CMV exposure and phaechromocytoma or paraganglioma development

  • Research type

    Research Study

  • Full title

    Are phaeochromocytoma and paraganglioma development associated with previous CMV exposure?

  • IRAS ID

    264898

  • Contact name

    Scott Akker

  • Contact email

    s.a.akker@qmul.ac.uk

  • Sponsor organisation

    Barts Health NHS Trust

  • Duration of Study in the UK

    1 years, 0 months, 9 days

  • Research summary

    Phaeochromocytomas and paragangliomas are rare tumours that produce adrenaline and related hormones. It is now recognised that around 40-50% of patients with these tumours have an underlying gene mutation. The most important of these genes is the B subunit of the SDH enzyme (SDHB) as this accounts for 25% of familial cases and has the highest rate of the tumours becoming malignant at 30-40%. However, only 30-40% of people with the SHDB mutation develop an associated tumour in their lifetime.

    There are currently no identified factors that predict which people with the SDHB mutation will go onto develop a tumour, and no reliable biochemical markers that detect tumour formation. Therefore, all affected carriers have to undergo regular imaging screening to try and detect tumours early in their development so that they can be removed surgically before the tumour has a chance to become malignant and spread to the rest of the body. If metastatic spread occurs, treatment options remain very limited.

    CMV is a common virus, affecting more than 50% of the population, that is usually harmless and asymptomatic. A recent study has shown that a series of paraganglioma tumours all had signs of the CMV virus. This raises the possibility that previous CMV exposure may predispose to tumour development.

    We would like to investigate this by doing a pilot study testing patients who are carriers of SDHB mutations – both with and without tumours – for CMV infection. We would also like to test patients with known tumours, but not necessarily with the mutation, for previous CMV infection. This will be done by collecting an additional blood sample along with the patients’ routine blood tests, or earlier if they wish. We will then compare the groups to see if there is a link between CMV virus infection and tumour formation.

  • REC name

    London - West London & GTAC Research Ethics Committee

  • REC reference

    19/LO/1158

  • Date of REC Opinion

    15 Jul 2019

  • REC opinion

    Favourable Opinion