Characterization & Comparison of Drugable Mutations in Primary and Metastatic Tumors, CTCs and cfDNA in MBCpatients (MIRROR)
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|ClinicalTrials.gov Identifier: NCT02626039|
Recruitment Status : Completed
First Posted : December 10, 2015
Last Update Posted : August 11, 2020
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Characterization of the driver mutations in an individual metastatic breast cancer patient is critical for many reasons. Effective targeted therapies require identifying genomic alterations in the tumoral tissue. The scarce efficacy of many currently available targeted drugs may be due to the outbreak of resistant clones with different genotype that already present at the initiation of therapy. It is well known the intra-tumor heterogeneity with genetic and non-genetic factors considered as the origin of the tumor cell-clon composition. The acquisition of multiple mutations (driver and passenger), altogether with the stage of differentiation, according to the cancer stem cell hypothesis, confers to the tumor cells clinically important properties, such as resistance to therapies and seeding abilities.
Moreover, there is a current challenge in establishing whether the metastatic cells arise from the most aggressive and dominant clone in the primary tumor or the metastasic tissue diverges with substantial genetic changes very early in the evolution of the disease. Primary and metastatic tumor may have a close clonal relationship or evolve in parallel and acquire different genomic alterations. In the real life, it is plausible that both models coexist with different predominance according to the tumoral tissue and etiology.
The study hypothesizes that breast cancer metastases and primary tumors could harbor different genomic profiles related to genomic regions of interest in a clinically relevant proportion of metastatic breast cancer patients.
Moreover, the genomic aberrations found in the metastatic breast cancer tissue could also be detected in CTCs and circulating free DNA.
If true, CTCs and circulating free DNA would be convenient, non-invasive, easily accessible sources of genomic material for the analysis of mutations and other genomic aberrations.
|Condition or disease|
|Metastatic Breast Cancer|
|Study Type :||Observational|
|Actual Enrollment :||40 participants|
|Official Title:||Characterization and Comparison of Drugable Mutations in Primary Tumors, Metastatic Tissue, Circulating Tumor Cells and Cell-Free Circulating DNA in Metastatic Breast Cancer Patients|
|Study Start Date :||November 2013|
|Actual Primary Completion Date :||July 2018|
|Actual Study Completion Date :||August 2018|
- Cohen's kappa coefficient to measure the inter-rater agreement for mutations and other genomic findings (categorical items) between the metastatic tissue and the primary tumor tissue in Metastatic Breast Cancer patients. [ Time Frame: 26 months ]
- Number of somatic genomic findings (found in the primary and metastatic tumor) in circulating tumoral cells (CTC) and circulating free DNA(cfDNA) obtained from peripheral blood (liquid biopsy). [ Time Frame: 26 months ]
- Description of the mutations in analyzed genes in the primary tumor and in CTC/cfDNA for each patient. [ Time Frame: 26 months ]Note: circulating tumor cells couldn't be sequenced
Biospecimen Retention: Samples With DNA
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|Ages Eligible for Study:||18 Years and older (Adult, Older Adult)|
|Sexes Eligible for Study:||Female|
|Accepts Healthy Volunteers:||No|
|Sampling Method:||Non-Probability Sample|
Women with metastatic breast cancer in which FFPE samples from the primary tumors are available and in whom a biopsy of the metastatic relapse is clinically indicated.
Investigators will offer enrollment to consecutively seen women who meet the entry criteria. Target enrollment is 40 patients
- Metastatic breast cancer confirmed by radiologic findings
- ≥ 18 years old
- Able to give signed consent
- Availability to get the paraffin block of her primary tumor.
- First metastatic relapse or tumor regrowth while on treatment for metastatic disease (progressive disease while on treatment)
- Biopsy of the metastatic site clinically indicated
- Inability to get a core sample from a metastatic site
- Bone disease only (the decalcification process usually prevents an appropriate genomic study).
- Unable to drawn peripheral blood
- Unable to give the informed consent
- Coagulation disorders
- ECOG status 3-4
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): NCT02626039
|Hospital General Universitario Gregorio Marañón|
|Madrid, Spain, 28007|
|Study Chair:||Miguel Martín, Ph||Hospital General Universitario Gregorio Marañon|
|Responsible Party:||Hospital General Universitario Gregorio Marañon|
|Other Study ID Numbers:||
|First Posted:||December 10, 2015 Key Record Dates|
|Last Update Posted:||August 11, 2020|
|Last Verified:||August 2020|
Metastatic Breast Cancer
Neoplasms by Site