Hepatocellular carcinoma (HCC) is the 4th most common cause of cancer death globally but only 20% are diagnosed in its early stages where curative treatment can be carried out. Current standard-of-care surveillance of patients at high risk of developing HCC with 6-monthly serum alpha-fetoprotein (AFP) and ultrasound imaging (US) has a sensitivity of approximately 63% for detecting early HCC. There is an urgent need for a more efficacious and convenient modality of surveillance of high-risk patients to diagnose HCC at an early stage. In another study (AHCC10 ELEGANCE, NCT04965259), 2,000 patients at risk of developing HCC will be enrolled to develop the 1st miRNA in-vitro diagnostic (IVD) kit for HCC that has higher accuracy and better ease of use compared with the extant combination of AFP and US. This prospective study will act as a positive control to the AHCC10 ELEGANCE Study and aims to address the absence of efficacious modalities of surveillance by validating a panel of circulating miRNA biomarkers signatures with histologically proven HCC. This study will determine progressive changes in the profiles of miRNA signatures pre- and post- surgical resection to identify signatures predictive of recurrence. Additionally, this study also aims to identify changes in key metabolites and microbiome with correlation to changes in choline, bile acid and tryptophan metabolic pathways with changes in the composition and function of gut microbiota to establish actionable biomarkers that can predict HCC recurrence.
This is a prospective study involving 100 patients with diagnosis of hepatocellular carcinoma (HCC) confirmed by histology at surgical resection. Eligible patients will receive CT scans at 6 months and 12 months post-surgery to monitor for recurrence. Pre- and post-surgery bio-samples (blood, urine, stool) will also be collected to monitor changes in profiles of miRNA, metabolome and microbiome.
Study Type
OBSERVATIONAL
Enrollment
101
National University Hospital
Singapore, Singapore
National Cancer Centre Singapore
Singapore, Singapore
Singapore General Hospital
Singapore, Singapore
Tan Tock Seng Hospital
Singapore, Singapore
Changi General Hospital
Singapore, Singapore
Sengkang General Hospital
Singapore, Singapore
miRNA biomarker signatures diagnostic for HCC or for recurrence prediction.
Changes in the profile of circulating micro-RNA biomarkers pre- and post- surgical resection.
Time frame: Baseline and every 6 monthly thereafter, up to 12 months.
Gut microbiome profiling for recurrence prediction.
Differences in the profile of gut microbiota among HCC and healthy population retrieved from database.
Time frame: Baseline and every 6 monthly thereafter, up to 12 months.
Metabolome profiling for recurrence prediction.
Changes in the profile of metabolome in urine and plasma pre- and post- surgical resection.
Time frame: Baseline and every 6 monthly thereafter, up to 12 months.
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