An Exosome-Based Liquid Biopsy for the Differential Diagnosis of Primary Liver Cancer

NCT ID: NCT06342414

Last Updated: 2025-04-02

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

400 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-03-15

Study Completion Date

2026-06-18

Brief Summary

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It is sometimes difficult to precisely understand whether a primary liver cancer is a hepatocellular carcinoma or a cholangiocarcinoma. The researchers will develop and validate a liquid biopsy, based on exosomal content analysis and powered by machine learning, to help clinicians differentiate these two cancers before surgery.

Detailed Description

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Primary liver cancers (PLCs) encompass a diverse group of malignancies originating from the liver, collectively ranking as the third leading cause of cancer-related mortality worldwide in 2020. Among PLCs, intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) represent the most predominant subtypes. Despite their collective grouping as PLCs, ICC and HCC patients exhibit distinct etiologies, pathologies, and clinical characteristics, necessitating different treatment approaches. Accurate differentiation between ICC and HCC is paramount to optimize patient outcomes and guide personalized treatment decisions. However, a definitive diagnosis is often obtained only after the pathological review of the resected neoplastic tissue, which requires invasive tumor sampling and poses risks of complications such as hemorrhage and tumor cell seeding. Consequently, there is a pressing clinical need to develop noninvasive diagnostic approaches to achieve an accurate differential diagnosis for patients with these distinct forms of PLCs.

This study involves the development and validation of a liquid biopsy, assessing circulating exosomal microRNAs (exo-miRNA) for indirect sampling of tumor tissue in the bloodstream. The researchers intend to harness machine learning and bioinformatics to create a cost-efficient, non-invasive, clinic-friendly assay with high sensitivity and specificity, aiding the differential diagnosis between ICC and HCC.

The researchers intend to do so in three phases:

1. To perform comprehensive small RNA-Seq from exo-miRNA from patients with ICC and HCC.
2. To develop and train a differential diagnosis panel based on advanced machine-learning models to obtain a final differential diagnosis biomarker.
3. To validate the findings in an independent cohort of ICC and HCC.

In summary, this proposal promises to improve patient care and help clinicians perform a more reliable differential diagnosis between ICC and HCC in patients with primary liver cancer.

Conditions

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Hepatocellular Carcinoma Intrahepatic Cholangiocarcinoma Cholangiocarcinoma Primary Liver Cancer Primary Liver Carcinoma Hepatic Cancer Hepatic Carcinoma

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

RETROSPECTIVE

Study Groups

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Hepatocellular Carcinoma (Training)

A cohort of patients with histologically confirmed hepatocellular carcinoma (HCC)

ELUCIDATE

Intervention Type DIAGNOSTIC_TEST

ELUCIDATE (Evaluation of Liver Cholangiocarcinoma Intrahepatic)

Intrahepatic Cholangiocarcinoma (Training)

A cohort of patients with histologically confirmed intrahepatic cholangiocarcinoma (ICC)

ELUCIDATE

Intervention Type DIAGNOSTIC_TEST

ELUCIDATE (Evaluation of Liver Cholangiocarcinoma Intrahepatic)

Hepatocellular Carcinoma (Validation)

A cohort of patients with histologically confirmed hepatocellular carcinoma (HCC)

ELUCIDATE

Intervention Type DIAGNOSTIC_TEST

ELUCIDATE (Evaluation of Liver Cholangiocarcinoma Intrahepatic)

Intrahepatic Cholangiocarcinoma (Validation)

A cohort of patients with histologically confirmed intrahepatic cholangiocarcinoma (ICC)

ELUCIDATE

Intervention Type DIAGNOSTIC_TEST

ELUCIDATE (Evaluation of Liver Cholangiocarcinoma Intrahepatic)

Interventions

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ELUCIDATE

ELUCIDATE (Evaluation of Liver Cholangiocarcinoma Intrahepatic)

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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ELUCIDATE (Evaluation of Liver Cholangiocarcinoma Intrahepatic)

Eligibility Criteria

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Inclusion Criteria

* A histologically confirmed diagnosis of hepatocellular carcinoma
* A histologically confirmed diagnosis of intrahepatic cholangiocarcinoma
* Received standard diagnostic and staging procedures as per local guidelines
* Availability of at least one blood-derived sample, drawn before receiving any curative-intent treatment

Exclusion Criteria

* Lack of or inability to provide informed consent
* Synchronous hepatocellular carcinoma and intrahepatic cholangiocarcinoma
* Primary liver cancer other than hepatocellular carcinoma or intrahepatic cholangiocarcinoma
* Secondary liver cancer
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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City of Hope Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ajay Goel, PhD

Role: PRINCIPAL_INVESTIGATOR

City of Hope Medical Center

Locations

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City of Hope Medical Center

Duarte, California, United States

Site Status RECRUITING

Graduate School of Medical Sciences, Kyushu University

Fukuoka, , Japan

Site Status RECRUITING

Graduate School of Medical Sciences, Kumamoto University

Kumamoto, , Japan

Site Status RECRUITING

Hokkaido University Graduate School of Medicine

Sapporo, , Japan

Site Status RECRUITING

Tokushima University

Tokushima, , Japan

Site Status RECRUITING

Countries

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United States Japan

Central Contacts

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Ajay Goel, PhD

Role: CONTACT

6262183452

Facility Contacts

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Ajay Goel, PhD

Role: primary

626-218-3452

Tomoharu Yoshizumi

Role: primary

Hideo Baba

Role: primary

Akinobu Taketomi

Role: primary

Mitsuo Shimada

Role: primary

References

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Other Identifiers

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23228/ELUCIDATE

Identifier Type: -

Identifier Source: org_study_id

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