A Study of the Role of Circulating Tumor DNA in Predicting the Likelihood of Organ Preservation After Clinical Complete Response to Neoadjuvant Therapy for Rectal Cancer
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| ClinicalTrials.gov Identifier: NCT03749083 |
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Recruitment Status :
Withdrawn
(Funding)
First Posted : November 21, 2018
Last Update Posted : July 8, 2019
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| Condition or disease | Intervention/treatment |
|---|---|
| Gastrointestinal Malignancies | Other: The Functional Assessment of Cancer Therapy- Colorectal |
| Study Type : | Observational |
| Actual Enrollment : | 0 participants |
| Observational Model: | Cohort |
| Time Perspective: | Prospective |
| Official Title: | A Study of the Role of Circulating Tumor DNA in Predicting the Likelihood of Organ Preservation After Clinical Complete Response to Neoadjuvant Therapy for Rectal Cancer |
| Estimated Study Start Date : | December 31, 2019 |
| Estimated Primary Completion Date : | October 31, 2021 |
| Estimated Study Completion Date : | October 31, 2024 |
| Group/Cohort | Intervention/treatment |
|---|---|
Tumor Sequencing
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Other: The Functional Assessment of Cancer Therapy- Colorectal
The Functional Assessment of Cancer Therapy- Colorectal (FACT-C) questionnaire measures health-related quality of life for people with chronic illnesses. |
- One year local recurrence rate in participants that test positive for ctDNA compared to participants that tested negative for ctDNA [ Time Frame: 1 year ]Local recurrence will be defined as recurrence of the pathologically confirmed adenocarcinoma. This may be detected by endoscopy for intraluminal recurrence or after radical surgery for radiographic evidence of extraluminal/mesorectal recurrence. The recurrence must be in the peri-anastomic site or rectal stump, or pre-sacral area. Regional nodal recurrence and lateral pelvic lymph node recurrence of rectal cancer are also included in this definition.
- Local recurrence rate at any time up to 5 years in patients who have achieved a clinical complete response after rectal cancer treatment but who test positive for circulating tumor DNA at study entry [ Time Frame: 5 years ]Local recurrence will be defined as recurrence of the pathologically confirmed adenocarcinoma. This may be detected by endoscopy for intraluminal recurrence or after radical surgery for radiographic evidence of extraluminal/mesorectal recurrence. The recurrence must be in the peri-anastomic site or rectal stump, or pre-sacral area. Regional nodal recurrence and lateral pelvic lymph node recurrence of rectal cancer are also included in this definition.
- Overall rate of local recurrence by stratified KRAS/BRAF status and possibly other gene targets [ Time Frame: 5 years ]Local recurrence will be defined as recurrence of the pathologically confirmed adenocarcinoma. This may be detected by endoscopy for intraluminal recurrence or after radical surgery for radiographic evidence of extraluminal/mesorectal recurrence. The recurrence must be in the peri-anastomic site or rectal stump, or pre-sacral area. Regional nodal recurrence and lateral pelvic lymph node recurrence of rectal cancer are also included in this definition.
- Median EORTC QLQ-CR29 Score [ Time Frame: Baseline, 6 months, 12 months, 24 months ]European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) for Colorectal cancer(CR) 29 item questionnaire. The survey will be given at baseline, 6, 12, and 24 months. Results will be reported as the median score for each question. A score of 1 represents 'Not at All' and 4 represents 'Very Much'.
- Median SF-12 Health Survey Score [ Time Frame: Baseline, 6 months, 12 months, 24 months ]The SF-12 is a 12 item validated questionnaire that assesses a participants view of their health. Scores will be normalized on a 100 point scale with higher scores representing better health.
- Median LARS Score [ Time Frame: Baseline, 6 months, 12 months, 24 months ]The Low Anterior Resection Syndrome (LARS) Score is used to assess bowel dysfunction. The survey is assessed on a scale of 0-42 points, with a higher score indicating worse bowel dysfunction.
- Median FIQOL Score [ Time Frame: Baseline, 6 months, 12 months, 24 months ]Fecal Incontinence Quality of Life (FIQOL) Score. Lower scores represent lower functional status.
- Median Fecal Incontinence Severity Index (FISI) score [ Time Frame: Baseline, 6 months, 12 months, 24 months ]The FISI measures incontinence for gas, mucus, liquid stool,and solid stool. The survey assesses the number of times per day that the participant experiences incontinence for gas, mucus, liquid stool,and solid stool. Higher scores represent a higher degree of fecal incontinence.
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Sampling Method: | Non-Probability Sample |
Inclusion Criteria:
- Participants must have achieved a clinical complete response (cCR) within 3 months of last therapy - defined as absence of residual ulceration, mass or mucosal irregularity at endoscopic assessment - following neoadjuvant therapy with chemoradiation or chemotherapy followed by radiation for stage I, II, or III non-metastatic rectal cancer. (Whitening of the mucosa with presence of telangiectasia will be accepted as cCR.)
- Participants must have original tumor tissue (formalin-fixed, paraffin-embedded specimens) available for analysis
- Participants must be 18 years of age or older.
- Participants must be able to understand and willing to sign a written informed consent document.
- Participants must have received long course chemoradiation to 40-54 Gy.
- Participants must have received at least 4 cycles of FOLFOX
- Participant must be no more than 3 months past the conclusion of initial chemoradiation of rectal cancer (i.e., end of chemoradiation).
Exclusion Criteria:
- Participants may not have any other organ cancer evident at the time of enrollment.
- Participants may not have any other concurrent serious illness that makes participation on this study impractical or clinically inappropriate.
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): NCT03749083
| United States, Massachusetts | |
| Massachusetts General Hospital Cancer Center | |
| Boston, Massachusetts, United States, 02214 | |
| Beth Israel Deaconess Medical Center | |
| Boston, Massachusetts, United States, 02215 | |
| Brigham and Women Hospital | |
| Boston, Massachusetts, United States, 02215 | |
| Newton-Wellesley Hospital | |
| Newton, Massachusetts, United States, 02459 | |
| Principal Investigator: | Theodore S Hong, MD | Massachusetts General Hospital |
| Responsible Party: | Theodore Sunki Hong, Principal Investigator, Massachusetts General Hospital |
| ClinicalTrials.gov Identifier: | NCT03749083 |
| Other Study ID Numbers: |
18-304 |
| First Posted: | November 21, 2018 Key Record Dates |
| Last Update Posted: | July 8, 2019 |
| Last Verified: | July 2019 |
| 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 |
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Gastrointestinal Malignancies |
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Neoplasms |

