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Recognition of Circulating Tumor DNA in Soft Tissue Sarcoma

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03896620
Recruitment Status : Recruiting
First Posted : April 1, 2019
Last Update Posted : January 22, 2021
Information provided by (Responsible Party):
Meena Bedi, Medical College of Wisconsin

Brief Summary:

A tissue biopsy is currently the only clinical test or procedure that is able to confirm the initial diagnosis of soft tissue or metastatic sarcoma and evaluate its progress during treatment. However, tissue biopsy collection can be challenging (depending on the location of the tumor), and this procedure poses physical risks to the patient. A tissue biopsy also needs to be recollected at various time points in order to assess if the patient is responding to treatment.

In this project, the investigator would like to collect blood samples in addition to the sample of the tumor that will be collected before treatment is started. The investigator would like to analyze both blood and tumor, in hopes of identifying new biomarkers of sarcoma that can help the study doctors better diagnose sarcoma for patients in the future without needing to collect a piece of their tumor.

A biomarker is something found in the blood, other body fluids, or tissues that can be used to measure the progress of disease, how a treatment is working, or its likelihood of being successful. In this project, the investigator would like to compare ctDNA from blood to the DNA in the tumor. ctDNA, or circulating tumor DNA, is DNA originating from the tumor that is present in the blood. It can be assessed by taking an additional sample of blood when it will be collected for normal laboratory tests. These biomarkers may also help the study doctors detect how a patient is responding to their treatment or help predict their response to future treatment.

Condition or disease Intervention/treatment
Sarcoma Device: Preoperative RT Device: Postoperative RT Drug: Chemotherapy Other: Surgery

Detailed Description:

In the proposed study, the investigators wish to prospectively collect blood samples from 25 patients with localized soft tissue sarcomas and 25 patients with metastatic sarcoma (schema III) at various time points outlined. The presence/absence, as well as the change of ctDNA in circulation, will then be measured after the therapies administered and correlated with overall survival, progression-free survival and local control.

The risks to the subjects enrolled on this study include the general risks of undergoing the standard procedures, such as blood draws, imaging, radiation therapy, chemotherapy and surgery, which will be discussed prior to the therapies and images each patient undergoes. The risks of the procedures are not risks of the study with exception to blood draws. There is also a risk of loss of confidentiality, but the data will be deidentified once acquired. Thus, this risk is minimal.

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Study Type : Observational
Estimated Enrollment : 50 participants
Observational Model: Other
Time Perspective: Other
Official Title: Recognition of Circulating Tumor DNA in Soft Tissue Sarcoma
Actual Study Start Date : June 18, 2019
Estimated Primary Completion Date : May 1, 2023
Estimated Study Completion Date : May 1, 2024

Resource links provided by the National Library of Medicine

Group/Cohort Intervention/treatment
Stage II-III Sarcomas undergoing preoperative radiation therapy (RT)
This group will have preoperative chemotherapy (if administered), preoperative radiation and surgery.
Device: Preoperative RT
Radiation delivered before surgery.

Drug: Chemotherapy
Physician's choice of chemotherapy.

Other: Surgery
Surgical excision of tumor.

Stage II-III Sarcomas undergoing postoperative RT
This group will have surgery, postoperative radiation, post operative chemotherapy (if administered).
Device: Postoperative RT
Radiation delivered after surgery.

Drug: Chemotherapy
Physician's choice of chemotherapy.

Other: Surgery
Surgical excision of tumor.

Stage IV Sarcomas
This group will only have chemotherapy.
Drug: Chemotherapy
Physician's choice of chemotherapy.

Primary Outcome Measures :
  1. ctDNA measure [ Time Frame: Reported at baseline, 4 weeks after first intervention, 4 weeks following radiation treatment, 4 weeks post third intervention, 1 year. ]
    Blood samples (10 mL each time) will be collected. ctDNA is measured in percentage: variant allele fraction percentage.

Secondary Outcome Measures :
  1. Overall survival. [ Time Frame: 2 Years ]
    This is defined as the number of months from study entry to death from any cause.

  2. Progression-free survival. [ Time Frame: 2 Years ]
    The number of months from study entry to disease progression or death from any cause.

Biospecimen Retention:   Samples With DNA
In this project, the investigator will do genetic testing on blood and tumor samples. Whole genome sequencing will be included as part of the genetic testing for this research. Genetic testing will be done because the study doctor would like to identify new biomarkers of sarcoma.

Information from the National Library of Medicine

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.

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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
Study Population
Patients with localized, stage II-III or stage IV histologically confirmed soft tissue sarcomas of the extremity, chest wall or retroperitoneal primaries will be eligible for this study. Stage IV patients may have had prior therapy but must obtain a biopsy within registration requirements for study enrollment.

Inclusion Criteria:

  • Have signed an Institutional Review Board (IRB)/Independent Ethics Committee (IEC)-approved informed consent form (ICF) prior to any study-specific evaluation.
  • Diagnosis of soft tissue sarcoma.
  • ≥ 18 years of age.
  • Planned biopsy obtained within four weeks after registration.
  • History and physical within eight weeks prior to registration.
  • For stage II-III patients, no prior therapy to primary site of sarcoma.
  • Computerized tomography (CT), positron emission tomography (PET) /CT or MR imaging of the affected primary site obtained in stage II-III or metastatic site in stage IV patients within eight weeks prior to registration.
  • CT chest or PET /CT acquired to assess distant disease within eight weeks prior to registration for stage II-III patients.
  • Karnofsky Performance Scale (KPS) 60 or above within four weeks prior to registration.
  • Documentation of stage within eight weeks prior to registration.
  • Biopsy of primary or metastatic disease site must be safe, feasible and in concordance with standard of care per the treating physician and/or radiologist.
  • Life expectancy ≥ 12 weeks.
  • For patients with stage IV sarcoma: clinically appropriate, standard, first or second line systemic therapy is planned.

Exclusion Criteria:

  • Pregnant women.
  • Patients with a history of metastatic disease from a primary other than sarcoma.
  • Patients who cannot undergo imaging as part of treatment planning or surveillance.

Information from the National Library of Medicine

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 identifier (NCT number): NCT03896620

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Contact: Medical College of Wisconsin Cancer Center Clinical Trials Office 414-805-8900

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United States, Wisconsin
Froedtert Hospital & the Medical College of Wisconsin Recruiting
Milwaukee, Wisconsin, United States, 53226
Contact: Meena Bedi, MD    414-805-4600   
Sponsors and Collaborators
Medical College of Wisconsin
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Principal Investigator: Meena Bedi Medical College of Wisconsin
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Responsible Party: Meena Bedi, Associate Professor, Medical College of Wisconsin Identifier: NCT03896620    
Other Study ID Numbers: PRO00034441
First Posted: April 1, 2019    Key Record Dates
Last Update Posted: January 22, 2021
Last Verified: January 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: Yes
Product Manufactured in and Exported from the U.S.: No
Keywords provided by Meena Bedi, Medical College of Wisconsin:
Additional relevant MeSH terms:
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Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type