Detection of Minimal Residual Disease Using Exosomal miRNA Distant Metastasis Markers

NCT ID: NCT07243015

Last Updated: 2025-11-21

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

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-01-15

Study Completion Date

2026-06-18

Brief Summary

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Gastric cancer (GC) is a leading cause of cancer-related death worldwide. Even in patients undergoing curative surgery for non-metastatic disease, postoperative recurrence frequently occurs due to undetected minimal residual disease (MRD). This study aims to establish a highly sensitive and specific liquid biopsy assay using exosomal microRNAs (exo-miRNAs) to detect MRD and predict distant metastasis before clinical recurrence.

Detailed Description

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Postoperative recurrence in gastric cancer is largely driven by occult micrometastatic disease that remains undetectable by conventional imaging. While circulating tumor DNA (ctDNA) assays have shown utility in MRD detection, their limited sensitivity and tumor-type variability hinder consistent application in gastric cancer.

Exosomal microRNAs (exo-miRNAs), encapsulated within lipid bilayer vesicles, remain stable in circulation and reflect tumor-derived molecular information. This study seeks to develop and validate an exosomal miRNA-based signature capable of detecting minimal residual disease and predicting future distant metastasis after curative gastrectomy.

Study Phases

1. Discovery Phase - Comprehensive small RNA sequencing to identify miRNAs specific to distant metastasis in gastric cancer.
2. Training Phase - RT-qPCR-based quantification of candidate exo-miRNAs in postoperative plasma samples to develop an MRD signature.
3. Validation Phase - Independent cohort testing to evaluate the diagnostic performance, sensitivity, and specificity of the exosomal MRD panel.

Ultimately, the ENLIGHT assay aims to guide postoperative adjuvant chemotherapy by stratifying patients according to MRD status, enabling precision surveillance and early intervention.

Conditions

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Gastric Cancer

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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Discovery Cohort - Distant Metastasis Positive

Patients with postoperative distant metastasis; used for biomarker discovery via small RNA sequencing.

small RNA-seq or array

Intervention Type DIAGNOSTIC_TEST

small RNA-seq or array

Discovery Cohort - Distant Metastasis Negative

Patients without postoperative metastasis; used as reference controls in discovery phase.

small RNA-seq or array

Intervention Type DIAGNOSTIC_TEST

small RNA-seq or array

Training Cohort - MRD Positive (High Risk)

Patients exhibiting postoperative recurrence within 12 months.

ENLIGHT Assay

Intervention Type DIAGNOSTIC_TEST

RT-qPCR-based exo-miRNA quantification

Training Cohort - MRD Negative (Low Risk)

Patients without recurrence ≥12 months postoperatively.

ENLIGHT Assay

Intervention Type DIAGNOSTIC_TEST

RT-qPCR-based exo-miRNA quantification

Validation Cohort - MRD Positive

Independent validation cohort with confirmed distant metastasis or MRD positivity.

ENLIGHT Assay

Intervention Type DIAGNOSTIC_TEST

RT-qPCR-based exo-miRNA quantification

Validation Cohort - MRD Negative

Independent validation cohort without recurrence/metastasis.

ENLIGHT Assay

Intervention Type DIAGNOSTIC_TEST

RT-qPCR-based exo-miRNA quantification

Interventions

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small RNA-seq or array

small RNA-seq or array

Intervention Type DIAGNOSTIC_TEST

ENLIGHT Assay

RT-qPCR-based exo-miRNA quantification

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed gastric adenocarcinoma.
* Underwent curative-intent resection (R0).
* Availability of pre- and postoperative plasma samples.
* Documented clinical follow-up data (recurrence/metastasis status).
* Provided written informed consent.

Exclusion Criteria

* Insufficient plasma volume or RNA quality for exosomal extraction.
* Presence of synchronous or metachronous malignancies.
* Received neoadjuvant chemotherapy without postoperative follow-up.
* Lack of consent or incomplete clinicopathologic data.
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

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

626-218-3452

Facility Contacts

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Ajay Goel, PhD

Role: primary

626-218-3452

Other Identifiers

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23228/ENLIGHT

Identifier Type: -

Identifier Source: org_study_id

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