Exploratory Study of Clonal Evolution in Cancer for Patients Undergoing Transoral Robotic Surgery for Radiation Exposed Residual/reCurrent Tumours of the Upper Aerodigestive Tract

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

RECRUITING

Total Enrollment

20 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-11-18

Study Completion Date

2026-10-07

Brief Summary

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Radical radiotherapy for head and neck squamous cell cancer (HNSCC) can be administered to primary disease with curative intent. Residual disease, recurrence or further tumours may subsequently occur in this irradiated field. It is unknown whether these cancers reflect primary resistance or represent the evolution of resistance on treatment.

Understanding this could allow stratification of patients to more effective primary treatments, such as transoral robotic surgery, or help tailor systemic therapies for these cancers in previously irradiated fields.

RECUT+ is an exploratory molecular analysis study to assess the selective impact of radiation therapy on HNSCC.

Participants will be recruited from the Royal Marsden Hospital (RMH), Chelsea, a tertiary referral H\&N cancer unit in London, UK, specialising in transoral robotic surgery.

Retrospective participants will be identified from previous Head and neck MDT lists at RMH.

Prospective participants will be screened for by the RECUT+ team during the weekly H\&N MDT meetings at the Royal Marsden Hospital (RMH).

Blood/saliva samples will be collected pre operatively (prospective participants) and post operatively (retrospective and prospective participants) for germline and circulating tumour DNA analysis.

Biopsy samples from the original cancer and resected specimens from the post radiotherapy residual/recurrent/new primary disease will undergo molecular analysis to assess for any selective impact of radiotherapy on these further tumours.

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Detailed Description

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Conditions

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Head and Neck Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

OTHER

Study Groups

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Retrospective Cohort

Patients who have previously had radiotherapy and then have had their local residual/recurrent disease managed with salvage TORS at the Royal Marsden Hospital will be eligible for inclusion. They will be informed of the RECUT+ study by a member of their usual care team at RMH during their routine outpatient appointments for follow up of their H\&N cancer.

Potential participants will be asked to consent to provide blood/saliva sample for germline DNA and for permission for their original tumour biopsy sample and their residual/recurrent resection to undergo DNA analysis. Where patients have returned to their referring institution and are no longer under active regular follow up at RMH, a research pack will be sent to the patient via post and email. This pack will contain the Cover Letter, the Participant Information Sheet and the Informed Consent Form. It will also contain a saliva collection tube, buccal swab, blood tubes and instructions for how to provide blood/saliva samples.

DNA Analysis

Intervention Type OTHER

Molecular analysis includes DNA analysis on the blood/saliva and on the cancer specimens from the biopsies \& subsequent resections

Prospective Cohort

Patients who have previously had radiotherapy and then are due to have their local residual/recurrent disease managed with salvage transoral robotic surgery at the Royal Marsden Hospital (RMH) will be approached prior to their salvage surgery at a routine outpatient appointment. They will be asked to consent to provide blood/saliva sample for germline DNA pre and post operatively. They will also be asked for permission for their original tumour biopsy sample and their residual/recurrent resection to undergo DNA analysis

DNA Analysis

Intervention Type OTHER

Molecular analysis includes DNA analysis on the blood/saliva and on the cancer specimens from the biopsies \& subsequent resections

Interventions

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DNA Analysis

Molecular analysis includes DNA analysis on the blood/saliva and on the cancer specimens from the biopsies \& subsequent resections

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Aged over 18
* Previous H\&N cancer treated with radiotherapy.
* Undergoing TORS as part of their management for residual, recurrent or new primary H\&N cancer.

Exclusion Criteria

* Where TORS is used in a diagnostic setting only
* Nasopharyngeal and thyroid head and neck cancers
* Where no tissue specimens are available from the recurrent/residual/secondary tumour for the retrospective cohort

Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No