Detecting Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma (LyMIC)

NCT ID: NCT06381648

Last Updated: 2025-07-03

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

190 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-04-15

Study Completion Date

2025-07-01

Brief Summary

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Lymph node metastasis (LNM) is a major prognostic factor in intrahepatic cholangiocarcinoma (ICC), and accurate preoperative prediction of the presence or absence of LNM has significant clinical implications in determining treatment strategy. Despite this, there are currently no reliable biomarkers established to detect LNM in ICC.

This study seeks to develop a liquid biopsy assay that can accurately detect LNM before treatment in ICC patients.

Detailed Description

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Intrahepatic cholangiocarcinoma (ICC) is a malignant tumor of the liver arising from epithelial cells of the biliary tract, accounting for 10-15% of primary liver cancers, and the incidence of ICC has increased rapidly worldwide over the past decade. The long-term prognosis is dismal, with a 5-year overall survival (OS) as low as 25-30%. Many studies have highlighted lymph node metastasis as a strong predictor of poor prognosis in ICC patients, prompting efforts such as appropriate lymphadenectomy to accurately predict disease stage and reduce outcomes associated with LNM. Adequate lymphadenectomy in patients with suspected LNM is essential for achieving R0 resection and is a necessary component of complete cure and long-term survival. The routine use of highly invasive lymphadenectomy in all patients remains controversial, and lymphadenectomy rates for ICC range from 26.9% to 100% depending on the literature and are not universally adopted currently.

Currently, LNM is detected preoperatively by imaging, but imaging alone is not sufficient to diagnose LNM, as negative findings by imaging findings may have low sensitivity and may not rule out LNM. Other attempts have been made to develop predictive scoring systems based on Carbohydrate antigen 19-9 (CA 19-9) levels, location of the primary tumor, lymph node patterns on CT and MRI, and other clinical factors to predict LNM in ICC, but all these predictive systems rely heavily on judgment regarding lymph node size and tumor growth patterns are largely left to diagnostic imaging.

This study seeks to validate a panel of more accurate and non-invasive biomarkers (exo-miRNAs) in preoperative blood samples. Accurate preoperative detection of the presence of LNM would help provide clear criteria for ICC treatment decisions, such as the implementation of elective lymphadenectomy or the addition of chemotherapy.

Conditions

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Cholangiocarcinoma Cholangiocarcinoma, Intrahepatic Cholangiocarcinoma Resectable Cholangiocarcinoma; Liver

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Intrahepatic Cholangiocarcinoma, With Lymph node metastasis (Training)

Patients with ICC who had lymph node metastases at the time of primary tumor treatment with D2 dissection, in the first cohort.

LyMIC (Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma)

Intervention Type DIAGNOSTIC_TEST

A panel of exosomal miRNAs, whose expression levels are tested in serum or plasma samples collected prior to primary tumor resection, with reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR)

Intrahepatic Cholangiocarcinoma, Without Lymph node metastasis (Training)

Patients with ICC who did not have lymph node metastases at the time of primary tumor treatment with D2 dissection, in the first cohort.

LyMIC (Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma)

Intervention Type DIAGNOSTIC_TEST

A panel of exosomal miRNAs, whose expression levels are tested in serum or plasma samples collected prior to primary tumor resection, with reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR)

Intrahepatic Cholangiocarcinoma, With Lymph node metastasis (Validation)

Patients with ICC who had lymph node metastases at the time of primary tumor treatment with D2 dissection, in the second cohort.

LyMIC (Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma)

Intervention Type DIAGNOSTIC_TEST

A panel of exosomal miRNAs, whose expression levels are tested in serum or plasma samples collected prior to primary tumor resection, with reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR)

Intrahepatic Cholangiocarcinoma, Without Lymph node metastasis (Validation)

Patients with ICC who did not have lymph node metastases at the time of primary tumor treatment with D2 dissection, in the second cohort.

LyMIC (Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma)

Intervention Type DIAGNOSTIC_TEST

A panel of exosomal miRNAs, whose expression levels are tested in serum or plasma samples collected prior to primary tumor resection, with reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR)

Interventions

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LyMIC (Lymph Node Metastasis in Intrahepatic Cholangiocarcinoma)

A panel of exosomal miRNAs, whose expression levels are tested in serum or plasma samples collected prior to primary tumor resection, with reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR)

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* 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 Intrahepatic cholangiocarcinoma and non- Intrahepatic cholangiocarcinoma diagnosed at or before surgery
* 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

Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University

Hokkaido, Sapporo, Japan

Site Status

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University

Fukuoka, , Japan

Site Status

Department of Surgery, Tokushima University

Tokushima, , Japan

Site Status

Countries

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United States Japan

References

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Other Identifiers

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23228/LyMIC

Identifier Type: -

Identifier Source: org_study_id

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