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
COMPLETED
Total Enrollment
809 participants
Study Classification
OBSERVATIONAL
Study Start Date
2023-03-15
Study Completion Date
2024-06-15
Brief Summary
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Gastric cancer continues to have a poor prognosis primarily due to the inability to detect it in its early stages. This study will develop and validate a blood assay to facilitate the non-invasive detection of gastric cancer.
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Detailed Description
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Gastric cancer continues to have a poor prognosis primarily due to the inability to detect it in its early stages. Because conventional endoscopy is invasive and costly, gastric cancer is currently not considered to be screenable at a population level. However, if one could find less invasive and cheaper tools that accurately detect gastric cancer in its early stages, it could make a significant difference. Accurate biomarkers could help identify patients with gastric cancer before it becomes incurable.
This study aims to develop a non-invasive test to detect gastric cancer early. It consists of four phases:
1. Discovering potential biomarkers with a comprehensive and genome-wide transcriptomic sequencing analysis that will involve gastric cancer tissue, normal tissue, and serum samples from patients with gastric cancer, as well as samples from people without the disease.
2. Using machine learning to develop a combination "signature" of cell-free (cf) and exosomal (exo)-miRNA in serum specimens from a training cohort.
3. A validation of this signature in an independent cohort to confirm its accuracy.
4. An evaluation of the temporal trend of this signature in paired samples collected pre-surgery and post-surgery to investigate their potential and specificity as indicators of minimal residual disease.
In summary, this study aims to develop a highly accurate and cost-effective blood test for detecting gastric cancer early. Success could lead to significant improvements in clinical practice by catching cancer when it is most treatable. By combining different genetic markers (cell-free microRNA and exosomal microRNA) for accuracy, this study has the potential to reduce gastric cancer deaths and could lead to new screening methods in the future.
This study aims to develop a non-invasive test to detect gastric cancer early. It consists of four phases:
1. Discovering potential biomarkers with a comprehensive and genome-wide transcriptomic sequencing analysis that will involve gastric cancer tissue, normal tissue, and serum samples from patients with gastric cancer, as well as samples from people without the disease.
2. Using machine learning to develop a combination "signature" of cell-free (cf) and exosomal (exo)-miRNA in serum specimens from a training cohort.
3. A validation of this signature in an independent cohort to confirm its accuracy.
4. An evaluation of the temporal trend of this signature in paired samples collected pre-surgery and post-surgery to investigate their potential and specificity as indicators of minimal residual disease.
In summary, this study aims to develop a highly accurate and cost-effective blood test for detecting gastric cancer early. Success could lead to significant improvements in clinical practice by catching cancer when it is most treatable. By combining different genetic markers (cell-free microRNA and exosomal microRNA) for accuracy, this study has the potential to reduce gastric cancer deaths and could lead to new screening methods in the future.
Conditions
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Gastric Cancer
Gastric Adenocarcinoma
Gastric Cancer Stage
Gastric Neoplasm
Gastric Lesion
Gastric Cancer in Situ
Gastric Cancer Stage IV
Gastric Cancer Stage IIIB
Gastric Cancer Stage III
Gastric Cancer Stage IB
Gastric Cancer Stage IA
Gastric Cancer, Stage 0
Gastric Cancer Stage IIIA
Gastric Cancer Stage II
Gastric Cancer TNM Staging
Gastric Cancer Metastatic to Lung
Gastric Cancer Metastatic to Liver
Gastric Cancer Stage I
Gastric Cancer TNM Staging Primary Tumor (T) T2B
Study Design
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Observational Model Type
CASE_CONTROL
Study Time Perspective
RETROSPECTIVE
Study Groups
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Patients with Gastric Cancer (Training)
Individuals with a pathologically confirmed diagnosis of gastric cancer
DESTINEX
Intervention Type
DIAGNOSTIC_TEST
A panel of microRNA, whose expression level is tested in serum samples.
Patients without Gastric Cancer (Training)
Individuals without cancer at the time of blood sampling
DESTINEX
Intervention Type
DIAGNOSTIC_TEST
A panel of microRNA, whose expression level is tested in serum samples.
Patients with Gastric Cancer (Validation)
Individuals with a pathologically confirmed diagnosis of gastric cancer
DESTINEX
Intervention Type
DIAGNOSTIC_TEST
A panel of microRNA, whose expression level is tested in serum samples.
Patients without Gastric Cancer (Validation)
Individuals without cancer at the time of blood sampling
DESTINEX
Intervention Type
DIAGNOSTIC_TEST
A panel of microRNA, whose expression level is tested in serum samples.
Interventions
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DESTINEX
A panel of microRNA, whose expression level is tested in serum samples.
Intervention Type
DIAGNOSTIC_TEST
Other Intervention Names
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DESTINEX (DEtection of STomach NEoplasia in circulating eXosomes)
Eligibility Criteria
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Inclusion Criteria
* Histological diagnosis of stage I, II, III, IV gastric cancer (TNM classification, 8th edition) (cases).
* Received standard diagnostic and staging procedures as per local guidelines, and at least one sample was drawn before receiving any curative-intent treatment.
* Confirmed cancer-free status at the time of study inclusion (Non-disease controls).
* Received standard diagnostic and staging procedures as per local guidelines, and at least one sample was drawn before receiving any curative-intent treatment.
* Confirmed cancer-free status at the time of study inclusion (Non-disease controls).
Exclusion Criteria
* Lack of written informed consent.
* Systemic therapy before sampling.
* Synchronous gastric and non-gastric cancer diagnosed at or before surgery.
* Systemic therapy before sampling.
* Synchronous gastric and non-gastric cancer diagnosed at or before surgery.
Minimum Eligible Age
18 Years
Eligible Sex
ALL
Accepts Healthy Volunteers
Yes
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
Nagoya University
Nagoya, , Japan
Site Status
Mie University
Tsu, , Japan
Site Status
Countries
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United States
Japan
References
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Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet. 2020 Aug 29;396(10251):635-648. doi: 10.1016/S0140-6736(20)31288-5.
Reference Type
BACKGROUND
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
Reference Type
BACKGROUND
Nishiwada S, Cui Y, Sho M, Jun E, Akahori T, Nakamura K, Sonohara F, Yamada S, Fujii T, Han IW, Tsai S, Kodera Y, Park JO, Von Hoff D, Kim SC, Li W, Goel A. Transcriptomic Profiling Identifies an Exosomal microRNA Signature for Predicting Recurrence Following Surgery in Patients With Pancreatic Ductal Adenocarcinoma. Ann Surg. 2022 Dec 1;276(6):e876-e885. doi: 10.1097/SLA.0000000000004993. Epub 2021 Jun 16.
Reference Type
BACKGROUND
Pasechnikov V, Chukov S, Fedorov E, Kikuste I, Leja M. Gastric cancer: prevention, screening and early diagnosis. World J Gastroenterol. 2014 Oct 14;20(38):13842-62. doi: 10.3748/wjg.v20.i38.13842.
Reference Type
BACKGROUND
Lee JH, Kim JG, Jung HK, Kim JH, Jeong WK, Jeon TJ, Kim JM, Kim YI, Ryu KW, Kong SH, Kim HI, Jung HY, Kim YS, Zang DY, Cho JY, Park JO, Lim DH, Jung ES, Ahn HS, Kim HJ. Clinical practice guidelines for gastric cancer in Korea: an evidence-based approach. J Gastric Cancer. 2014 Jun;14(2):87-104. doi: 10.5230/jgc.2014.14.2.87. Epub 2014 Jun 30.
Reference Type
BACKGROUND
Shimada H, Noie T, Ohashi M, Oba K, Takahashi Y. Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association. Gastric Cancer. 2014 Jan;17(1):26-33. doi: 10.1007/s10120-013-0259-5. Epub 2013 Apr 10.
Reference Type
BACKGROUND
Heitzer E, Haque IS, Roberts CES, Speicher MR. Current and future perspectives of liquid biopsies in genomics-driven oncology. Nat Rev Genet. 2019 Feb;20(2):71-88. doi: 10.1038/s41576-018-0071-5.
Reference Type
BACKGROUND
Siravegna G, Mussolin B, Venesio T, Marsoni S, Seoane J, Dive C, Papadopoulos N, Kopetz S, Corcoran RB, Siu LL, Bardelli A. How liquid biopsies can change clinical practice in oncology. Ann Oncol. 2019 Oct 1;30(10):1580-1590. doi: 10.1093/annonc/mdz227.
Reference Type
BACKGROUND
Jung G, Hernandez-Illan E, Moreira L, Balaguer F, Goel A. Epigenetics of colorectal cancer: biomarker and therapeutic potential. Nat Rev Gastroenterol Hepatol. 2020 Feb;17(2):111-130. doi: 10.1038/s41575-019-0230-y. Epub 2020 Jan 3.
Reference Type
BACKGROUND
Rupaimoole R, Slack FJ. MicroRNA therapeutics: towards a new era for the management of cancer and other diseases. Nat Rev Drug Discov. 2017 Mar;16(3):203-222. doi: 10.1038/nrd.2016.246. Epub 2017 Feb 17.
Reference Type
BACKGROUND
Schwarzenbach H, Nishida N, Calin GA, Pantel K. Clinical relevance of circulating cell-free microRNAs in cancer. Nat Rev Clin Oncol. 2014 Mar;11(3):145-56. doi: 10.1038/nrclinonc.2014.5. Epub 2014 Feb 4.
Reference Type
BACKGROUND
Shigeyasu K, Toden S, Zumwalt TJ, Okugawa Y, Goel A. Emerging Role of MicroRNAs as Liquid Biopsy Biomarkers in Gastrointestinal Cancers. Clin Cancer Res. 2017 May 15;23(10):2391-2399. doi: 10.1158/1078-0432.CCR-16-1676. Epub 2017 Jan 31.
Reference Type
BACKGROUND
Toiyama Y, Okugawa Y, Goel A. DNA methylation and microRNA biomarkers for noninvasive detection of gastric and colorectal cancer. Biochem Biophys Res Commun. 2014 Dec 5;455(1-2):43-57. doi: 10.1016/j.bbrc.2014.08.001. Epub 2014 Aug 13.
Reference Type
BACKGROUND
Okugawa Y, Grady WM, Goel A. Epigenetic Alterations in Colorectal Cancer: Emerging Biomarkers. Gastroenterology. 2015 Oct;149(5):1204-1225.e12. doi: 10.1053/j.gastro.2015.07.011. Epub 2015 Jul 26.
Reference Type
BACKGROUND
Nik Mohamed Kamal NNSB, Shahidan WNS. Non-Exosomal and Exosomal Circulatory MicroRNAs: Which Are More Valid as Biomarkers? Front Pharmacol. 2020 Jan 20;10:1500. doi: 10.3389/fphar.2019.01500. eCollection 2019.
Reference Type
BACKGROUND
Lopez K, Lai SWT, Lopez Gonzalez EJ, Davila RG, Shuck SC. Extracellular vesicles: A dive into their role in the tumor microenvironment and cancer progression. Front Cell Dev Biol. 2023 Mar 21;11:1154576. doi: 10.3389/fcell.2023.1154576. eCollection 2023.
Reference Type
BACKGROUND
Zhu L, Li J, Gong Y, Wu Q, Tan S, Sun D, Xu X, Zuo Y, Zhao Y, Wei YQ, Wei XW, Peng Y. Exosomal tRNA-derived small RNA as a promising biomarker for cancer diagnosis. Mol Cancer. 2019 Apr 2;18(1):74. doi: 10.1186/s12943-019-1000-8.
Reference Type
BACKGROUND
Miyazaki K, Wada Y, Okuno K, Murano T, Morine Y, Ikemoto T, Saito Y, Ikematsu H, Kinugasa Y, Shimada M, Goel A. An exosome-based liquid biopsy signature for pre-operative identification of lymph node metastasis in patients with pathological high-risk T1 colorectal cancer. Mol Cancer. 2023 Jan 6;22(1):2. doi: 10.1186/s12943-022-01685-8.
Reference Type
BACKGROUND
Lane JS, Hoff DV, Cridebring D, Goel A. Extracellular Vesicles in Diagnosis and Treatment of Pancreatic Cancer: Current State and Future Perspectives. Cancers (Basel). 2020 Jun 10;12(6):1530. doi: 10.3390/cancers12061530.
Reference Type
BACKGROUND
Lennon KM, Wakefield DL, Maddox AL, Brehove MS, Willner AN, Garcia-Mansfield K, Meechoovet B, Reiman R, Hutchins E, Miller MM, Goel A, Pirrotte P, Van Keuren-Jensen K, Jovanovic-Talisman T. Single molecule characterization of individual extracellular vesicles from pancreatic cancer. J Extracell Vesicles. 2019 Nov 4;8(1):1685634. doi: 10.1080/20013078.2019.1685634. eCollection 2019.
Reference Type
BACKGROUND
Akers JC, Gonda D, Kim R, Carter BS, Chen CC. Biogenesis of extracellular vesicles (EV): exosomes, microvesicles, retrovirus-like vesicles, and apoptotic bodies. J Neurooncol. 2013 May;113(1):1-11. doi: 10.1007/s11060-013-1084-8. Epub 2013 Mar 2.
Reference Type
BACKGROUND
Chaput N, Thery C. Exosomes: immune properties and potential clinical implementations. Semin Immunopathol. 2011 Sep;33(5):419-40. doi: 10.1007/s00281-010-0233-9. Epub 2010 Dec 21.
Reference Type
BACKGROUND
Nakamura K, Zhu Z, Roy S, Jun E, Han H, Munoz RM, Nishiwada S, Sharma G, Cridebring D, Zenhausern F, Kim S, Roe DJ, Darabi S, Han IW, Evans DB, Yamada S, Demeure MJ, Becerra C, Celinski SA, Borazanci E, Tsai S, Kodera Y, Park JO, Bolton JS, Wang X, Kim SC, Von Hoff D, Goel A. An Exosome-based Transcriptomic Signature for Noninvasive, Early Detection of Patients With Pancreatic Ductal Adenocarcinoma: A Multicenter Cohort Study. Gastroenterology. 2022 Nov;163(5):1252-1266.e2. doi: 10.1053/j.gastro.2022.06.090. Epub 2022 Jul 16.
Reference Type
BACKGROUND
Li A, Yu J, Kim H, Wolfgang CL, Canto MI, Hruban RH, Goggins M. MicroRNA array analysis finds elevated serum miR-1290 accurately distinguishes patients with low-stage pancreatic cancer from healthy and disease controls. Clin Cancer Res. 2013 Jul 1;19(13):3600-10. doi: 10.1158/1078-0432.CCR-12-3092. Epub 2013 May 22.
Reference Type
BACKGROUND
Other Identifiers
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23228/DESTINEX
Identifier Type: -
Identifier Source: org_study_id
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