Biomarkers in Patients With Rectal Cancer Undergoing Chemotherapy and Radiation Therapy
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.
Procedure: Surgical Resection
Radiation: Radiation therapy
|Study Design:||Observational Model: Case-Only
Time Perspective: Prospective
|Official Title:||A Biologic Study of Global Gene Expression, NF-Kappa B and p53 in Adenocarcinoma of the Rectum.|
- 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 ]
- Downstream events induced by NF-kappa B activation [ Time Frame: 12 months ]
- Global gene expression profiles at baseline and during chemoradiotherapy [ Time Frame: prior to chemoradiation and 72 days post chemoradiation ]
- Correlation of changes in gene expression with patient outcomes [ Time Frame: 72 days post chemoradiation ]
- Downstream events related to activation of p53 in response to treatment with radiotherapy [ Time Frame: 72 post radiotherapy ]
- Correlation of p53 pathway-mediated events with clinical outcomes [ Time Frame: 72 days post chemoradiation ]
Biospecimen Retention: Samples With DNA
|Study Start Date:||December 2003|
|Estimated Study Completion Date:||December 2019|
|Estimated Primary Completion Date:||December 2018 (Final data collection date for primary outcome measure)|
Single Arm Trial
Capecitabine administration (where deemed appropriate by the treating medical oncologist) will commence on the second day of radiotherapy after the 24-hour biopsy has been performed. Dosing will be per current standard of care at the discretion of the treating Medical, Radiation and Surgical Oncologist
Other Name: XelodaDrug: 5-fluorouracil
Administration of 5-fluorouracil (where deemed appropriate by the treating medical oncologist) will commence on the second day of radiotherapy after the 24-hour biopsy has been performed. Dosing and dose modification will be per current standard of care at the discretion of the treating Medical, Radiation and Surgical Oncologist.
Other Name: 5-FUProcedure: Surgical Resection
Surgery will occur approximately 2-6 weeks after chemoradiation depending on clinical factors (i.e. resectability, presence or absence of metastatic disease).Radiation: Radiation therapy
Dosing and dose modification will be per current standard of care at the discretion of the treating Radiation Oncologist.
Other Name: EBRT - External Beam Radiation Therapy
- 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]).
- 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.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00280761
|Contact: Julie White, RNfirstname.lastname@example.org|
|United States, North Carolina|
|Lineberger Comprehensive Cancer Center at University of North Carolina - Chapel Hill||Recruiting|
|Chapel Hill, North Carolina, United States, 27599-7295|
|Contact: Bert O'Neil, MD 919-966-4432|
|Principal Investigator:||Cheryl Carlson, MD||UNC Lineberger Comprehensive Cancer Center|