In this proof-of-concept trial the investigators will study the effects of imatinib treatment on the biology of mesenchymal-type colon cancers.
Tumor biopsies from patients with newly diagnosed colon cancer will be pre-screened with an RT-qPCR test to identify tumors of the mesenchymal subtype. Patients with mesenchymal-type tumors that meet the in- and exclusion criteria will be treated with imatinib during the "window period" that normally precedes surgery. Immediately following tumor resection, biopsies will be taken from the surgical specimen. Gene and protein expression of the pre- and post-treatments biopsies will be compared to assess the effects of imatinib therapy on PDGFR- and cKIT-signalling and on the mesenchymal gene expression profile.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
5
Subjects will be treated with the medicinal product imatinib, which will be administered orally in tablets of 400mg, once per day, during two weeks prior to tumor resection.
Meander Medical Center
Amersfoort, Utrecht, Netherlands
Diakonessenhuis
Utrecht, Netherlands
University Medical Center Utrecht
Utrecht, Netherlands
Effects of treatment on the mesenchymal gene expression profile
To assess the extent of change in the mesenchymal phenotype, gene expression arrays will be generated from pre- and post-treatment tissue samples and the expression of genes associated with the poor-prognosis mesenchymal subtype will be compared.
Time frame: period from diagnostic colonoscopy until surgical resection (~5 weeks)
Extent of targeted inhibition of PDGFR and KIT phosphorylation in cancer cells
I. Measurement of PDGFR and cKIT inhibition by comparison of the fraction of autophosphorylated PDGFR and cKIT pre-treatment versus post-treatment, measured with ELISA on tissue samples derived from diagnostic biopsies and surgery.
Time frame: period from diagnostic colonoscopy until surgical resection (~5 weeks)
Correlation between plasma imatinib trough levels on day 14 and intratumoural concentration of imatinib in the resection specimen
Time frame: at time of surgery
Correlation between the extent of PDGFR and cKIT inhibition and systemic and intratumoural imatinib and CGP74588 concentration
Time frame: at time of surgery
Change in plasma CEA-concentrations
Time frame: period between diagnostic colonoscopy until surgical resection (~5 weeks)
Change in plasma levels of circulating tumor DNA
Time frame: period between diagnostic colonoscopy until surgical resection (~5 weeks)
Effects of imatinib on the ability of cancer cells to form in vitro 3D cell cultures (organoids)
V. The ability to establish organoids from imatinib-treated tumours will be compared with the general success rate of organoid formation from colon tumours at the Hubrecht Institute.
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Time frame: at time of surgery
Number of participants with treatment-related adverse events as assessed by CTCAEv4.02
The occurrence, frequency and severity of adverse events during preoperative treatment with imatinib, peroperatively or in the postoperative period (up to 14 days after tumour resection).
Time frame: from start of treatment until 2 weeks after last dose imatinib