Feasibility Study of Multi-Platform Profiling of Resected Biliary Tract Cancer
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ClinicalTrials.gov Identifier: NCT04561453 |
Recruitment Status :
Recruiting
First Posted : September 23, 2020
Last Update Posted : February 20, 2024
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Condition or disease | Intervention/treatment |
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Biliary Tract Cancer Cholangiocarcinoma Gallbladder Cancer Intrahepatic Cholangiocarcinoma Perihilar Cholangiocarcinoma Extrahepatic Cholangiocarcinoma Hilar Cholangiocarcinoma Distal Bile Duct Cancer | Diagnostic Test: Multi-Platform Profiling with Organoid Drug Sensitivity Screening and ctDNA Monitoring |
Study Type : | Observational |
Estimated Enrollment : | 20 participants |
Observational Model: | Case-Only |
Time Perspective: | Prospective |
Official Title: | A Prospective Feasibility Study of Multi-Platform Profiling Using Biospecimens From Patients With Resected Biliary Tract Cancer |
Actual Study Start Date : | July 8, 2020 |
Estimated Primary Completion Date : | July 31, 2024 |
Estimated Study Completion Date : | July 1, 2025 |
Group/Cohort | Intervention/treatment |
---|---|
Resected Biliary Duct Cancer |
Diagnostic Test: Multi-Platform Profiling with Organoid Drug Sensitivity Screening and ctDNA Monitoring
All patients in the study will have organoid creation and organoid drug sensitivity screening attempted on their fresh tumor tissue from surgical resection. All patients will also have blood taken pre-operatively and at multiple post-operative time points to monitor circulating tumor DNA. |
- Success Rate of Organoid Culture and Drug Screen [ Time Frame: Within 12 weeks after surgery ]The investigators will measure the percentage of patients for whom organoids are able to be successfully cultured and subjected to a drug screen.
- Success Rate of Obtaining circulating tumor DNA (ctDNA) quantification and Ability to assess change in ctDNA levels across those time points [ Time Frame: Through study completion, an average of 4 years. ]The investigators will measure the percentage of patients for whom ctDNA was able to be collected and quantified at multiple key time points across the course of a patient's treatment.
- Physician-Adjudicated Utility of Profiling Test Results - Post-Adjuvant Therapy [ Time Frame: At the time of completion of adjuvant therapy, on average 6 months after surgery. ]Through surveys, the investigators will ask cancer physicians how helpful the profiling test results are anticipated to be to the ultimate management of the patient after they have received adjuvant chemotherapy.
- Prospective Concordance of Organoid Drug Screen Results and In Vivo Drug Activity [ Time Frame: Through study completion, an average of 4 years. ]For patients that are treated with drugs that were also evaluated by the initial organoid drug screen, the investigators will measure how often the organoid's response to the drug paralleled the response of the cancer to the drug when administered to the patient.
- Predictive Value of circulating tumor DNA (ctDNA) for Recurrence [ Time Frame: From date of randomization until the date of first documented radiographic recurrence, an average of 2 years after surgery. ]The investigators will evaluate how often measurable post-operative ctDNA levels were able to predict ultimate recurrence of clinical disease. The investigators will measure the lead time of ctDNA-assessed recurrence over radiographic recurrence.
- Concordance of Organoid Drug Screen Results with Next Generation Sequencing (NGS)-Predicted Drug Sensitivities [ Time Frame: Within 12 weeks after surgery when results of NGS and Organoid Drug Screen have returned. ]The investigators will evaluate how often the organoid drug screen responded to a drug that genomic profiling by NGS would have predicted the cancer would be sensitive to.
- Physician-Adjudicated Utility of Profiling Test Results - At Time of Recurrence [ Time Frame: At the time of cancer recurrence, on average 24 months after surgery. ]Through surveys, the investigators will ask cancer physicians how helpful the profiling test results were to the ultimate management of the patient at the time their cancer recurred.
- Predictive Value of circulating tumor DNA (ctDNA) for Response to Medical Therapy [ Time Frame: Through study completion, an average of 4 years. ]The investigators will correlate ctDNA level trends with radiographic responses to medical treatments.
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
Subjects must meet all of the following criteria to be enrolled in the study:
- Be ≥18 years of age.
- Have a preoperative biopsy with a histopathological diagnosis consistent with a biliary tract cancer (intrahepatic or extrahepatic cholangiocarcinoma or gallbladder carcinoma) or, absent a biopsy, have a clinical presentation consistent with a biliary tract cancer, and are eligible for curative resection
- Surgical candidate for the requisite resection as assessed by a liver surgeon or as assessed by, if deemed necessary, a pre-operative evaluation by internal medicine, cardiology and/or anesthesia.
- Pre-operative imaging showing a measurable amount of disease that, per the judgement of the surgical oncologist, will be enough to allocate to at least genomic profiling as well as the organoid creation portion of this research study.
- Be willing to undergo surgical resection and willing to have the surgery performed at University of Washington.
- Be willing to follow-up with medical oncology post-operatively and allow the study team to collect longitudinal data on their course as well as longitudinal blood samples for circulating tumor DNA surveillance
- Have an ECOG performance status of 0-2.
- Have an expected survival of ≥6 months.
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Have adequate bone marrow function as evidenced by:
- Absolute neutrophil count ≥1,000/mm3 or 1.0 ×10^9/L
- Hemoglobin ≥8 g/dL
- Platelets ≥60,000/mm3 or 60 × 10^9/L
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Have adequate hepatic function as evidenced by the below, or are expected to have adequate hepatic function (as defined below) post-operatively:
- Serum total bilirubin ≤2 × upper limit of normal (ULN), unless considered due to Gilbert's disease or a biliary obstruction
- Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤8 × ULN
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Have adequate renal function as evidenced by the below or are expected to have adequate renal function (as defined below) post-operatively:
a. Serum creatinine <1.5 × ULN OR b. Creatinine clearance ≥50 mL/min based on the Cockcroft-Gault glomerular filtration rate (GFR) estimation: (140 - Age) x (weight in kg) x (0.85 if female)/72 x sCr
- Be able to understand and willing to sign the informed consent form and to comply with scheduled visits, treatment plans, procedures, and laboratory tests, including serial peripheral blood sampling, during the study.
Exclusion Criteria:
Subjects who meet any of the following criteria will not be enrolled in the study:
- Mixed hepatocellular carcinoma-cholangiocarcinoma on histology.
- Refuses to sign the consent.
- Received any prior systemic targeted therapy (excludes chemotherapy) or an investigational agent directed at their presumed cholangiocarcinoma prior to resection
- Received any prior radiation or catheter-directed therapy to the malignant tumor being resected, unless there has been definitive malignant progression of that tumor since the time of the post-treatment imaging assessment after radiation or catheter-directed therapy.
- Received any systemic anticancer therapy or an investigational agent for another indication (a synchronous cancer of a different primary site) in the 6 months prior to discovery of their presumed cholangiocarcinoma by imaging
- Have known extrahepatic metastases or locally advanced disease precluding resection of the cholangiocarcinoma.
- Have a history of another primary cancer, with the exception of: a) curatively resected non-melanoma skin cancer; b) curatively treated cervical carcinoma in situ; or c) other primary solid or liquid tumor with no known active disease present that, in the opinion of the Investigator, will not affect subject outcome in the setting of current cholangiocarcinoma diagnosis.
- Are pregnant or breastfeeding
- Have any other acute or chronic medical or psychiatric condition, including recent (within 12 months of cholangiocarcinoma diagnosis) or active suicidal ideation or behavior, or a laboratory abnormality that may increase the risk associated with study participation or may interfere with the interpretation of study results and, in the judgment of the Investigator, would make the subject inappropriate for entry into this study.
- Have been committed to an institution by virtue of an order issued either by the judicial or administrative authorities.
- Are dependent on the Sponsor, Investigator, or study site, per local institution regulations.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04561453
Contact: Gentry King, MD | 206 606 2494 | gentryk@uw.edu |
United States, Illinois | |
University of Illinois at Chicago | Not yet recruiting |
Chicago, Illinois, United States, 60612 | |
Principal Investigator: Shikha Jain, MD | |
United States, Washington | |
University of Washington | Recruiting |
Seattle, Washington, United States, 98195 | |
Contact: Gentry King, MD 206-606-2494 gentryk@uw.edu | |
Principal Investigator: Gentry King, MD |
Principal Investigator: | Gentry King, MD | University of Washington Seattle Cancer Care Alliance |
Responsible Party: | University of Washington |
ClinicalTrials.gov Identifier: | NCT04561453 |
Other Study ID Numbers: |
RG1121019 STUDY00010051 ( Other Identifier: Fred Hutch/University of Washington Cancer Consortium ) |
First Posted: | September 23, 2020 Key Record Dates |
Last Update Posted: | February 20, 2024 |
Last Verified: | February 2024 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
organoid circulating tumor DNA ctDNA |
drug screen profiling feasibility |
Cholangiocarcinoma Biliary Tract Neoplasms Gallbladder Neoplasms Bile Duct Neoplasms Klatskin Tumor Adenocarcinoma Carcinoma Neoplasms, Glandular and Epithelial |
Neoplasms by Histologic Type Neoplasms Digestive System Neoplasms Neoplasms by Site Biliary Tract Diseases Digestive System Diseases Gallbladder Diseases Bile Duct Diseases |