The goal of this clinical trial is to investigate if plasma ctDNA and eccDNA before resection for suspicion of pancreatic ductal adenocarcinoma (PDAC) can predict early recurrence and overall survival, and to investigate if plasma ctDNA combined with CT scan and endoscopic ultrasound surveillance increases the median overall survival compared with standard-of-care surveillance.
The aim of the CIRCPAC study is to evaluate if plasma ctDNA from patients scheduled for surgical resection of PDAC can identify patients who will benefit from surgery and if plasma ctDNA can identify recurrence earlier and improve the survival and quality of life of the patients compared with standard-of-care surveillance. Patients operated for PDAC will be included in this Danish multicenter study including an observational study (Sub-study 1: 700 patients) and an interventional randomized trial (Sub-study 2: 410 patients). In Sub-study 1, patients will have blood samples drawn prior to surgery, 4 weeks after surgery, and 6 months after surgery. In Sub-study 2, patients without recurrence 4 months after surgery, will be randomized in a 1:1 manor to an experimental arm (arm A) with ctDNA guided surveillance, or to a control arm (B) with standard surveillance.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
1,000
ctDNA guided surveillance
Aalborg Universitetshospital
Aalborg, Denmark
RECRUITINGAarhus Universitetshospital
Aarhus, Denmark
RECRUITINGCopenhagen University Hospital - Rigshospitalet
Copenhagen, Denmark
RECRUITINGSub-study 1 ctDNA
Preoperative plasma ctDNA levels before PDAC resection predicting early recurrence.
Time frame: 36 months
Sub-study 1 eccDNA
Preoperative plasma eccDNA levels before PDAC resection predicting early recurrence.
Time frame: 36 months
Sub-study 2 ctDNA DFS
Number of patients with recurrence assessed by ctDNA
Time frame: 3 years from surgery for PDAC
Sub-study 2 ctDNA OS
Overall survival of patients in arm A compared with patients in Arm B
Time frame: 3 years from surgery for PDAC
Sub-study 2 eccDNA
Number of patients with recurrence assessed by eccDNA
Time frame: 3 years from surgery for PDAC
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Copenhagen University Hospital - Herlev and Gentofte
Herlev, Denmark
RECRUITINGOdense Universitetshospital
Odense, Denmark
RECRUITING