French Assessment of Minimal Residual Disease by Liquid Biopsies in Stage III Colorectal Patients
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 70
- 试验地点
- 2
- 主要终点
- 3-year disease-free survival (DFS)
研究概览
简要总结
Improving personalized cancer treatments and finding the best strategies to treat each patient relies on using new diagnostic technologies. Currently, for colorectal cancer, the methods used to decide who gets additional post-surgery treatment are suboptimal. Some patients get too much treatment, while others do not get enough.
There is a new way to explore if there is any cancer left in a patient's body using circulating tumor DNA (ctDNA) detected in blood samples. This can help decide who needs more treatment after surgery. Even though many tests have been developed, it has yet to be determined which test performs best at relevant time points.
The GUIDE.MRD consortium is a group of experts, including scientists, technology, and pharmaceutical companies. The consortium is working on creating a reliable standard for the ctDNA tests, validating their clinical utility, and collecting data to help decide on the best treatment for each patient.
FRENCH-MRD-CRC is the French study of the european GUIDE.MRD project.
详细描述
FRENCH.MRD.CRC is a part of WP3 of the overarching GUIDE.MRD project. Each study chair has a local clinical trial protocol where patients are recruited. After the end of recruitment, samples will be analyzed under the GUIDE.MRD consortium.
The overall aim of GUIDE.MRD is to investigate the clinical utility of ctDNA analysis to predict and guide the choice of multi-modal therapies prospectively. The fundamental steps towards this aim are assessment and benchmarking of the many available ctDNA diagnostics to identify the best-suited tests for clinical application. Clinical samples will be used to benchmark ctDNA diagnostics and assess their true clinical performance. The samples should reflect clinical situations where the ctDNA diagnostics are particularly useful, such as post-operatively, post-adjuvant, during chemotherapy, and longitudinally during post-treatment surveillance. In these situations, ctDNA diagnostics could be used to either monitor treatment response (in case of MRD after surgery) or to identify relapse at an early time point. Based on ctDNA information, medical treatment could be changed, or radiology could be used to reveal the location of residual disease.
The rationale for the observational clinical study FRENCH.MRD.CRC is to prospectively collect the clinical samples needed to enable assessment of the performance of ctDNA diagnostics in the setting of colorectal cancer (CRC). There are two main scenarios where ctDNA diagnostic is useful in CRC:
Stage III CRC (locally advanced, non-metastasized disease): This patient group is particularly relevant because adjuvant therapy is recommended for all stage III patients, due to their high recurrence risk, ~25%. Nevertheless, most patients do not recur, and most of these do not need therapy at all, because they were already cured by surgery alone, which leads to substantial overtreatment. Furthermore, the 25% of patients who recur despite both surgery and adjuvant therapy, probably could benefit from further multimodal therapies. The challenge is, however, that currently there is no marker in clinical use that can identify those patients with residual disease and need for therapy. Circulating tumor DNA is potentially such a marker. However, currently, it is unknown, which, if any, of the many different ctDNA diagnostics developed in recent years have the required performance to provide clinical utility in the management of stage III CRC. This clinical dilemma will be addressed with the first cohort of GUIDE.MRD-01-CRC.
The FRENCH.MRD.CRC study is logistically divided into two parts, and patients are offered participation in each part separately. The parts are called "FRENCH.MRD.CRC part 1 - SURGERY", and "FRENCH.MRD.CRC part 2 - SURVEILLANCE".
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •FRENCH.MRD.CRC PART I Inclusion criteria
- •Colon or rectal cancer, clinical tumor stage I-III.
- •Patient 18 years or older.
- •Scheduled for curative intent resection surgery (including "compromised" curative resections).
排除标准
- •Hereditary colorectal cancer linked to familial colonic polyposis or Lynch syndrome.
- •Verified distant metastases.
- •Malignant colorectal polyps diagnosed after polypectomy.
- •Patients who are unlikely to comply with the protocol (e.g. uncooperative attitude), inability to return for subsequent visits) and/or otherwise considered by the Investigator to be unlikely to complete the study.
- •Pregnant or nursing woman, or in childbearing age and not willing to use contraception
- •Protected and vulnerable adult
- •Not covered by Health insurance
- •Patient unable to understand and sign written informed consent.
- •FRENCH.MRD.CRC PART II Inclusion criteria
- •Participation in FRENCH.MRD.CRC part 1 - SURGERY
- •Colorectal cancer, UICC stage III
- •Has received curative-intent resection and is a candidate for adjuvant chemotherapy (3- or 6-months regime) Exclusion criteria
- •Inflammatory bowel disease (Crohn's disease or ulcerative colitis) related colon cancer
- •Not treated with adjuvant chemotherapy despite indication (incomplete treatment not included)
- •Treated with neoadjuvant chemo-radiation therapy
- •Synchronous colorectal and non-colorectal cancer diagnosed per operative (except skin cancer other than melanoma)
- •Other cancers (excluding colorectal cancer or skin cancer other than melanoma) within 3 years from eligibility screening
- •Patients who are unlikely to comply with the protocol (e.g. uncooperative attitude), inability to return for subsequent visits) and/or otherwise considered by the Investigator to be unlikely to complete the study
研究组 & 干预措施
Stage III colorectal cancer patients
MRD assessment by ctDNA analysis Patients will be managed according to current standard-of-care
干预措施: Blood sample/lliquid biopsy (Biological)
结局指标
主要结局
3-year disease-free survival (DFS)
时间窗: 3 years after end of recruitment
Disease-free survival was defined as the time between the date of the baseline blood sampling/inclusion\] and the date of the first event among or recurrence or death from any cause.
次要结局
- Sensitivity (Se) of the ctDNA diagnostics(3 years after end of recruitment)
- Positive predictive value of the ctDNA diagnostics(3 years after end of recruitment)
- Time to clinical recurrence(3 years after end of recruitment)
- Specificity (Sp) of the ctDNA diagnostics(3 years after end of recruitment)
- Negative predictive value of the ctDNA diagnostics(3 years after end of recruitment)
- Area under the curve of the ctDNA diagnostics(3 years after end of recruitment)
- Overall survival(3 years after end of recruitment)
- Time to molecular recurrence(3 years after end of recruitment)