Role of Circulating Tumour DNA Testing in Assessing for Alterations of Primary Anti-EGFR Resistance in RAS/RAF Wild-type Metastatic Colorectal Cancer Patients

National University Hospital, Singapore40 enrolled

Overview

The study aims to explore the clinical utility of circulating tumour DNA (ctDNA) in assessing for alterations of anti-epidermal growth factor receptor (EGFR) primary resistance in RAS and BRAF wild-type metastatic colorectal cancer (CRC) patients treated with anti-EGFR monoclonal antibodies (cetuximab / panitumumab) in combination with fluorouracil (FU)-doublet chemotherapy.

A single blood sample (20mL) will be collected after the patient has given informed consent. The blood sample will be collected within 4 weeks prior to the patient starting chemotherapy. Blood samples collected will be processed in accordance with the Guardant360 Clinical Blood Collection Kit instructions (Guardant Health, Inc.). Patient outcomes with respect to response rate, progression-free survival, overall survival, toxicities and other co-morbid conditions will be ascertained by medical record review conducted by the study personnel. Prospective clinical data that will be collected include: patient demographics, tumor stage and pathological tumor characteristics at diagnosis, laboratory data at diagnosis and serial pre-specified time points, imaging outcomes, chemotherapy information, date of recurrence, and date and cause of death. Although the data will be censored at the study end-points, the patient's medical record will be reviewed indefinitely to follow the health outcomes.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Colorectal Cancer

Eligibility

Sex: ALLMin age: 21 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with newly diagnosed stage IV colon or rectal cancer who are RAS/BRAF wild-type by routine tumor profiling and who are beginning standard-of-care treatment with fluorouracil-based doublet chemotherapy in combination with anti-EGFR monoclonal antibodies. Prior treatment with adjuvant therapy is allowed if completed more than 6 months prior to relapse of disease. Exclusion Criteria: * Pregnant women will be excluded from the study. * Patient unable to give informed consent will be excluded from the study. * Patients who have previously received chemotherapy in the metastatic setting. * Patients who have previously received adjuvant chemotherapy less than 6 months prior to relapse of metastatic disease.

Locations (1)

National University Hospital

Singapore, Singapore

RECRUITING

Outcomes

Primary Outcomes

Detection rate of alterations of anti-epidermal growth factor receptor primary resistance using Circulating tumour DNA

ctDNA analysis will be carried out using Guardant360 platform to identify subgroup of patients who have primary resistance to anti-EGFR therapy.

Time frame: One timepoint, within 4 weeks prior to starting of anti-EGFR therapy

Secondary Outcomes

Response rate

Response rate to treatment received as per standard care.

Time frame: 1 year 6 months

Progression-free survival

The time from commencement of cancer treatment to disease progression or death from any cause.

Time frame: 1 year 6 months

Overall survival

The length of time from start of treatment to death.

Time frame: 1 year 6 months

Adverse reactions experience by patient

Toxicities in patients who have primary resistance to anti-EGFR therapy will be collected and analysed.

Time frame: 1 year 6 months

Central Contacts

Cheng Ean Chee

CONTACT

+65 6779 5555 cheng_ean_chee@nuhs.edu.sg

Cheng Ean Chee

CONTACT

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.