Investigation of the Value of ctDNA in Diagnosis, Treatment, and Surveillance of Surgically Resectable Colorectal Cancer

NCT ID: NCT03038217

Last Updated: 2017-02-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-02-28

Study Completion Date

2021-12-31

Brief Summary

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In this study, we aim to investigate the value of circulating tumor DNA (ctDNA) analysis in the diagnosis, treatment, and surveillance of patients with surgically resectable colorectal cancer, by performing serial analysis of ctDNA, next-generation sequencing of surgical specimens, and observation of patients undergoing radical resection of the tumor with or without adjuvant chemo- and/or radiotherapy.

Detailed Description

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A prospective, observational study to determine the value of circulating tumor DNA (ctDNA) for predicting the therapeutic effects of the combined modality treatment for colorectal cancer and the patients' long-term prognosis.

Research objects: patients with surgically resectable colorectal cancer. After giving fully informed consent, the prospective participants will undergo the classical combined modality treatment according to NCCN guidelines. Serial analysis of ctDNA will be performed at specific time points including pre-treatment, (post-NCRT for NCRT patients), postoperative week 1, post-ACT, postoperative year 1, 2, and 3. The next-generation sequencing of surgical specimens will be performed as well. Participants will be observed and examined during the entire course of treatment and the follow-up period. The 3 year disease free survival (3y-DFS) will be the primary end-point.

Conditions

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Rectal Cancer, Adenocarcinoma Neoadjuvant Chemoradiation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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ACT group

Group of patients with pathologically confirmed Stage II-III colorectal cancer who receive postoperative treatment with chemotherapeutic agent (ACT) using Capecitabine +/- Oxaliplatin.

Group Type EXPERIMENTAL

Capecitabine +/- Oxaliplatin

Intervention Type DRUG

Patients in ACT group will undergo postoperative adjuvant chemotherapy with single agent Capecitabine regimen or combined Capecitabine +Oxaliplatin regimen.

Non-ACT group

Group of patients with pathologically confirmed stage II colorectal cancer who receive no adjuvant chemotherapy.

Group Type EXPERIMENTAL

No adjuvant chemotherapy

Intervention Type OTHER

Patients in Non-ACT group will not undergo postoperative adjuvant chemotherapy.

LR group

Group of patients with clinically staged T1-2N0 rectal cancer who undergo local resection (LR)

Group Type EXPERIMENTAL

local resection

Intervention Type PROCEDURE

Patients in the LR group will undergo local resection of the T1-2N0 rectal carcinoma

RR group

Group of patients with clinically staged T1-2N0 rectal cancer who undergo radical resection (RR)

Group Type EXPERIMENTAL

radical resection

Intervention Type PROCEDURE

Patients in the RR group will undergo radical resection of the T1-2N0 rectal carcinoma

Interventions

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Capecitabine +/- Oxaliplatin

Patients in ACT group will undergo postoperative adjuvant chemotherapy with single agent Capecitabine regimen or combined Capecitabine +Oxaliplatin regimen.

Intervention Type DRUG

local resection

Patients in the LR group will undergo local resection of the T1-2N0 rectal carcinoma

Intervention Type PROCEDURE

radical resection

Patients in the RR group will undergo radical resection of the T1-2N0 rectal carcinoma

Intervention Type PROCEDURE

No adjuvant chemotherapy

Patients in Non-ACT group will not undergo postoperative adjuvant chemotherapy.

Intervention Type OTHER

Other Intervention Names

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LR RR

Eligibility Criteria

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Inclusion Criteria

1. Patients aged 18 to 75 years old.
2. Patients with surgically resectable colorectal cancer, while without distal metastasis of the disease.
3. Patients with ASA physical status scroe of I to III.
4. Patients who can fully understand the content of the informed consent form and sign it upon their own opinions.
5. Patients who can coordinate with the researchers to undergo the long-term post-treatment rechecks and follow-ups.

Exclusion Criteria

1. Patient has any underlying or current medical condition, which, in the opinion of the Investigator, would interfere with the evaluation of the patient (e.g., end-stage liver disease, pulmonary hypertension, systemic lupus erythematosis etc.).
2. Patient is pregnant or lactating.
3. Patient has a history of malignancy within 5 years except curatively treated basal cell carcinoma, squamous cell carcinoma in a non-mucosal, ultraviolet exposed area, or cervical carcinoma.
4. Patient is participating in any other clinical trials within 30 days prior to screening.
5. Patient has severe mental illness.
6. Patient has any other conditions, which, in the opinion of the Investigator, would interfere with the evaluation of the subject.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Geneplus-Beijing Co. Ltd.

INDUSTRY

Sponsor Role collaborator

Peking Union Medical College Hospital

OTHER

Sponsor Role lead

Responsible Party

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Guole Lin

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Central Contacts

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Jiaolin Zhou, MD

Role: CONTACT

8613910136704

References

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Reinert T, Scholer LV, Thomsen R, Tobiasen H, Vang S, Nordentoft I, Lamy P, Kannerup AS, Mortensen FV, Stribolt K, Hamilton-Dutoit S, Nielsen HJ, Laurberg S, Pallisgaard N, Pedersen JS, Orntoft TF, Andersen CL. Analysis of circulating tumour DNA to monitor disease burden following colorectal cancer surgery. Gut. 2016 Apr;65(4):625-34. doi: 10.1136/gutjnl-2014-308859. Epub 2015 Feb 4.

Reference Type BACKGROUND
PMID: 25654990 (View on PubMed)

Stroun M, Anker P, Maurice P, Lyautey J, Lederrey C, Beljanski M. Neoplastic characteristics of the DNA found in the plasma of cancer patients. Oncology. 1989;46(5):318-22. doi: 10.1159/000226740.

Reference Type BACKGROUND
PMID: 2779946 (View on PubMed)

Tie J, Wang Y, Tomasetti C, Li L, Springer S, Kinde I, Silliman N, Tacey M, Wong HL, Christie M, Kosmider S, Skinner I, Wong R, Steel M, Tran B, Desai J, Jones I, Haydon A, Hayes T, Price TJ, Strausberg RL, Diaz LA Jr, Papadopoulos N, Kinzler KW, Vogelstein B, Gibbs P. Circulating tumor DNA analysis detects minimal residual disease and predicts recurrence in patients with stage II colon cancer. Sci Transl Med. 2016 Jul 6;8(346):346ra92. doi: 10.1126/scitranslmed.aaf6219.

Reference Type BACKGROUND
PMID: 27384348 (View on PubMed)

Zhou J, Chang L, Guan Y, Yang L, Xia X, Cui L, Yi X, Lin G. Application of Circulating Tumor DNA as a Non-Invasive Tool for Monitoring the Progression of Colorectal Cancer. PLoS One. 2016 Jul 26;11(7):e0159708. doi: 10.1371/journal.pone.0159708. eCollection 2016.

Reference Type BACKGROUND
PMID: 27459628 (View on PubMed)

Other Identifiers

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PekingUMCH-Colorectal Surgery

Identifier Type: -

Identifier Source: org_study_id

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