ctDNA-guided Surveillance for Stage III CRC, a Randomized Intervention Trial

NCT ID: NCT04084249

Last Updated: 2024-07-09

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

359 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-01

Study Completion Date

2028-06-30

Brief Summary

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IMPROVE-IT2 is a randomized multicenter trial comparing the outcomes of ctDNA guided post-operative surveillance and standard-of-care CT-scan surveillance. The hypothesis of this study is that ctDNA guided post-operative surveillance combining ctDNA and radiological assessments could result in earlier detection of recurrent disease and identify more patients eligible for curative treatment.

Detailed Description

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Conditions

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Colorectal Cancer Colo-rectal Cancer ctDNA Gastro-Intestinal Disorder Colorectal Neoplasms Gastrointestinal Cancer Gastrointestinal Neoplasms Digestive System Disease Digestive System Neoplasm Colonic Diseases Colonic Neoplasms Colonic Cancer Rectal Diseases Rectal Neoplasms Rectal Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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ctDNA guided surveillance

ctDNA analysis will be performed every 4 months postoperatively (4, 8, 12, 16, 20 and 24). At time of first positive ctDNA, patients undergo a whole-body FDG-PET/CT-scan for radiological assessment and a colonoscopy. If the initial assessment is without evidence of recurrence, patients will be offered high-intensive radiological surveillance with FDG-PET/CT-scans every 3 months, until recurrence detection or 21 months has passed. At baseline and months 12, 18, 24 and 36 patients complete the QoL questionnaires including EORTC QLQ-C30, fear of cancer recurrence inventory (FCRI), and impact of events scale for cancer (IES-C). At every FDG-PET/CT-scans the patients also complete the questionnaire.

Group Type EXPERIMENTAL

ctDNA-analysis

Intervention Type DIAGNOSTIC_TEST

Minimally-invasive blood-based analysis of circulating tumor DNA (ctDNA).

Intensified Follow-up Schedule

Intervention Type OTHER

PET/CT-scans every 3. month

Standard Danish follow-up program

Patients will undergo surveillance according to current Danish Guidelines with CT-scans at months 12 and 36 postoperative and colonoscopy every 5 year until age 75. Longitudinal blood samples will be collected at same time-points as in the experimental group but not analyzed until end of trial. At baseline and months 12, 18, 24 and 36 patients complete the QoL questionnaires including EORTC QLQ-C30, fear of cancer recurrence inventory (FCRI), and impact of events scale for cancer (IES-C).

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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ctDNA-analysis

Minimally-invasive blood-based analysis of circulating tumor DNA (ctDNA).

Intervention Type DIAGNOSTIC_TEST

Intensified Follow-up Schedule

PET/CT-scans every 3. month

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Colon or rectal cancer, tumor stage III (pT1-4N1-2,cM0) or stage II high-risk (pT4N0,cM0 and pT3N0, cM0 with risk factors)
* Have received curative intend resection and be candidates for adjuvant chemotherapy

Exclusion Criteria

* Not treated with adjuvant chemotherapy
* Synchronous colorectal and non-colorectal cancer diagnosed per-operative (except skin cancer other than melanoma)
* Other cancers (excluding colorectal cancer or skin cancer other than melanoma) within 3 years from screening
* Patients who are unlikely to comply with the protocol (e.g. uncooperative attitude), inability to return for subsequent visits) and/or otherwise considered by the Investigator to be unlikely to complete the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Aarhus

OTHER

Sponsor Role collaborator

Claus Lindbjerg Andersen

OTHER

Sponsor Role lead

Responsible Party

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Claus Lindbjerg Andersen

Professor

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Claus L Andersen, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Molecular Medicin, Aarhus University Hospital

Locations

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Herlev Hospital

Herlev, Capital Region of Denmark, Denmark

Site Status

Gødstrup Hospital

Herning, Central Jutland, Denmark

Site Status

Regional Hospital Horsens

Horsens, Central Jutland, Denmark

Site Status

Regional Hospital Randers

Randers, Central Jutland, Denmark

Site Status

Aalborg University Hospital

Aalborg, North Denmark, Denmark

Site Status

Odense University Hospital

Odense, The Region of Southern Denmark, Denmark

Site Status

Aarhus University Hospital

Aarhus, , Denmark

Site Status

Bispebjerg Hospital

Copenhagen, , Denmark

Site Status

Zealand University Hospital

Køge, , Denmark

Site Status

Regional Hospital Viborg

Viborg, , Denmark

Site Status

Countries

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Denmark

References

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Nors J, Henriksen TV, Gotschalck KA, Juul T, Sogaard J, Iversen LH, Andersen CL. IMPROVE-IT2: implementing noninvasive circulating tumor DNA analysis to optimize the operative and postoperative treatment for patients with colorectal cancer - intervention trial 2. Study protocol. Acta Oncol. 2020 Mar;59(3):336-341. doi: 10.1080/0284186X.2019.1711170. Epub 2020 Jan 10. No abstract available.

Reference Type BACKGROUND
PMID: 31920137 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

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Other Identifiers

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IMPROVE-IT2

Identifier Type: -

Identifier Source: org_study_id

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