- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02476682
Non-invasive Risk Stratification of CR AMN/SSP (FIT)
June 28, 2023 updated by: Professor Michael Bourke
Evaluation of Stool and Blood Based Tests for Colorectal Advanced Mucosal Neoplasia
The purpose of this study is to determine the clinical utility of stool and blood methylation tests for detection of advanced mucosal neoplasia (AMN) and sessile serrated polyps (SSP).
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
By not only diagnosing colorectal cancer (CRC) at an early stage, but also removing precursor lesions (adenomas), colonoscopy with polypectomy reduces the risk of developing and dying from CRC.
Approximately 90% of polyps are less than 10 mm and are easily removed by competent endoscopists.
Laterally spreading lesions (LST) and sessile lesions of the colon, also known as advanced mucosal neoplasia (AMN) are underrecognised types of lesions that are more likely to progress to cancer.
They include sessile serrated polyps (SSP), an emerging entity of flat polyps with malignant potential.
Detection of hemoglobin (a component of blood) in stool is an established validated screening tool for CRC.
Its specific role in the prediction of AMN, and particularly SSPs is yet to be defined.
Blood tests measuring the level of tumour derived methylated deoxyribonucleic acid (DNA) in blood circulating have been demonstrated to have clinical utility for detection of CRC and AMN.
A blood based CRC screening test has the potential to increase compliance.
This study aims to determine the clinical utility of stool and blood methylation tests for detection of AMN and SSPs.
Stool and blood will be obtained from consenting patients referred for endoscopic removal of known ANM and SSP (study arm) as well as from consenting patients scheduled for colonoscopy screening (control arm).
The level of stool hemoglobin and methylated tumour derived DNA in circulation will be measured in the two study groups.
Cutoff values will be generated to assess best predictive capability of high risk lesions based on these tests.
Study Type
Observational
Enrollment (Actual)
205
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
- Name: Rebecca Sonson, BN MPH
- Phone Number: 59779 0298455555
- Email: Rebecca.Sonson@health.nsw.gov.au
Study Contact Backup
- Name: Michael J Bourke, MBBS, FRACP
- Phone Number: 59779 98455555
- Email: bec2153@gmail.com
Study Locations
-
-
New South Wales
-
Westmead, New South Wales, Australia, 2145
- Westmead Endoscopy Unit
-
-
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
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
Yes
Sampling Method
Probability Sample
Study Population
The study population will be comprised of subjects diagnosed with AMN/SSP and subjects scheduled for screening colonoscopy.
Description
Inclusion Criteria:
- Individuals capable and willing of proving satisfactory informed consent
- Individuals with colonic lesions larger than 20mm
- Individuals diagnosed with laterally spreading or sessile polyp morphology
- Individuals schedules for screening colonoscopy and with no prior history of CRC
- Ability and willingness to collect stool sample at home
- Ability and willingness to undergo venepuncture procedure
Exclusion Criteria:
- Individuals not able or unwilling to provide informed consent
- Individuals less than 18 year of age
- Individuals who undergo an incomplete colonoscopy or resection, which raises doubt as to the status of the colon (post-hoc exclusion)
- Individuals with a prior history of CRC
- Individuals with a history of Irritable Bowel Disease (IBD), hereditary nonpolyposis colorectal cancer (HNPCC) or Familial adenomatous polyposis (FAP)
- Individuals with bleeding diathesis
- Pregnancy
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
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Normal subjects
blood or stool samples will be collected from people referred for screening colonoscopy
|
blood or stool samples will be collected
|
Colorectal cancer
blood or stool samples will be collected from people with colorectal cancer detected at colonoscopy or resection
|
blood or stool samples will be collected
|
Polyps <10mm and no high risk features
blood or stool samples will be collected from people with no polyps or low risk polyps (<10mm, no villous component or dysplasia) detected at colonoscopy
|
blood or stool samples will be collected
|
Advanced Mucosal Neoplasia
blood or stool samples will be collected from people with AMN detected at resection
|
|
Sessile Serrated Adenoma
blood or stool samples will be collected from people with SSP detected at resection
|
|
non-colorectal neoplastic disease
Participants with disease that is not colorectal neoplasia.
Analysis of this cohort is not a primary endpoint but the investigators will report assay positivity in this group on an opportunistic basis.
This cohort will include patients diagnosed with, for example, inflammatory bowel disease or extracolonic cancer.
|
blood or stool samples will be collected
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Demographics
Time Frame: 1 day
|
Data to adequately describe demographic situations of each participant.
|
1 day
|
Level of methylated DNA in circulation
Time Frame: 5 years
|
The process will use an automated extraction procedure incorporating state-of-the-art magnetic silica-coated beads on a QIASymphony (Qiagen).
The extracted DNA is bisulphite-converted and further purified (automated on a QIACube HT liquid handler) prior to analyzing 12uL of bis-DNA in a multi-plexed (BCAT1, IKZF1, ACTB (control assay)) real-time PCR for measuring the methylation levels of target amplicons.
|
5 years
|
Level of haemoglobin in stool
Time Frame: 5 years
|
Suspended stool collected in the HM-JACKarc sampling device will be processed for Hb measurements using commercially available reagents and the bench-top analyser instrument, HM-JACKarc, according to manufacturer recommendation (Kyowa Medex Co Ltd, Japan).
Measured haemoglobin concentrations will be reported as ug Hb/g stool.
A 20 ug Hb/g stool a cut-off concentration will be used for qualitative reporting.
|
5 years
|
Demographics
Time Frame: 1 day
|
Data to adequately decribe the clinical situations of each participant.
|
1 day
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Michael J Bourke, MBBS FRACP, Westmead Hospita;
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)
January 11, 2016
Primary Completion (Actual)
July 1, 2020
Study Completion (Actual)
July 1, 2021
Study Registration Dates
First Submitted
June 10, 2015
First Submitted That Met QC Criteria
June 16, 2015
First Posted (Estimated)
June 19, 2015
Study Record Updates
Last Update Posted (Actual)
June 29, 2023
Last Update Submitted That Met QC Criteria
June 28, 2023
Last Verified
June 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HREC2014/9/4.4(4079)
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.
Clinical Trials on Adenomatous Polyps
-
Mercy Medical CenterCompletedColonic Adenomatous PolypsUnited States
-
Mercy Medical CenterCompletedColonic Adenomatous PolypsUnited States
-
University of California, San FranciscoCompleted
-
Emory UniversityNational Cancer Institute (NCI); National Institutes of Health (NIH)CompletedColorectal Adenomatous PolypsUnited States
-
Professor Michael BourkeCompletedAdenomatous Polyp of Large IntestineAustralia
-
Emory UniversityNational Cancer Institute (NCI)CompletedColorectal Adenomatous PolypsUnited States
-
Istituto Clinico HumanitasOlympusCompletedAdenomatous Polyp
-
Lumendi, LLCUnknown
-
Baylor College of MedicineTerminatedAdenomatous Polyp of ColonUnited States
-
Stanford UniversityCompletedPolyp of Colon | Colo-rectal Cancer | Adenomatous Polyp of ColonUnited States
Clinical Trials on blood or stool samples will be collected
-
Institut Claudius RegaudFondation ARCRecruiting
-
Institut Claudius RegaudCompleted
-
Hospices Civils de LyonJanssen, LPCompleted
-
Institut Claudius RegaudRecruitingCervical Cancer | Head and Neck Cancer | Ovarian Cancer | Non Small Cell Lung Cancer | Anal Cancer | Cervical Intraepithelial Neoplasia 3 | Glioblastoma Multiforme of Brain StemFrance
-
Gayle GordilloTerminated
-
Zhejiang Cancer HospitalRecruitingCholangiocarcinoma | Biliary Tract TumorChina
-
Institut Claudius RegaudRecruiting
-
Ataturk UniversityCompletedCardiovascular Diseases | Periodontal DiseasesTurkey
-
Ataturk UniversityRecruitingObesity | Diabetes Mellitus | PeriodontitisTurkey
-
University Hospital, BordeauxCompleted