IMPROVE-pT1: Accurate Allocation of Completion Resection in Early Colorectal Cancer
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ClinicalTrials.gov Identifier: NCT06040632 |
Recruitment Status :
Recruiting
First Posted : September 15, 2023
Last Update Posted : December 8, 2023
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After introducing a nationwide screening program for colorectal cancer (CRC) in Denmark, more cases of early-stage CRC are being detected. Cancers in the earliest stages are often removed locally, either during the diagnostic colonoscopy or through planned minimally invasive surgery.
This early detection of cancer, and thereby an improved prognosis, is a positive feature but has also introduced a new clinical dilemma. Is the patient fully cured by the local resection, or do they need further surgery? Whether further surgery is recommended at the Multi-Disciplinary Team (MDT) board meeting depends on the outcome of specific criteria from the histopathological assessment of the locally removed specimen.
The presence of these criteria does not, however, translate directly into the presence of residual disease - merely into a theoretically increased risk. In Denmark, after surgery, the fraction of cases with residual disease has been around 15% for many years. In the remaining 85% of cases, local removal alone was curative - and the surgery appears excessive.
Investigating blood samples for the presence of circulating tumor DNA (ctDNA) is a new and promising method for cancer detection. The method utilizes that cancer cells release ctDNA into the circulation. ctDNA detected in blood drawn from a patient a few days after local removal of a tumor indicates that residual disease is present and further treatment, such as surgery, is needed.
The purpose of this study is to investigate, whether analyses of ctDNA can correctly identify patients with residual disease after local removal of early CRC. If this identification proves accurate, many patients can be spared further surgery.
Condition or disease |
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Colorectal Cancer Colorectal Polyp Colorectal Cancer Stage I |
Study Type : | Observational |
Estimated Enrollment : | 67 participants |
Observational Model: | Cohort |
Time Perspective: | Prospective |
Official Title: | Accurate Allocation of Completion Resection in Early Colorectal Cancer: an Observational Cohort Study |
Actual Study Start Date : | September 1, 2022 |
Estimated Primary Completion Date : | December 2024 |
Estimated Study Completion Date : | July 2027 |
- ctDNA analysis [ Time Frame: After recruitment of the last patient, we expect that ctDNA analyses can be performed within 6 months ]Blood samples will be categorized as either ctDNA positive or negative
- Pathological evaluation of the resected specimen from the completion resection [ Time Frame: After recruitment of the last patient, these data will be available (expected in spring 2024) ]Evaluations will be used to group patients into residual and no residual disease after local resection
- 30- and 90-day mortality related to the completion resection [ Time Frame: These data will be extracted from the patient's medical records 3 months after surgery ]Mortality data for secondary outcomes
- Postoperative morbidities [ Time Frame: After recruitment of the last patient, these data will be extracted from the patient's medical records within 6 months ]Morbidity data for secondary outcomes
Biospecimen Retention: Samples With DNA
Blood samples will be drawn prior to and around 14 days after completion resection.
Blood draw: 80 mL - 7 x EDTA tubes, 1 x serum tube
Formalin-fixed paraffin-embedded (FFPE) tissue from the local treatment will be obtained from the relevant Pathological departments, for the purpose of extracting DNA for mutational analysis.
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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:
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Patients having undergone local resection of pT1 colorectal cancer and with planned completion resection, as recommended by the local MDT board
- The reason for the planning of completion resection may be non-micro radical tumor removal, piece-meal resection making assessment of resection margin impossible or the presence of one or more histological risk factors
Exclusion Criteria:
- Patients not able to understand information about the study and/or give informed consent
- Patients not accepting blood samples stored in biobank
- Cases with non-obtainable primary tumor tissue, required for the conduction of mutational analyses
- Other recent (within 5 years) or current malignant disease, except basocellular carcinoma of the skin
- Planned completion resection due to other factors, such as patient's wish or hereditary disposition for CRC, and with the absence of risk factors mentioned above
- Withdrawal of consent
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): NCT06040632
Contact: Claus L Andersen, PhD | +45 7845 5319 | cla@clin.au.dk | |
Contact: Mads F Klein, MD, PhD | mads.falk.klein@regionh.dk |
Denmark | |
Bispebjerg Hospital | Recruiting |
Copenhagen, Capital Region Of Denmark, Denmark, 2400 | |
Contact: Nis Hallundbæk Schlesinger Nis.Hallundbaek.Schlesinger@regionh.dk | |
Herlev Hospital | Recruiting |
Herlev, Capital Region Of Denmark, Denmark, 2730 | |
Contact: Mads F Klein, MD, Ph.D mads.falk.klein@regionh.dk | |
Contact: Jeppe Kildsig, MD Jeppe.Kildsig@regionh.dk | |
Aarhus University Hospital | Recruiting |
Aarhus, Central Denmark Region, Denmark, 8000 | |
Contact: Lene H Iversen, MD, DMSc lene.h.iversen@dadlnet.dk | |
Gødstrup Hospital | Recruiting |
Herning, Central Denmark Region, Denmark, 7400 | |
Contact: Claudia Jaensch, MD, PhD Claudia.Jaensch@goedstrup.rm.dk | |
Regional Hospital Horsens | Recruiting |
Horsens, Central Denmark Region, Denmark, 8700 | |
Contact: Kåre A Gotschalck, MD, Ph.D kaarsune@rm.dk | |
Regional Hospital Randers | Recruiting |
Randers, Central Denmark Region, Denmark, 8930 | |
Contact: Peter Bondeven, MD, PhD petefred@rm.dk | |
Regional Hospital Viborg | Recruiting |
Viborg, Central Denmark Region, Denmark, 8800 | |
Contact: Uffe S Løve, MD, PhD uffescho@rm.dk | |
Aalborg University Hospital | Recruiting |
Aalborg, North Denmark Region, Denmark, 9000 | |
Contact: Ole Thorlacius-Ussing, MD, PhD otu@rn.dk | |
Odense University Hospital | Recruiting |
Odense, The Region Of Southern Denmark, Denmark, 5000 | |
Contact: Per Vadgaard Andersen, MD, PhD Per.vadgaard.andersen@rsyd.dk |
Principal Investigator: | Mads F Klein, MD, PhD | Copenhagen University Hospital at Herlev | |
Principal Investigator: | Jeppe Kildsig, MD | Copenhagen University Hospital at Herlev | |
Principal Investigator: | Kåre A Gotschalck, MD, PhD | Regional Hospital Horsens | |
Principal Investigator: | Anne-Sofie Kannerup, MD, PhD | Regional Hospital Randers | |
Principal Investigator: | Lene H Iversen, MD, DMSc | Aarhus University Hospital |
Responsible Party: | University of Aarhus |
ClinicalTrials.gov Identifier: | NCT06040632 |
Other Study ID Numbers: |
IMPROVE-pT1 |
First Posted: | September 15, 2023 Key Record Dates |
Last Update Posted: | December 8, 2023 |
Last Verified: | August 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | Undecided |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Colorectal Neoplasms Intestinal Neoplasms Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Neoplasms |
Digestive System Diseases Gastrointestinal Diseases Colonic Diseases Intestinal Diseases Rectal Diseases |