InteGRAtive Analysis of TuMor, Microenvironment, ImmunitY and Patient Expectation for Personalized Response Prediction in Gastric Cancer

Istituto Romagnolo per lo Studio dei Tumori Dino Amadori IRST S.r.l. IRCCS250 enrolled

Overview

Multicentric, exploratory, non-pharmacologic, retrospective/prospective, translational study aiming to identify the molecular, cellular and psychological-sociological variables predictive of response to chemotherapy in gastric cancer patients.

Gastric cancer (GC) is a complex disease that represents the fifth most common malignancy in the world and the third leading cause of cancer death in both sexes. Chemotherapy (CT) combined with surgery represents the standard of care for stages II-III GC, but the efficacy of such treatments is still limited for many patients. It is mandatory to develop novel strategies aimed at identifying predictive markers, as well as deciphering the impact of the psychological-social and cultural environment of each patient on the outcome. GRAMMY study proposes a novel interdisciplinary approach integrating high impact basic, translational and psychological/sociological research towards developing an optimized patient stratification tool for the early prediction of therapy-resistant GC patient groups.

Study Type

OBSERVATIONAL

Enrollment

250

Conditions

Gastric Cancer

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with diagnosis of histologically confirmed, potentially resectable adenocarcinoma of the stomach (GC) or the gastric-esophageal junction (GEJ) treated with the standard regimens (5-Fluoro-Uracil or Capecitabine + Oxaliplatin +/- Docetaxel) * Participant is willing and able to give informed consent for participation in the study (prospective and retrospective cohort) or Substitutive Informed Consent Declaration Form will be subscribed by the PI for patients that are not reachable * Male or Female, aged \>18 years * Availability of tissue samples and clinico-pathological data for retrospective cohort Exclusion Criteria: * Age \< 18 years * Early Gastric Cancer and T2 (if N0) * Linitis plastica * Positive peritoneal cytology or peritoneal involvement * Distant metastases * Patient refusal to participate * Patient refusal to the use of their own samples for research * Patient withdrawing from treatment plan whilst under therapy due to patient co-morbidities or failure to comply with clinical counselling * Patients with underlying pathologies rendering sampling of biological material either as endangering patient's clinical status or as unusable * Patients with mental illness hindering the capacity to provide precise information in questionnaires or successfully comply with caregiver's recommendations

Locations (5)

Centre Hospitalier Regional et Universitaire (CHRU)

Brest, France

NOT_YET_RECRUITING

INSERM, Faculty of Medicine (UMR1078)

Brest, France

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1st Department of Propaedeutic Surgery, National & Kapodistrian University of Athens (NKUA)

Athens, Greece

NOT_YET_RECRUITING

Outcomes

Primary Outcomes

Genomic alterations in tumoral tissue in responders and non-responders

Number of Genomic alterations in tumoral tissue

Time frame: 36 months

Quantitative and qualitative analysis of the tumor microenvironment composition in responders and non-responders

Analysis of type and size of immune cell subpopulations surrounding primary tumor and extracellular matrix composition on FFPE samples collected at diagnosis and/or surgery. Correlation of data acquired to Participant's response score (TRG or DFS).

Time frame: 36 months

Analysis of cell-free DNA (cfDNA) from blood samples in responders and non-responders

cfDNA will be quantified in Participant's peripheral blood derivatives (plasma, serum) and characterized for Genomic alterations. Samples will be obtained (1) prior to and (2) by completion of chemotherapy in the Neoadjuvant Chemotherapy (NCT) treated cohorts, together with sampling after surgery (3). TRG score will be utilized as measure of response. Accordingly, in NCT-naive cohorts, analysis of samples obtained 1) pre- operatively and 2) by completion of post-operative chemotherapy treatment will be correlated with the respective Disease-Progression clinical indicators.

Time frame: 36 months

Analysis of circulating tumor cells (CTC) from blood samples in responders and non-responders.

gene expression profile of CTC cells (when isolated in sufficient quantity)

Time frame: 36 months

Peripheral blood mononuclear cells (PBMCs) and host immunity parameters in responders and non-responders

Phenotype analysis of representative immune cell subpopulations (i.e. monocytes, helper T cells, cytotoxic T cells, Tregs, Natural Killer (NK) /NKT) in Participants' peripheral blood samples obtained prior- and post- treatment. Combinational analysis of data acquired in correlation with Patient's response score.

Time frame: 36 months