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Blood Clearance Kinetics of the Nucleosome and CTCF in Peritoneal Metastasis Colorectal Cancer.

Not Applicable
Not yet recruiting
Conditions
Peritoneal Carcinomatosis
Peritoneal Metastases From Colorectal Cancer
Interventions
Biological: Blood sampling
Registration Number
NCT06929013
Lead Sponsor
Hospices Civils de Lyon
Brief Summary

Colorectal cancer is highly prevalent in France, ranking second among women and third among men. Its primary metastatic sites include the liver, lungs, and peritoneum. For peritoneal metastases, when the disease is moderately extensive, cytoreductive surgery is recommended in an expert centre. Following this procedure, the surgeon uses the CC-Score (Completeness of Cytoreduction after Surgery Score) to assess the completeness of surgical resection by evaluating the largest remaining tumor residue. This subjective score is currently the main prognostic factor for oncological outcomes post-surgery. However, there is no objective score based on biological criteria to evaluate the radicality of resection, despite the hypothesis that the micrometastatic component of the disease could be biologically assessed using appropriate circulating markers.

New biomarkers are emerging and appear relevant for determining the presence of tumor residual disease. Notable among these are circulating tumor DNA, which can detect mutated DNA released by tumor cells into the patient's blood through high-throughput sequencing, and new markers related to epigenetic modifications in cancer cells. These markers target specific nucleosomes or the transcription factor CTCF and show promise in detecting residual disease.

To effectively use these markers for constructing a biological score to detect residual disease in peritoneal carcinomatosis, it is essential to understand their perioperative kinetics. This is crucial because cellular debris release is expected post-surgery, necessitating the determination of the most relevant time point for measurement. Additionally, these markers appear to be correlated with blood inflammation levels, requiring a description of this correlation to account for this potential confounding factor. Finally, the sensitivity and specificity of these markers must be determined by studying their perioperative kinetics in patient groups undergoing surgeries other than cytoreductions for peritoneal carcinomatosis.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
52
Inclusion Criteria
  • Common criteria:

    • Male/female over 18 years of age.
    • Weight ≥ 55 kg at inclusion.
    • Signature of a free and informed consent form.
  • Specific criteria:

Group 1:

  • Peritoneal metastases colorectal cancer histologically proven
  • Synchronous or metachronous peritoneal metastases.
  • Patients eligible for initial cytoreduction surgery.
  • Non mucinous tumor (mucinous cells contingent <30%).

Group 2:

Colorectal cancer

Group 3:

Non-oncological chronic inflammatory diseases

Group 4:

Non-oncological chronic inflammatory diseases : parietal repairs, elective sigmoidectomy for diverticulosis

Group 5:

Abdominal sepsis conditions: peritonitis due to digestive perforation in non-oncological pathology, non-perforated appendicitis, cholecystitis.

Non inclusion Criteria:

  • Patient with an active cancer (excluding colorectal cancer).
  • Person with a progressive autoimmune disease.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Peritoneal metastases colorectal cancerBlood sampling* Peritoneal metastases colorectal cancer histologically proven * Synchronous or metachronous peritoneal metastases. * Patients eligible for initial cytoreduction surgery. * Non mucinous tumor (mucinous cells contingent \<30%).
Colorectal cancerBlood samplingHistologically proven colorectal cancer with no known metastatic
Non-oncological chronic inflammatory diseasesBlood samplingSurgery for inflammatory bowel disease (Crohn's, chronic ulcerative colitis) such as ileocaecal resection, colectomy, and bowel resection.
Non-malignant diseasesBlood samplingNon-inflammatory and non-oncological diseases: * Parietal repairs. * Elective sigmoidectomy for diverticulosis
Abdominal sepsis conditionsBlood sampling* Peritonitis due to digestive perforation in non-oncological pathology. * Non-perforated appendicitis. * Cholecystitis.
Primary Outcome Measures
NameTimeMethod
Kinetic of nucleosome and CCCTC-binding factor (CTCF)From the inclusion (baseline) to 4 to 6 weeks after surgical procedure.

Blood clearance kinetics of the nucleosome (H3K27me3, H3K36me3, H3.1 et H3K9me3) and CCCTC-binding factor (CTCF).

Secondary Outcome Measures
NameTimeMethod
Kinetic of inflammatory markers - AlbuminFrom the inclusion (baseline) to 4 to 6 weeks after surgical procedure.

Blood clearance kinetics of albumin

Kinetic of inflammatory markers - C-reactive proteinFrom the inclusion (baseline) to 4 to 6 weeks after surgical procedure.

Blood clearance kinetics of C-reactive protein

Kinetic of inflammatory markers - Interleukin IL-6From the inclusion (baseline) to 4 to 6 weeks after surgical procedure.

Blood clearance kinetics of Interleukin IL-6

Correlation between inflammatory markers, nucleosome and CCCTC-binding factor (CTCF).Completed postoperative follow-up : at least 4 to 6 weeks after surgery

Correlation test between blood concentration of inflammatory markers (albumin, C-reactive protein, Interleukin IL-6), nucleosome nucleosome (H3K27me3, H3K36me3, H3.1 et H3K9me3) and CCCTC-binding factor (CTCF).

Nucleosome and CCCTC-binding factor (CTCF) sensitivity and specificityCompleted postoperative follow-up : at least 4 to 6 weeks after surgery

To assess the sensitivity and specificity of the nucleosome and CCCTC-binding factor (CTCF) blood clearance kinetic for the colorectal cancer peritoneal metastatic condition

Trial Locations

Locations (1)

Hôpital Lyon Sud

🇫🇷

Pierre-benite, France

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