Circulating and Urine Tumor DNA Dynamics Predict Minimal Residual Disease and Recurrence Risk in Locally Advanced Upper Tract Urothelial Carcinoma
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Adjuvant chemotherapy, adjuvant immunotherapy.
- Кому может быть актуально
- Состояния в реестре: Muscle Invasive Upper Tract Urothelial Carcinoma. Базовые параметры: от 18 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Китай
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Circulating and Urine Tumor DNA Dynamics Predict Minimal Residual Disease and Recurrence Risk in Locally Advanced Upper Tract Urothelial Carcinoma(CURATE-UTUC): A Multicenter Prospective Longitudinal Cohort Study
Обзор
In our study, the ultra-deep sequencing of circulating tumor DNA (ctDNA) and urine tumor DNA (utDNA) were performed to assess whether ctDNA and utDNA can be used as predictive biomarkers for the detection of minimal residual disease (MRD) and early diagnosis of UTUC recurrence, and explored the role of ctDNA and utDNA detection of MRD in the prediction of adjuvant therapy efficacy and prognostic evaluation.
Подробное описание
60% of Upper Urinary Tract Urothelial Carcinoma (UTUC) patients with muscle-invasive disease at diagnosis, which progresses rapidly, aggressively, and has a poor prognosis. Up to 30-40% of the patients may develop bladder recurrance after radical nephroureterectomy for primary upper tract urothelial carcinoma.
Minimal residual disease (MRD) refers to the small number of malignant cells that remain after curative treatments (curative intent surgical resection, radiotherapy, and/or chemotherapy). MRD is common in patients with blood cancer, and is known to be associated with recurrence and poor prognosis. Recent studies also reported that MRD-negative in postoperative solid tumors such as colorectal/colon cancer and muscle-invasive bladder cancer is associated with better survival outcomes. However, the clinical values of MRD monitoring for adjuvant therapy in postoperative UTUC remain inadequate.
A total of 84 patients with stage II-IV UTUC will be recruited in this clinical trial. The following plasma samples, urine samples and tumor tissues will be collected from each patient including T0 (preoperatively, 2\[1-3\] days before surgery), T1 (28±3 days postoperatively), T2 (within 7 days after cycle 2 adjuvant therapy), T3 (end-of-treatment), and quarterly/semi-annually during surveillance (T4-T6) until recurrence/24 months. In addition, demographic and tumor characteristics of the patients will be collected for subsequent analysis, including age, sex, tumor stage, pathological stage, disease couse time, etc. Tumor tissues and matched peripheral blood were collected before treatment and WES was used ctDNA detection techniques. For each patient, we selected up to 40 clonal somatic mutations for personalized, tumor informed ctDNA assay design.Statistical analyses will be performed to analyze the survival outcomes and to explore the clinical value of MRD monitoring for adjuvant therapy in postoperative UTUC.
Вмешательства
- Препарат Adjuvant chemotherapy
cisplatin/carboplatin-gemcitabine 4-6 cycles - Препарат adjuvant immunotherapy
immunotherapy for one year
Первичные конечные точки
- extravesical recurrence free survival [Срок оценки: 2 year]
Вторичные конечные точки (5)
- Lead time of molecular recurrence detection [Срок оценки: 2 year]
- intravesical recurrence free survival [Срок оценки: 2 year]
- recurrence-free survival [Срок оценки: 2 year]
- Overall survival [Срок оценки: 2 year]
- Diagnostic performance of MRD assay [Срок оценки: 2 year]
Критерии участия
Критерии включения
- pathological comfirmed T2-4 or N+ and M0 upper tract urothelial carcinoma
- Male or female aged ≥18 years old who are willing to sign the informed consent form
- have no distant metastasis
- have an ECOG 0 to 2
- upper tract urothelial carcinoma patients received radical nephroureterectomy
- have no multiple primary carcinoma
- received adjuvant chemotherapy or immunotherapy after surgery within 12 weeks
- ≥2 postoperative liquid biopsy assessments (T1 and T2)
Критерии исключения
- a prior history of bladder or synchronous bladder cancer
- Pregnant or lactating women, or patients who are fertile but do not take contraceptive measures;
- Severe infection;
- Severe heart disease;
- Uncontrollable neurological or mental disorders;
- Severe diabetes mellitus;
- Patients with severe autoimmune diseases.
- Neoadjuvant therapy exposure
- No bilateral UTUC
- Surveillance time < month
- <2 postoperative MRD surveillance assessments
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Модель наблюдения
- Когортное
Центры проведения
Китай · 1 центр
- Renji Hospital — Шанхай
Идентификаторы
NCT: NCT05595408 · CURATE-UTUC