Study on the Relationship Between Plasma MRD and cfDNA HPV and the Efficacy and Prognosis of Locally Advanced Cervical Cancer After Concurrent Chemoradiotherapy

July 14, 2023 updated by: Guizhou Provincial People's Hospital
Cervical cancer CC is the most common malignant tumor in the female reproductive system, seriously endangering women's health and life, and is one of the leading causes of death for women worldwide.Globally, HPV causes about 85% of cervical cancers and about 60% of oropharyngeal cancers, causing more than 500,000 cancers each year.ctDNA is a potential biomarker because it contains tumor-specific genetic and epigenetic abnormalities that can be used in cancer diagnosis and prognosis prediction.MRD is considered a promising prognostic marker that can be used to identify individuals at increased risk of recurrence and individuals who may benefit from treatment.The expression level of MRD and plasma HPV before and after radiotherapy and chemotherapy for cervical cancer was analyzed by liquid biopsy ctDNA detection technology, which predicted the efficacy of cervical cancer radiotherapy and chemotherapy, which was helpful for monitoring and estimating the risk of disease recurrence after cervical cancer radiotherapy and chemotherapy, and verified the expression of MRD and plasma HPV as the basis for adjuvant chemotherapy after cervical cancer radiotherapy and the basis for optimal chemotherapy time node selection.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

Current treatments for cervical cancer include surgery, radiotherapy, chemotherapy, and immunotherapy. However,5 year survival remains unsatisfactory because most patients with cervical cancer are typically diagnosed locally advanced or have distant lymph node metastases.HPV can integrate its own genome into the host genome by disrupting the open reading frame of the E2 gene and increase the expression of the E6 and E7 genes. The p53 protein of the host cell is degraded by the production of the E6 virulent protein, which inactivates the pRb protein that controls the cell cycle, thereby cancerizing the entire host cell [6]. According to TCGA 2017 data, HPV integration into the host genome was found in more than 80% of HPV-positive cervical cancer patients. Han K et al. found that HPV testing can assess the prognosis of cervical cancer patients.Circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), circulating tumor RNA (ctRNA), exosomes, proteins, and metabolites that are liquid biopsy analytes can be identified using biomarkers such as somatic point mutations, deletions, amplification, gene fusion, DNA methylation markers, miRNAs, proteins, or metabolites.Minimal tumor residual (MRD) refers to the residual tumor cells or biomarkers in the body after local or systemic cancer treatment, the activation of which can promote tumor metastasis and recurrence, also known as minimal residual disease, measurable residual disease, and molecular residual disease.Recently, the use of ctDNA analysis to determine MRD in solid tumors after intention-to-treat treatment and before clinical or radiological disease recurrence has shown significant therapeutic promise. In addition, MRD identification by ctDNA analysis correlates with poor prognosis in patients with malignant tumors.This project will use liquid biopsy ctDNA detection technology to analyze the expression level of MRD and plasma HPV before and after radiotherapy and chemotherapy for cervical cancer, predict the efficacy of radiotherapy and chemotherapy for cervical cancer, help monitor and estimate the risk of disease recurrence after radiotherapy and chemotherapy for cervical cancer, verify the expression of MRD and plasma HPV as the basis for adjuvant chemotherapy after radiotherapy and chemotherapy for cervical cancer and the basis for the selection of the optimal chemotherapy time, so as to provide clinically useful tumor markers for cervical cancer patients and reduce the mortality rate of cervical cancer.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Observational

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Locations

  • China
    • Guizhou
      • Guiyang, Guizhou, China

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Diagnosed cervical cancer patients who initially visited Guizhou Provincial People's Hospital from November 2022 to November 2024

Description

Inclusion criteria

  • Age: ≥ 18 years old, ≤ 75 years old.
  • Pathological histologic confirmation of cervical cancer.
  • Imaging or PET/CT examination can be performed to understand the tumor and complete all follow-up.
  • Measurable lesions before treatment.
  • Good physical condition: ECOG score 0-1 (or KPS score 70-100).
  • Estimated survival≥ 6 months.
  • The baseline blood routine and biochemical indexes before radiotherapy and chemotherapy met the following standards: hemoglobin ≥ 80g/L, absolute neutrophil count (ANC) ≥ 1.5×109/L, platelet ≥ 100×109/L, ALT, AST ≤ 2.5 times the normal upper limit; Serum albumin ≥ 30 g/L.
  • There are three preoperative items: if the patient has syphilis, plum repellent therapy is required before treatment.
  • The patient has no history of allergy to rubber products.
  • Cardiopulmonary function is basically normal

Exclusion Criteria:

  • Those who are allergic to rubber products.
  • Those with severe acute infection and uncontrolled or purulent and chronic infection wounds that do not heal, chronic hepatitis B active stage, active tuberculosis, syphilis outbreak and AIDS.
  • Patients with pre-existing severe heart disease, including: congestive heart failure, uncontrollable high-risk arrhythmia, unstable angina, myocardial infarction, severe valvular heart disease, and intractable hypertension.
  • Those with neurological or psychiatric diseases or mental disorders that are not easy to control, poor compliance, unable to cooperate with and describe treatment responses, uncontrolled primary brain tumors or central nervous system metastases, and those with obvious cranial hypertension signs or neuropsychiatric symptoms.
  • with malignant serous effusion.
  • History of severe enteritis and cystitis, bleeding, intestinal perforation, rectovaginal fistula, rectoval bladder fistula, etc.
  • Those who have participated in other clinical trials.
  • Other situations in which the investigator believes that the subject is not suitable to participate in this experiment

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Expression levels of MRD
Time Frame: Before chemoradiotherapy
Blood collected by patients prior to concurrent chemoradiotherapy were tested to observe the expression levels of MRD
Before chemoradiotherapy
Positive expression of plasma HPV
Time Frame: Before chemoradiotherapy
Tissue samplescollected by patients prior to concurrent chemoradiotherapy were tested to observe the positive expression of plasma HPV
Before chemoradiotherapy
Expression levels of MRD
Time Frame: During concurrent chemoradiotherapy, up to 6 weeks
Blood collected in concurrent chemoradiotherapy were examined to observe the expression levels of MRD
During concurrent chemoradiotherapy, up to 6 weeks
Positive expression of plasma HPV
Time Frame: During concurrent chemoradiotherapy,up to 6 weeks
Tissue samples collected in concurrent chemoradiotherapy were examined to observe the positive expression of plasma HPV
During concurrent chemoradiotherapy,up to 6 weeks
Expression levels of MRD
Time Frame: 4 weeks after the end of concurrent chemoradiotherapy
Blood collected 4 weeks after the end of concurrent chemoradiotherapy were tested to observe the expression levels of MRD
4 weeks after the end of concurrent chemoradiotherapy
Positive expression of plasma HPV
Time Frame: 4 weeks after the end of concurrent chemoradiotherapy
Tissue samples collected 4 weeks after the end of concurrent chemoradiotherapy were tested to observe the positive expression of plasma HPV
4 weeks after the end of concurrent chemoradiotherapy
Expression levels of MRD
Time Frame: 12 weeks after the end of concurrent chemoradiotherapy
Blood collected 12 weeks after the end of concurrent chemoradiotherapy were tested to observe the expression levels of MRD
12 weeks after the end of concurrent chemoradiotherapy
Positive expression of plasma HPV
Time Frame: 12 weeks after the end of concurrent chemoradiotherapy
Blood and tissue samples collected 12 weeks after the end of concurrent chemoradiotherapy were tested to observe the positive expression of plasma HPV
12 weeks after the end of concurrent chemoradiotherapy
Expression levels of MRD
Time Frame: 24 weeks after the end of concurrent chemoradiotherapy
Blood and tissue samples collected by patients 24 weeks after the end of concurrent chemoradiotherapy were tested to observe the expression levels of MRD
24 weeks after the end of concurrent chemoradiotherapy
Positive expression of plasma HPV
Time Frame: 24 weeks after the end of concurrent chemoradiotherapy
Blood and tissue samples collected by patients 24 weeks after the end of concurrent chemoradiotherapy were tested to observe the positive expression of plasma HPV
24 weeks after the end of concurrent chemoradiotherapy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Guizhou Provincial People's Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 1, 2022

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
November 30, 2024

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2026

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
June 9, 2023

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 14, 2023

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
July 18, 2023

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
July 18, 2023

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
July 14, 2023

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
July 1, 2023

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • (2023)089

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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