Trial Outcomes & Findings for Multi-Target Colorectal Cancer Screening Test for the Detection of Colorectal Advanced Adenomatous Polyps and Cancer (NCT NCT01397747)

NCT ID: NCT01397747

Last Updated: 2015-12-03

Results Overview

An optical colonoscopic procedure is the reference method. Lesions will be confirmed as malignant by histopathologic examination. The DNA test includes quantitative molecular assays for KRAS mutations, aberrant NDRG4 and BMP3 methylation, and Beta-actin, plus a hemoglobin immunoassay. Results were generated with the use of a logistic-regression algorithm, with values of 183 or more considered to be positive. FIT values of more than 100 ng of hemoglobin per milliliter of buffer were considered to be positive. Tests were processed independently of colonoscopic findings. The test functions as a screening tool by generating a score, based on the detection of hemoglobin and multiple DNA methylation and mutational markers, together with an assessment of the total amount of human DNA in each sample. Sensitivity= 100\*(multitarget DNA or FIT positive test/positive colonoscopy); Specificity= 100\*(multitarget DNA or FIT negative test/negative colonoscopy).

Recruitment status

COMPLETED

Target enrollment

12776 participants

Primary outcome timeframe

90 Days

Results posted on

2015-12-03

Participant Flow

12,776 participants provided written informed consent. 1,760 could not be evaluated (464- withdrew consent, 1,168- did not undergo colonoscopy, 128- did not submit stool sample).

Participant milestones

Participant milestones
Measure
Average Risk Patients
Subjects will be men and women, 50-84 years of age, inclusive, who are at average risk of developing colorectal cancer. We compared a noninvasive, multitarget stool DNA test with fecal immunochemical test (FIT) in persons at average risk for colorectal cancer. Results were compared to colonoscopy and histopathology was performed on any biopsy or excised lesions.
Overall Study
STARTED
11016
Overall Study
COMPLETED
9989
Overall Study
NOT COMPLETED
1027

Reasons for withdrawal

Reasons for withdrawal
Measure
Average Risk Patients
Subjects will be men and women, 50-84 years of age, inclusive, who are at average risk of developing colorectal cancer. We compared a noninvasive, multitarget stool DNA test with fecal immunochemical test (FIT) in persons at average risk for colorectal cancer. Results were compared to colonoscopy and histopathology was performed on any biopsy or excised lesions.
Overall Study
Multitarget DNA test excluded
689
Overall Study
Colonoscopy excluded
304
Overall Study
FIT excluded
34

Baseline Characteristics

Multi-Target Colorectal Cancer Screening Test for the Detection of Colorectal Advanced Adenomatous Polyps and Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Average Risk Patients
n=10023 Participants
Subjects will be men and women, 50-84 years of age, inclusive, who are at average risk of developing colorectal cancer. We compared a noninvasive, multitarget stool DNA test with fecal immunochemical test (FIT) in persons at average risk for colorectal cancer. Results were compared to colonoscopy and histopathology was performed on any biopsy or excised lesions.
Age, Continuous
64.2 years
STANDARD_DEVIATION 8.42 • n=5 Participants
Sex: Female, Male
Female
5378 Participants
n=5 Participants
Sex: Female, Male
Male
4645 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
991 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
9028 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
4 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
36 Participants
n=5 Participants
Race (NIH/OMB)
Asian
259 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
23 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
1071 Participants
n=5 Participants
Race (NIH/OMB)
White
8422 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
206 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
6 Participants
n=5 Participants
BMI
28.83 kg/m^2
STANDARD_DEVIATION 5.836 • n=5 Participants
Smoking History
Never Smoked
5531 participants
n=5 Participants
Smoking History
Former Smoker
3589 participants
n=5 Participants
Smoking History
Current Smoker
903 participants
n=5 Participants

PRIMARY outcome

Timeframe: 90 Days

An optical colonoscopic procedure is the reference method. Lesions will be confirmed as malignant by histopathologic examination. The DNA test includes quantitative molecular assays for KRAS mutations, aberrant NDRG4 and BMP3 methylation, and Beta-actin, plus a hemoglobin immunoassay. Results were generated with the use of a logistic-regression algorithm, with values of 183 or more considered to be positive. FIT values of more than 100 ng of hemoglobin per milliliter of buffer were considered to be positive. Tests were processed independently of colonoscopic findings. The test functions as a screening tool by generating a score, based on the detection of hemoglobin and multiple DNA methylation and mutational markers, together with an assessment of the total amount of human DNA in each sample. Sensitivity= 100\*(multitarget DNA or FIT positive test/positive colonoscopy); Specificity= 100\*(multitarget DNA or FIT negative test/negative colonoscopy).

Outcome measures

Outcome measures
Measure
Multitarget DNA Test Results
n=9989 Participants
Subjects will be men and women, 50-84 years of age, inclusive, who are at average risk of developing colorectal cancer. We compared a noninvasive, multitarget stool DNA test in persons at average risk for colorectal cancer. Results were compared to colonoscopy and histopathology was performed on any biopsy or excised lesions.
FIT Test Results
n=9989 Participants
Subjects will be men and women, 50-84 years of age, inclusive, who are at average risk of developing colorectal cancer. We compared a fecal immunochemical test (FIT) in persons at average risk for colorectal cancer. Results were compared to colonoscopy and histopathology was performed on any biopsy or excised lesions.
Sensitivity and Specificity of the Exact CRC Screening Test With Comparison to Colonoscopy, Both With Respect to Cancer.
Sensitivity for any Colorectal Cancer
92.3 percent
Interval 83.0 to 97.5
73.8 percent
Interval 61.5 to 84.0
Sensitivity and Specificity of the Exact CRC Screening Test With Comparison to Colonoscopy, Both With Respect to Cancer.
Sensitivity Stage I to III
93.3 percent
Interval 83.8 to 98.2
73.3 percent
Interval 60.3 to 83.9
Sensitivity and Specificity of the Exact CRC Screening Test With Comparison to Colonoscopy, Both With Respect to Cancer.
Sensitivity CRC and HGD
83.7 percent
Interval 75.1 to 90.2
63.5 percent
Interval 53.5 to 72.7
Sensitivity and Specificity of the Exact CRC Screening Test With Comparison to Colonoscopy, Both With Respect to Cancer.
Sensitivity Advanced precancerous lesions
42.2 percent
Interval 38.9 to 46.0
23.8 percent
Interval 20.8 to 27.0
Sensitivity and Specificity of the Exact CRC Screening Test With Comparison to Colonoscopy, Both With Respect to Cancer.
Sensitivity nonadvanced adenoma
17.2 percent
Interval 15.9 to 18.6
7.6 percent
Interval 6.7 to 8.6
Sensitivity and Specificity of the Exact CRC Screening Test With Comparison to Colonoscopy, Both With Respect to Cancer.
Specificity nonsignificant findings
86.6 percent
Interval 85.9 to 87.2
94.9 percent
Interval 94.4 to 95.3
Sensitivity and Specificity of the Exact CRC Screening Test With Comparison to Colonoscopy, Both With Respect to Cancer.
Specificity negative results colonoscopy
89.8 percent
Interval 88.9 to 90.7
96.4 percent
Interval 95.8 to 96.9

Adverse Events

Average Risk Patients

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Director of Clinical Operations

Exact Sciences

Phone: 608-284-5700

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place