A Biologic Study of Global Gene Expression, NF-Kappa B and p53 in Adenocarcinoma of the Rectum.
Overview
- Phase
- Not Applicable
- Intervention
- capecitabine
- Conditions
- Colorectal Cancer
- Sponsor
- UNC Lineberger Comprehensive Cancer Center
- Enrollment
- 47
- Locations
- 1
- Primary Endpoint
- Activation of NF-kappa B in response to treatment with external beam radiotherapy
- Status
- Completed
- Last Updated
- 3 years ago
Overview
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.
Investigators
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Arms & Interventions
1
Single Arm Trial
Intervention: capecitabine
1
Single Arm Trial
Intervention: 5-fluorouracil
1
Single Arm Trial
Intervention: Surgical Resection
1
Single Arm Trial
Intervention: Radiation therapy
Outcomes
Primary Outcomes
Activation of NF-kappa B in response to treatment with external beam radiotherapy
Time Frame: 6-8 weeks after chemoradiation
Correlation of NF-kappa B pathway activation with therapeutic outcomes
Time Frame: 6-8 weeks after chemoradiation
Secondary Outcomes
- Downstream events induced by NF-kappa B activation(12 months)
- Global gene expression profiles at baseline and during chemoradiotherapy(prior to chemoradiation and 72 days post chemoradiation)
- Correlation of changes in gene expression with patient outcomes(72 days post chemoradiation)
- Downstream events related to activation of p53 in response to treatment with radiotherapy(72 post radiotherapy)
- Correlation of p53 pathway-mediated events with clinical outcomes(72 days post chemoradiation)