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Biomarkers in Patients With Rectal Cancer Undergoing Chemotherapy and Radiation Therapy

Completed
Conditions
Colorectal Cancer
Interventions
Procedure: Surgical Resection
Radiation: Radiation therapy
Registration Number
NCT00280761
Lead Sponsor
UNC Lineberger Comprehensive Cancer Center
Brief Summary

RATIONALE: Studying samples of tumor tissue from patients with cancer in the laboratory may help doctors learn more about changes that occur in DNA and identify biomarkers related to cancer. It may also help doctors understand how patients respond to treatment.

PURPOSE: This clinical trial is studying biomarkers in patients with rectal cancer undergoing chemotherapy and radiation therapy.

Detailed Description

OBJECTIVES:

Primary

* Observe whether NF-kappa B is activated in response to treatment with external beam radiotherapy.

* Correlate NF-kappa B pathway activation (presumed to be anti-apoptotic in nature) with therapeutic outcomes (as measured by rate of pathologic complete response or downstaging by endoscopic ultrasound \[EUS\]).

Secondary

* Study downstream events induced by NF-kappa B activation.

* Determine global gene expression profiles at baseline and during chemoradiotherapy.

* Correlate changes in gene expression (compared with the baseline gene expression pattern) induced by a single dose of external beam radiotherapy with patient outcomes (as measured by pathologic response rate or downstaging by EUS).

* Study downstream events related to activation of p53 in response to treatment with radiotherapy.

* Correlate p53 pathway-mediated events with clinical outcomes.

OUTLINE: Patients receive fluorouracil or capecitabine and undergo radiotherapy and surgery per standard care.

Patients undergo tumor pinch biopsies at baseline and on days 1 and 2 of chemoradiotherapy. At the time of final surgical resection, a portion of the remaining rectal tumor will be liquid nitrogen banked. Patients not deemed surgical candidates are evaluated by transrectal ultrasound 6-8 weeks after completion of chemoradiotherapy to assess ultrasound response (downstaging versus no downstaging).

Tumor tissue samples are analyzed for NF-kappa B pathway activation; downstream events induced by NF-kappa B activation; changes in global gene expression; p53 function; apoptosis; and mRNA expression. Laboratory techniques used include tissue microarray, ELISA, RNase protection assay, fluorescence semi-quantitative PCR, TUNEL, IHC, and cDNA microarray analysis.

If normal tissue from biopsies is not available, whole blood may be collected at any point while patient remains on study for correlative analysis or research related to rectal cancer.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
47
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
1Surgical ResectionSingle Arm Trial
1Radiation therapySingle Arm Trial
15-fluorouracilSingle Arm Trial
1capecitabineSingle Arm Trial
Primary Outcome Measures
NameTimeMethod
Activation of NF-kappa B in response to treatment with external beam radiotherapy6-8 weeks after chemoradiation
Correlation of NF-kappa B pathway activation with therapeutic outcomes6-8 weeks after chemoradiation
Secondary Outcome Measures
NameTimeMethod
Downstream events induced by NF-kappa B activation12 months
Global gene expression profiles at baseline and during chemoradiotherapyprior to chemoradiation and 72 days post chemoradiation
Correlation of changes in gene expression with patient outcomes72 days post chemoradiation
Downstream events related to activation of p53 in response to treatment with radiotherapy72 post radiotherapy
Correlation of p53 pathway-mediated events with clinical outcomes72 days post chemoradiation

Trial Locations

Locations (1)

Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill

🇺🇸

Chapel Hill, North Carolina, United States

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