Circulating Tumor DNA in Peripheral T-cell Lymphomas (CIRCULATE)
Next-Generation Sequencing-based, Tumor- and Plasma-informed Droplet Digital PCR Assay for Detection of Circulating Tumor DNA in Peripheral T-cell Lymphomas
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
In this observational prospective cohort study the investigators want to test the use of minimal-invasive liquid biopsies (blood plasma) for the detection of ctDNA in patients with newly diagnosed or relapsed/refractory PTCL. In each enrolled patient a diagnostic tumor-containing tissue biopsy as well as a baseline plasma sample will be subject to targeted next-generation sequencing (NGS) with the aim of identifying tumor-specific genetic alterations and clonal T-cell receptor rearrangements. This testing will be performed on biopsies that have been obtained as a part of standard-of-care diagnostic evaluation for PTCL and no further invasive biopsies will be performed.
Based on the NGS-analysis, a droplet digital polymerase chain reaction (ddPCR) assay will be designed for each patient. ddPCR will be used to detect ctDNA in plasma at diagnosis and later at defined time points during treatment and in the follow-up period.
At the same defined time points PET/CT scans will be performed for later comparative analysis. PTCL patients routinely have PET/CT scans performed before the start of treatment, mid-treatment, at the end of treatment and after hematopoietic stem cell transplant when applicable. PET/CT scans will be conducted every 6 months for the first 2 years of routine follow-up.
Active patient participation (i.e. blood sampling for ctDNA analysis and PET/CT scans) is expected to last up to 27 months from inclusion. Follow-up for survival analysis will be done for up to 5 years from inclusion.
The investigators hypothesize that the NGS-based tumor- and plasma-informed ddPCR assay applied in this study, will provide a highly sensitive and specific tool for prognostication, response evaluation and detection of relapse in patients with PTCL.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Patrick R Noerhave, MD
- Phone Number: +4551543715
- Email: panoer@rm.dk
Study Locations
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Central Jutland
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Aarhus, Central Jutland, Denmark, 8200
- Department of Hematology, Aarhus University Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients with newly diagnosed or relapsed/refractory peripheral T-cell lymphoma.
- All primary systemic PTCL entities from the International Consensus Classification 2022.
- ≥18 years of age.
- Life expectancy of 3 months or longer.
- ECOG performance status 0-4 at study entry (PS4 only if lymphoma-induced).
- Measurable disease.
- Written informed consent.
Exclusion Criteria:
- T-cell prolymphocytic leukemia
- T-cell large granular lymphocytic leukemia
- Chronic lymphoproliferative disorder of NK cells
- Adult T-cell leukemia / lymphoma
- Aggressive NK-cell leukemia
- Primary cutaneous T-cell lymphoma such as Sézary syndrome and Mycosis fungoides.
- Primary cutaneous CD30 positive T-cell lymphoproliferative disorders.
- Lymphomatoid papulosis.
- Primary cutaneous anaplastic large cell lymphoma.
- Primary cutaneous small/medium CD4-positive T-cell lymphoproliferative disorder.
- Primary cutaneous gamma-delta T-cell lymphoma.
- Primary cutaneous acral CD8-positive T-cell lymphoproliferative disorder.
- Primary cutaneous CD8-positive aggressive epidermotropic cytotoxic T-cell lymphoma.
- History of active cancer during the past year, except basal cell carcinoma of the skin or stage 0 cervical carcinoma (in situ).
- Unwillingness or inability to comply with the study protocol.
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
ctDNA occurrence
Time Frame: Up to 27 months
|
Proportion of patients with one or more measurable genetic alterations detected in plasma ctDNA by a tumor-informed, NGS-based patient-specific droplet digital PCR assay at baseline, cycle 2 day 1, cycle 3 day 1, mid-treatment, end of treatment, 6 month, 12 month, 18 month and 24 month follow-up.
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Up to 27 months
|
|
ctDNA quantification
Time Frame: Up to 27 months
|
Median ctDNA levels in plasma by a tumor- and plasma-informed, NGS-based patient-specific droplet digital PCR assay at baseline, cycle 2 day 1, cycle 3 day 1, mid-treatment, end of treatment, 6 month, 12 month, 18 month and 24 month follow-up.
|
Up to 27 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Progression free survival
Time Frame: Up to 5 years
|
Time from date of diagnosis until the date of disease progression or relapse or death from any cause, whichever occurred first.
|
Up to 5 years
|
|
Overall survival
Time Frame: Up to 5 years
|
Time from date of diagnosis to the date of death from any cause or the date of last follow-up.
Patients who are event-free at their last follow-up evaluation will be censored at that time point.
|
Up to 5 years
|
|
Radiographic assessment by PET/CT
Time Frame: Up to 27 months
|
Description of tumor staging, metabolic tumor volume and total lesion glycolysis by 18F-fludeoxyglucose positron emission tomography/computed tomography (PET/CT) before treatment.
Therapeutic response evaluation based on the 2014 Lugano classification criteria at mid-treatment, end of treatment, 6 month, 12 month, 18 month and 24 month follow-up.
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Up to 27 months
|
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Comparison of molecular and radiographic response
Time Frame: Up to 27 months
|
Concordance between detection of ctDNA (MRD-positive or MRD-negative) and therapeutic response assessed by PET/CT at mid-treatment, end of treatment, 6 month, 12 month, 18 month and 24 month follow-up.
|
Up to 27 months
|
|
Spatial and temporal mutational homo- or heterogeneity
Time Frame: Up to 27 months
|
Characterization of the con- or discordance between the genetic profile in tumor and plasma ctDNA at diagnosis and at relapse.
|
Up to 27 months
|
|
Fragment pattern analysis
Time Frame: Up to 27 months
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Description of fragment sizes of ctDNA by capillary electrophoresis at baseline, cycle 2 day 1, cycle 3 day 1, mid-treatment, end of treatment, 6 month, 12 month, 18 month and 24 month follow-up.
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Up to 27 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Study Chair: Francesco A d'Amore, MD, DMSc, Aarhus University Hospital and Aarhus University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms
- Immune System Diseases
- Neoplasms by Histologic Type
- Lymphatic Diseases
- Lymphoproliferative Disorders
- Immunoproliferative Disorders
- Lymphoma, Non-Hodgkin
- Lymphoma
- Lymphoma, T-Cell
- Hemic and Lymphatic Diseases
- Lymphoma, T-Cell, Peripheral
- Lymphoma, Extranodal NK-T-Cell
- Diagnostic Techniques and Procedures
- Diagnosis
- Tomography
- Diagnostic Imaging
- Radiography
- Image Interpretation, Computer-Assisted
- Radiographic Image Enhancement
- Image Enhancement
- Photography
- Tomography, X-Ray
- Tomography, X-Ray Computed
Other Study ID Numbers
Other Study ID Numbers
- 1-10-72-134-23
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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