A Noninvasive and Screening miRNA Signature for Gastrointestinal Cancer

NCT ID: NCT07224750

Last Updated: 2025-11-10

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

ACTIVE_NOT_RECRUITING

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-06-21

Study Completion Date

2026-06-18

Brief Summary

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Gastrointestinal (GI) cancers remain a major global health burden, largely due to the lack of effective and accessible early screening strategies. Current diagnostic approaches-including endoscopy, computed tomography (CT), and magnetic resonance imaging (MRI)-are either invasive, resource-intensive, or insufficiently sensitive for detecting early-stage disease, and are therefore not suitable for population-wide screening or for simultaneously identifying multiple GI tumor types. As a result, many patients are diagnosed at advanced stages, when therapeutic options are limited and prognosis is poor.

Circulating microRNAs (miRNAs) offer a promising alternative, as they are stable in peripheral blood and reflect tumor-related molecular alterations. In this study, the investigators aim to develop and validate a robust, noninvasive miRNA-based signature capable of distinguishing GI cancers from non-malignant controls. By integrating multi-cohort datasets and applying machine learning-based feature selection and predictive modeling, the investigators will construct a screening panel optimized for reproducibility, scalability, and early-stage detection. This noninvasive miRNA signature has the potential to support accessible, cost-effective, and clinically practical population-level screening for GI cancers, ultimately facilitating earlier diagnosis and improving outcomes for participants.

Detailed Description

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This study will establish a comprehensive, retrospective, international multi-center cohort consisting of peripheral blood samples from participants with major gastrointestinal cancers-including hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), pancreatic ductal adenocarcinoma (PDAC), esophageal squamous cell carcinoma (ESCC), gastric cancer (GC), and colorectal cancer (CRC)-as well as non-malignant controls. Small RNA sequencing will be performed to generate high-resolution circulating miRNA expression profiles.

During the discovery phase, the investigators will conduct rigorous preprocessing, normalization, batch effect correction, and differential expression analyses to identify circulating miRNAs associated with malignant transformation across GI cancer types. Machine learning-based feature selection (e.g., LASSO, mRMR, ensemble methods) and classifier development (e.g., SVM, Random Forest, XGBoost) will then be used to derive a minimal yet robust miRNA panel capable of optimally distinguishing cancer from non-cancer.

During the modeling and evaluation phase, the identified miRNA signature will undergo multi-center training and validation across international cohorts to ensure robustness across geographic regions, sequencing platforms, and clinical demographics. Beyond binary classification, the investigators will assess the panel's ability to discriminate among specific GI cancer subtypes, thereby supporting differential diagnosis and tumor-origin inference. Model performance will be evaluated using AUROC, sensitivity at clinically meaningful specificity thresholds, early-stage detection capability, and calibration in independent validation cohorts.

Through this sequential discovery → modeling → multi-center validation framework, the investigators aim to develop a noninvasive circulating miRNA panel that (1) accurately distinguishes cancer from non-cancer individuals and (2) differentiates among multiple gastrointestinal cancer types, thereby providing a clinically scalable solution for early cancer detection and population-level screening.

Conditions

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Hepatocellular Carcinoma (HCC) Cholangiocarcinoma Pancreatic Ductal Adenocarcinoma (PDAC) Esophageal Squamous Cell Carcinoma (ESCC) Gastric Cancer (GC) Colorectal Cancer Screening

Keywords

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Noninvasive screening Circulating miRNA Machine learning Gastrointestinal cancer Blood-based cancer detection

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Hepatocellular Carcinoma cohort

Patients diagnosed with hepatocellular carcinoma (HCC) confirmed by clinical, imaging, and/or histopathological criteria. Blood samples collected retrospectively from multiple international centers.

No interventions assigned to this group

Cholangiocarcinoma cohort

Patients diagnosed with cholangiocarcinoma (CCA), including intrahepatic and extrahepatic subtypes, confirmed clinically and/or histopathologically. Blood samples collected retrospectively from multiple international centers.

No interventions assigned to this group

Pancreatic Ductal Adenocarcinoma cohort

Patients diagnosed with pancreatic ductal adenocarcinoma (PDAC), confirmed by standard diagnostic criteria. Samples collected from multiple international centers.

No interventions assigned to this group

Esophageal Squamous Cell Carcinoma cohort

Patients diagnosed with esophageal squamous cell carcinoma (ESCC). Blood samples collected retrospectively from international collaborating centers.

No interventions assigned to this group

Gastric Cancer cohort

Patients diagnosed with gastric cancer (GC), confirmed clinically and/or histopathologically. Samples collected from multiple international centers.

No interventions assigned to this group

Colorectal Cancer cohort

Patients diagnosed with colorectal cancer (CRC), confirmed by standard diagnostic methods. Blood samples collected retrospectively from multiple international centers.

No interventions assigned to this group

Non-cancer / Healthy control group

Non-cancer individuals, including healthy volunteers and patients with benign gastrointestinal conditions. Blood samples collected from international centers and matched for age and sex where possible.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

1. Adults aged 18 years or older at the time of blood sample collection.
2. Patients with a confirmed diagnosis of one of the following gastrointestinal cancers: Hepatocellular carcinoma (HCC), Cholangiocarcinoma (CCA), Pancreatic ductal adenocarcinoma (PDAC), Esophageal squamous cell carcinoma (ESCC), Gastric cancer (GC), Colorectal cancer (CRC), Non-cancer control participants, including healthy volunteers or patients with benign gastrointestinal conditions.
3. Availability of retrospective blood samples collected according to institutional protocols.
4. Willingness to allow use of de-identified clinical and demographic data for research purposes.

Exclusion Criteria

* other active malignancies; insufficient sample quality/volume; recent chemotherapy/radiotherapy/surgery; any condition preventing reliable participation.
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 Nat Medical Ctr

Duarte, California, United States

Site Status

Countries

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United States

References

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Goddard KAB, Feuer EJ, Mandelblatt JS, Meza R, Holford TR, Jeon J, Lansdorp-Vogelaar I, Gulati R, Stout NK, Howlader N, Knudsen AB, Miller D, Caswell-Jin JL, Schechter CB, Etzioni R, Trentham-Dietz A, Kurian AW, Plevritis SK, Hampton JM, Stein S, Sun LP, Umar A, Castle PE. Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020. JAMA Oncol. 2025 Feb 1;11(2):162-167. doi: 10.1001/jamaoncol.2024.5381.

Reference Type BACKGROUND
PMID: 39636625 (View on PubMed)

Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, Jemal A. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024 May-Jun;74(3):229-263. doi: 10.3322/caac.21834. Epub 2024 Apr 4.

Reference Type BACKGROUND
PMID: 38572751 (View on PubMed)

Other Identifiers

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23228/MiGIC

Identifier Type: -

Identifier Source: org_study_id