Splicing-based Predictive Learning for Individual Chemotherapy Evaluation in Colorectal Cancer

NCT ID: NCT07226115

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

RECRUITING

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-06-21

Study Completion Date

2026-06-18

Brief Summary

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Colorectal cancer (CRC) remains one of the leading causes of cancer-related mortality worldwide. Although adjuvant chemotherapy improves survival after curative resection, its efficacy varies widely among patients. The absence of reliable predictive biomarkers often leads to overtreatment or undertreatment.

This study aims to develop a machine learning-based predictive model for adjuvant chemotherapy response using tumor-derived alternative splicing signatures.

By integrating RNA-seq data, splicing isoform and clinical outcomes, this study seeks to identify molecular predictors of treatment response and recurrence risk after surgery.

Detailed Description

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Colorectal cancer (CRC) remains a major global health burden, with adjuvant chemotherapy representing the standard of care after curative resection. However, patient responses to therapy vary widely, and no validated molecular model currently guides adjuvant treatment selection.

Recent studies suggest that aberrant alternative splicing-rather than gene-level expression alone-plays a crucial role in shaping chemotherapy sensitivity and tumor recurrence. Yet, these complex transcriptomic variations are often missed by standard differential expression analyses.

The ASPAIRE framework (Alternative Splicing and Predictive mAchIne learnIng for Response Evaluation) applies advanced computational modeling to capture multidimensional splicing features from RNA-seq data and transform them into clinically actionable predictions.

In this research effort, the investigators will leverage machine learning to predict adjuvant chemotherapy response for CRC. The research plan will employ three phases:

1. Identification of alternative splicing patterns associated with adjuvant chemotherapy response through RNA sequencing and computational feature extraction.
2. The investigators will then develop an assay based on reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and train a machine-learning model to predict chemotherapy response.
3. The investigators will independently validate the assay. This assay is provisionally termed " SPLICE " (Splicing-based Predictive Learning for Individual Chemotherapy Evaluation in Colorectal Cancer) and will be tested for disease free survival up to five years after treatment.

At the end of this study, this assay will have been developed and validated to help clinical decision-making by predicting both disease free survival.

Conditions

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Colorectal Cancer Colorectal Cancer Recurrent Colorectal Cancer Stage II Colorectal Cancer Stage III

Keywords

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Chemotherapy Adjuvant Response Splicing Prediction

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Non-responders of colorectal cancer (Training Cohort)

Non-responders of colorectal cancer who developed recurrent CRC within 60 months from primary tumor treatment, in the first cohort

SPLICE

Intervention Type OTHER

A panel of RNA splicing isoform, whose level is tested in tissue samples derived from the primary tumor.

Responders of colorectal cancer (Training Cohort)

Responders of colorectal cancer who did not develop recurrent CRC within 60 months from primary tumor treatment, in the first cohort

SPLICE

Intervention Type OTHER

A panel of RNA splicing isoform, whose level is tested in tissue samples derived from the primary tumor.

Non-responders of colorectal cancer, with recurrent disease (Validation Cohort)

Non-responders of colorectal cancer who developed recurrent CRC within 60 months from primary tumor treatment, in the second, independent, validation cohort

SPLICE

Intervention Type OTHER

A panel of RNA splicing isoform, whose level is tested in tissue samples derived from the primary tumor.

Responders of colorectal cancer (Validation Cohort)

Responders of colorectal cancer who did not develop recurrent CRC within 60 months from primary tumor treatment, in the second, independent, validation cohort

SPLICE

Intervention Type OTHER

A panel of RNA splicing isoform, whose level is tested in tissue samples derived from the primary tumor.

Interventions

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SPLICE

A panel of RNA splicing isoform, whose level is tested in tissue samples derived from the primary tumor.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed stage II-III colorectal cancer (TNM classification, 8th edition)
* Received standard adjuvant chemotherapy after curative resection
* Availability of tumor tissue (FFPE or frozen) before chemotherapy
* Sufficient clinical data for outcome analysis (recurrence, survival)
* Age 18-80 years Stage

Exclusion Criteria

* Inflammatory bowel disease
* Inadequate RNA quality or lack of consent
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 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

Countries

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United States

Central Contacts

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Ajay Goel, PhD

Role: CONTACT

Phone: 626-218-3452

Email: [email protected]

Facility Contacts

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Ajay Goel, PhD

Role: primary

References

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Auclin E, Zaanan A, Vernerey D, Douard R, Gallois C, Laurent-Puig P, Bonnetain F, Taieb J. Subgroups and prognostication in stage III colon cancer: future perspectives for adjuvant therapy. Ann Oncol. 2017 May 1;28(5):958-968. doi: 10.1093/annonc/mdx030.

Reference Type BACKGROUND
PMID: 28453690 (View on PubMed)

Dienstmann R, Salazar R, Tabernero J. Personalizing colon cancer adjuvant therapy: selecting optimal treatments for individual patients. J Clin Oncol. 2015 Jun 1;33(16):1787-96. doi: 10.1200/JCO.2014.60.0213. Epub 2015 Apr 27.

Reference Type BACKGROUND
PMID: 25918287 (View on PubMed)

Di Narzo AF, Tejpar S, Rossi S, Yan P, Popovici V, Wirapati P, Budinska E, Xie T, Estrella H, Pavlicek A, Mao M, Martin E, Scott W, Bosman FT, Roth A, Delorenzi M. Test of four colon cancer risk-scores in formalin fixed paraffin embedded microarray gene expression data. J Natl Cancer Inst. 2014 Sep 22;106(10):dju247. doi: 10.1093/jnci/dju247. Print 2014 Oct.

Reference Type BACKGROUND
PMID: 25246611 (View on PubMed)

Andre T, Boni C, Navarro M, Tabernero J, Hickish T, Topham C, Bonetti A, Clingan P, Bridgewater J, Rivera F, de Gramont A. Improved overall survival with oxaliplatin, fluorouracil, and leucovorin as adjuvant treatment in stage II or III colon cancer in the MOSAIC trial. J Clin Oncol. 2009 Jul 1;27(19):3109-16. doi: 10.1200/JCO.2008.20.6771. Epub 2009 May 18.

Reference Type BACKGROUND
PMID: 19451431 (View on PubMed)

Andre T, Meyerhardt J, Iveson T, Sobrero A, Yoshino T, Souglakos I, Grothey A, Niedzwiecki D, Saunders M, Labianca R, Yamanaka T, Boukovinas I, Vernerey D, Meyers J, Harkin A, Torri V, Oki E, Georgoulias V, Taieb J, Shields A, Shi Q. Effect of duration of adjuvant chemotherapy for patients with stage III colon cancer (IDEA collaboration): final results from a prospective, pooled analysis of six randomised, phase 3 trials. Lancet Oncol. 2020 Dec;21(12):1620-1629. doi: 10.1016/S1470-2045(20)30527-1.

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Okuno K, Kandimalla R, Mendiola M, Balaguer F, Bujanda L, Fernandez-Martos C, Aparicio J, Feliu J, Tokunaga M, Kinugasa Y, Maurel J, Goel A. A microRNA signature for risk-stratification and response prediction to FOLFOX-based adjuvant therapy in stage II and III colorectal cancer. Mol Cancer. 2023 Jan 20;22(1):13. doi: 10.1186/s12943-022-01699-2. No abstract available.

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Zhang JX, Song W, Chen ZH, Wei JH, Liao YJ, Lei J, Hu M, Chen GZ, Liao B, Lu J, Zhao HW, Chen W, He YL, Wang HY, Xie D, Luo JH. Prognostic and predictive value of a microRNA signature in stage II colon cancer: a microRNA expression analysis. Lancet Oncol. 2013 Dec;14(13):1295-306. doi: 10.1016/S1470-2045(13)70491-1. Epub 2013 Nov 13.

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Gray RG, Quirke P, Handley K, Lopatin M, Magill L, Baehner FL, Beaumont C, Clark-Langone KM, Yoshizawa CN, Lee M, Watson D, Shak S, Kerr DJ. Validation study of a quantitative multigene reverse transcriptase-polymerase chain reaction assay for assessment of recurrence risk in patients with stage II colon cancer. J Clin Oncol. 2011 Dec 10;29(35):4611-9. doi: 10.1200/JCO.2010.32.8732. Epub 2011 Nov 7.

Reference Type BACKGROUND
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Zhang M, Chen C, Lu Z, Cai Y, Li Y, Zhang F, Liu Y, Chen S, Zhang H, Yang S, Gen H, Jiang Y, Ning C, Huang J, Wang W, Fan L, Zhang Y, Jin M, Han J, Xiong Z, Cai M, Liu J, Huang C, Yang X, Xu B, Li H, Li B, Zhu X, Wei Y, Zhu Y, Tian J, Miao X. Genetic Control of Alternative Splicing and its Distinct Role in Colorectal Cancer Mechanisms. Gastroenterology. 2023 Nov;165(5):1151-1167. doi: 10.1053/j.gastro.2023.07.019. Epub 2023 Aug 3.

Reference Type BACKGROUND
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Reference Type RESULT
PMID: 31780575 (View on PubMed)

Other Identifiers

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23228/SPLICE

Identifier Type: -

Identifier Source: org_study_id