Clinical Value of MRD Monitoring for Adjuvant Therapy in Postoperative NSCLC

NCT ID: NCT05167604

Last Updated: 2021-12-22

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

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-09-30

Study Completion Date

2024-12-31

Brief Summary

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This clinical trial aims to explore the minimal residual disease (MRD) status of early NSCLC after curative surgery and the clinical outcomes of adjuvant chemotherapy. Next-generation sequencing technique will be used to examine the circulating tumor DNA (ctDNA) from MRD of 150 postoperative patients with stage IB-IIA NSCLC who received adjuvant chemotherapy.

Detailed Description

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Minimal residual disease (MRD) refers to the small number of malignant cells that remain after curative treatments (curative intent surgical resection, radiotherapy, and/or chemotherapy). MRD is common in patients with blood cancer, and is known to be associated with recurrence and poor prognosis. Recent studies also reported that MRD-negative in postoperative solid tumors such as colorectal/colon cancer and breast cancer is associated with better survival outcomes. However, the clinical values of MRD monitoring for adjuvant therapy in postoperative NSCLC remain inadequate.

Circulating tumor DNA (ctDNA), a type of cell-free DNA, refers to the DNA fragments that are derived from tumor cells and circulate in the blood. Recently, next-generation sequencing (NGS) was successfully applied to monitor NPM1, RUNX1 and FLT3 mutations in multiple myeloma. Thus, NGS technique is a promising tool for sensitive MRD monitoring, which provides the ctDNA profiling from MRD, and then provides future decision-making treatment for postoperative NSCLC patients. Thus, this clinical study aims to monitor the ctDNA status of MRD, and to explore the clinical value of MRD monitoring in decision-making adjuvant therapy for patients with stage IB-IIA NSCLC after curative surgery.

A total of 150 patients with primary curable stage IB-IIA NSCLC will be recruited in this clinical trial. The following samples will be collected from each patient including 1) preoperative blood samples; 2) surgical tissue samples; 3) blood samples 3-7 days after surgery; 4) blood samples every 3-6 month during adjuvant chemotherapy; and 5) white blood control samples. In addition, demographic and tumor characteristics of the patients will be collected for subsequent analysis, including age, sex, tumor stage, pathological stage, disease couse time, PS score, etc. NGS will be used to analyze the whole exons of potential driver genes to obtain the MRD status. Statistical analyses will be performed to analyze the survival outcomes of MRD-positive and MRD-negative group and to explore the clinical value of MRD monitoring for adjuvant therapy in postoperative NSCLC.

Conditions

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Carcinoma, Non-Small-Cell Lung Next-Generation Sequencing Chemotherapy, Adjuvant Neoplasm, Residual Circulating Tumor DNA

Keywords

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non-small cell lung cancer next-generation sequencing adjuvant chemotherapy minimal residual disease circulating tumor DNA

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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MRD-positive Cohort

ctDNA positivity in pretreatment and posttreatment plasma samples was defined by accessing the presence of one or more mutations identified in match tumor samples. A mutation was considered present when at least one consensus read contained the mutation and passed the local polishing pipeline. The MRD positive cohort was randomly divided into two groups, one group for interventional treatment and the other group for observation.

Adjuvants, Pharmaceutic

Intervention Type DRUG

Patients with stage IB-IIA NSCLC after curative surgery were treated with adjuvant chemotherapy. The blood samples of the patients before and after adjuvant chemotherapy will be collected to examine the MRD status

MRD-negative Cohort

ctDNA negative in pretreatment and posttreatment plasma samples was defined by accessing the presence of no mutation identified in match tumor samples. According to the clinical prognostic characteristics of the MRD negative group, the clinician decides to observe or treat.

Adjuvants, Pharmaceutic

Intervention Type DRUG

Patients with stage IB-IIA NSCLC after curative surgery were treated with adjuvant chemotherapy. The blood samples of the patients before and after adjuvant chemotherapy will be collected to examine the MRD status

Interventions

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Adjuvants, Pharmaceutic

Patients with stage IB-IIA NSCLC after curative surgery were treated with adjuvant chemotherapy. The blood samples of the patients before and after adjuvant chemotherapy will be collected to examine the MRD status

Intervention Type DRUG

Other Intervention Names

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adjuvant chemotherapy

Eligibility Criteria

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Inclusion Criteria

* Patients aged between 18 and 70 years
* Histological diagnosis of primary NSCLC
* Patients received curative surgery for primary NSCLC
* Tumor stage IB-IIA after curative-intent surgical resection
* ECOG score: 0-1
* Participant is willing to use an acceptable form of contraception during the study.
* Participant is willing and able to give informed consent for participation in the study.

Exclusion Criteria

* The patient has received neoadjuvant therapy, including radiotherapy and chemotherapy, targeted therapy and immunotherapy
* Patients are unwilling or unable to receive the curative-intent resection
* Patients have or have had history of malignant tumor
* Patients who suffer from severe uncontrolled disease that require systemic treatment or considered unsuitable for participating this trial due to other reasons by the investigator
* Patients with severe gastrointestinal dysfunction, cardiac dysfunction, interstitial lung disease, etc.
* Laboratory test results showed inadequate bone marrow or organ function
* Blood transfusion during or within 2 weeks before the surgery
* History of alcohol abuse or drug overdose
* Pregnant or breastfeeding women
* Patients who are currently or have participated in any other anti-tumor clinical trials
* Inadequate baseline data, such as preoperative and postoperative blood samples (Lack of 2 consecutive blood test or a total of 3 blood samples), surgical tumor tissues, and ctDNA test.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tang-Du Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Tao Jiang

Role: PRINCIPAL_INVESTIGATOR

Department of Thoracic Surgery, Tangdu Hospital, the Fourth Military Medical University

Locations

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The Second Affiliated The Second Affiliated Hospital of Air Force Medical University (Tangdu Hospital)

Xi'an, Baqiao, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Yunfeng Ni

Role: CONTACT

Phone: +86 13772088014

Email: [email protected]

Facility Contacts

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Yunfeng Ni

Role: primary

References

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Chin RI, Chen K, Usmani A, Chua C, Harris PK, Binkley MS, Azad TD, Dudley JC, Chaudhuri AA. Detection of Solid Tumor Molecular Residual Disease (MRD) Using Circulating Tumor DNA (ctDNA). Mol Diagn Ther. 2019 Jun;23(3):311-331. doi: 10.1007/s40291-019-00390-5.

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Reference Type RESULT
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Reference Type RESULT
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Reference Type RESULT
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Other Identifiers

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777436

Identifier Type: -

Identifier Source: org_study_id