severe active periodontal disease.

Exclusion Criteria:

  • Systemic antibiotics within 3 months (except short course under 5 days for uncomplicated infection).
  • Probiotics or prebiotics within 30 days.
  • Chronic proton-pump inhibitors for more than 3 continuous months.
  • Inflammatory bowel disease (Crohn, ulcerative colitis) or extensive bowel resection.
  • Pregnancy or lactation.
  • under 18.5 or over 40 kg/m².
  • Uncontrolled diabetes ( at or above 9% in prior 3 months).
  • Invasive dental treatment within 3 months.
  • Patients: simultaneous randomized trial of a non-INVIMA-approved experimental immunotherapy; or no evaluable FFPE block meeting quality thresholds.
  • Inability to ensure 12-month clinical follow-up.
Terms in these criteria, in plain language(10)

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.

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.

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.

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.

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.

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.

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.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

HbA1c

A blood test of average blood sugar over the past two to three months, given as a percentage or in mmol/mol. 6.5% (48 mmol/mol) or more is the usual threshold for diabetes, normally confirmed by a second test.

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Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
150 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • Patients with advanced solid tumors

    120 Colombian adults with advanced (stage III unresectable or IV) gastric, colorectal, breast, cervical or head-and-neck cancer, candidates for first-line immunotherapy (standard of care). Saliva, stool and tongue scraping collected at V0, V1 (6 mo) and V2 (12 mo); archival FFPE tumor block retrieved at V0.

    Drug: First-line immunotherapy (immune checkpoint inhibitors), INVIMA-approved, standard of care

  • Healthy controls

    30 healthy adult volunteers without prior cancer, active autoimmune disease or inflammatory bowel disease, and without antibiotics or invasive dental treatment in the prior 3 months. Saliva and stool collected at V0 only; no longitudinal follow-up.

Interventions

  • DrugFirst-line immunotherapy (immune checkpoint inhibitors), INVIMA-approved, standard of care

    Exposure observed: first-line immunotherapy with immune checkpoint inhibitors administered as standard of care (INVIMA-approved); no experimental intervention is assigned by the study. Healthy controls receive no immunotherapy.

06

What researchers measure

Primary outcomes

  1. Oral, fecal and intratumoral microbiome signatures associated with objective tumor response (RECIST 1.1) to first-line immunotherapy

    Characterization of oral, fecal and intratumoral microbiomes and identification of taxa and diversity metrics differentiating responders (CR+PR) from non-responders (SD+PD) by RECIST 1.1.

    Time frame: Baseline (V0) and through 12 months

  2. Differences in microbiome composition and diversity between cancer patients and healthy controls

    Comparison of alpha and beta diversity and differential taxonomic and functional abundance between cancer patients and healthy controls.

    Time frame: Baseline (V0)

Secondary outcomes

  1. Microbial, transcriptomic and metabolomic biomarkers associated with progression-free survival (PFS)

    Up to 36 months

    Time frame: Association of microbial diversity, key taxa, MAGs and functional pathways with progression-free survival, estimated by Kaplan-Meier and adjusted Cox models.

  2. Microbial biomarkers associated with overall survival (OS)

    Association of microbiome features with overall survival, estimated by Kaplan-Meier and adjusted Cox models.

    Time frame: Up to 36 months

Other outcomes

  1. Tumor transcriptomic profile and gene-expression pathways modulated by the intratumoral microbiome

    RNA-Seq characterization of tumor gene-expression and identification of pathways correlated with intratumoral microbiome composition.

    Time frame: Baseline (V0)

  2. Untargeted salivary and fecal metabolomic profile (subcohort, n=60)

    GC-MS untargeted metabolomics of saliva and stool in a stratified subcohort (50 patients, 10 controls) to identify metabolites associated with microbiome composition and immunotherapy response.

    Time frame: Baseline through 12 months

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Study locations

1 of 1 sites recruiting
  • Fundación CTIC - Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo
    Bogotá, Bogota D.C. 110131, Colombia
    Recruiting
    • Liliana Gutiérrez, RN, MSc · Contactlgutierrez@fctic.org · +573003768158
    • Andrés F Cardona, MD, MSc, PhD, MBA · Principal investigator
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References and documents

Publications

  • Mancini N, Peri F, Rescigno M, Zanoni I. Microbiome studies in the medical sciences and the need for closer multidisciplinary interplay. Sci Signal. 2020 Feb 4;13(617):eaba9911. doi: 10.1126/scisignal.aba9911. PubMed 32019901 ↗
  • Zhernakova A, Kurilshikov A, Bonder MJ, Tigchelaar EF, Schirmer M, Vatanen T, Mujagic Z, Vila AV, Falony G, Vieira-Silva S, Wang J, Imhann F, Brandsma E, Jankipersadsing SA, Joossens M, Cenit MC, Deelen P, Swertz MA; LifeLines cohort study; Weersma RK, Feskens EJ, Netea MG, Gevers D, Jonkers D, Franke L, Aulchenko YS, Huttenhower C, Raes J, Hofker MH, Xavier RJ, Wijmenga C, Fu J. Population-based metagenomics analysis reveals markers for gut microbiome composition and diversity. Science. 2016 Apr 29;352(6285):565-9. doi: 10.1126/science.aad3369. Epub 2016 Apr 28. PubMed 27126040 ↗
  • Dohlman AB, Arguijo Mendoza D, Ding S, Gao M, Dressman H, Iliev ID, Lipkin SM, Shen X. The cancer microbiome atlas: a pan-cancer comparative analysis to distinguish tissue-resident microbiota from contaminants. Cell Host Microbe. 2021 Feb 10;29(2):281-298.e5. doi: 10.1016/j.chom.2020.12.001. Epub 2021 Jan 6. PubMed 33382980 ↗
  • Parida S, Sharma D. The Microbiome and Cancer: Creating Friendly Neighborhoods and Removing the Foes Within. Cancer Res. 2021 Feb 15;81(4):790-800. doi: 10.1158/0008-5472.CAN-20-2629. Epub 2020 Nov 4. PubMed 33148661 ↗
  • Park EM, Chelvanambi M, Bhutiani N, Kroemer G, Zitvogel L, Wargo JA. Targeting the gut and tumor microbiota in cancer. Nat Med. 2022 Apr;28(4):690-703. doi: 10.1038/s41591-022-01779-2. Epub 2022 Apr 19. PubMed 35440726 ↗
  • Cullin N, Azevedo Antunes C, Straussman R, Stein-Thoeringer CK, Elinav E. Microbiome and cancer. Cancer Cell. 2021 Oct 11;39(10):1317-1341. doi: 10.1016/j.ccell.2021.08.006. Epub 2021 Sep 9. PubMed 34506740 ↗
  • El Tekle G, Garrett WS. Bacteria in cancer initiation, promotion and progression. Nat Rev Cancer. 2023 Sep;23(9):600-618. doi: 10.1038/s41568-023-00594-2. Epub 2023 Jul 3. PubMed 37400581 ↗
  • Parizadeh M, Arrieta MC. The global human gut microbiome: genes, lifestyles, and diet. Trends Mol Med. 2023 Oct;29(10):789-801. doi: 10.1016/j.molmed.2023.07.002. Epub 2023 Jul 27. PubMed 37516570 ↗
  • Govender P, Ghai M. Population-specific differences in the human microbiome: Factors defining the diversity. Gene. 2025 Jan 15;933:148923. doi: 10.1016/j.gene.2024.148923. Epub 2024 Sep 6. PubMed 39244168 ↗
  • Trakman GL, Fehily S, Basnayake C, Hamilton AL, Russell E, Wilson-O'Brien A, Kamm MA. Diet and gut microbiome in gastrointestinal disease. J Gastroenterol Hepatol. 2022 Feb;37(2):237-245. doi: 10.1111/jgh.15728. Epub 2021 Nov 16. PubMed 34716949 ↗

Individual participant data

Plan to share: Yes — De-identified genomic sequences (oral, fecal and intratumoral microbiome) will be deposited in public repositories (NCBI SRA / EBI ENA) with minimal metadata (tumor type, age by decade, sex). Analysis pipelines and code will be versioned and shared via GitHub and Zenodo. Raw data and code will be made public at study close.

Supporting information: Study protocol, Statistical analysis plan, Analytic code

Time frame: Available at study close (estimated 2029); retained at least 15 years per ICH-GCP archiving policy.

Access criteria: Open access via public repositories (SRA, ENA, Zenodo) for de-identified sequence data and analysis code.

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 7, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07676461
Lead sponsor
Centro de Tratamiento e Investigación sobre Cáncer, Luis Carlos Sarmiento Angulo
Collaborators
American Society of Clinical Oncology
Responsible party
Sponsor
First posted
Jun 30, 2026
Start date
Jun 11, 2026
Primary completion
Feb 28, 2029 (estimated)
Completion
Aug 30, 2029 (estimated)
Last update
Jul 7, 2026

Study contacts

Andrés F Cardona, MD, MSc, PhD, MBA
Contact
acardona@fctic.org
+573016348173
Liliana Gutiérrez, RN, MSc
Contact
lgutierrez@fctic.org
+573003768158
Andrés F Cardona, MD, MSc, PhD, MBA
principal investigator · Fundación CTIC - Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo

Oversight

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

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