French Assessment of MRD by Liquid Biopsies in PDAC Patients (FRENCH.MRD.PDAC)

French Assessment of Minimal Residual Disease by Liquid Biopsies in Pancreatic Ductal Adenocarcinoma Patients

The overall objective of this GUIDE.MRD consortium is to confirm that ctDNA detected after curative intended treatment for PDAC is a marker of residual disease and for risk-of-recurrence, and applicable in clinical practice.

Primary objective To confirm that ctDNA analyses performed after PDAC treatment can identify patients with a high risk-of-recurrence.

Specifically, the investigators want to determine the association between disease-free survival (DFS) and ctDNA detection status after

1. curative-intended surgery and
2. adjuvant chemotherapy.

FRENCH.MRD.PDAC is the French study of the european GUIDE.MRD project

Study Overview

• Status: Recruiting
• Conditions: Pancreatic Ductal Adenocarcinoma; Pancreatic Cancer Resectable; Minimal Residual Disease; Liquid Biopsy; ctDNA
• Intervention / Treatment: Biological: Blood sample/Liquid Biopsy

Detailed Description

PDAC is the most common subtype of pancreatic cancer. The main pillars of non-metastatic PDAC clinical management are (i) surgery and (ii) neoadjuvant treatment including chemotherapy, which can be followed by external radiotherapy in case of borderline/locally advanced tumors.

Adjuvant chemotherapy is standard-of-care and is given to most patients that tolerate it after the extensive surgical procedure. The sequence of perioperative chemotherapy (before, after, both) is currently a matter of debate.

Despite extensive surgical resection and chemotherapy, most patients relapse, and median overall survival in the group of patients that is treated with surgery and modern chemotherapy regimens is below 24 months.

Throughout the body, DNA is released from cells into the circulation. This DNA is collectively referred to as cell-free DNA (cfDNA). In a patient with a solid cancer such as PDAC, a fraction of the cfDNA found in the blood, originates from tumor cells, and is termed circulating tumor DNA (ctDNA).

At present, a multitude of different ctDNA tests are available, and a common standard is lacking. This study is part of the large, EU-funded GUIDE.MRD project that aims to develop international reference standards for ctDNA diagnostics and use the best, standardized tests in clinically meaningful scenarios, including postsurgery follow-up of patients with PDAC, colorectal cancer, and lung cancer.

Detailed Description:

The FRENCH.MRD.PDAC study will prospectively enroll patients in France who undergo potentially curative surgery for PDAC. The intervention is repeated blood sampling at pre-defined time points.

Primary objective To confirm that ctDNA analyses performed after PDAC treatment can identify patients with a high risk-ofrecurrence.

Specifically, the investigators want to determine the association between 3-year disease-free survival (DFS) and ctDNA detection status after

1. curative-intended surgery and
2. adjuvant chemotherapy.

Secondary objectives Secondary objective 1 (S1) To technically assess, compare, and rank existing commercial ctDNA diagnostics after intended curative PDAC treatment (upfront surgery or neoadjuvant treatment followed by surgery +/- postoperative chemotherapy) to identify the best method at each time point, with no impact on diagnosis or treatment of patients enrolled in the study.

Secondary objective 2 (S2) To assess the effect of standard-of-care adjuvant chemotherapy on the level of ctDNA. Especially, for patients with ctDNA detected after surgery, the investigators will measure and compare the ctDNA levels in plasma samples drawn before and after adjuvant chemotherapy. Furthermore, the change in ctDNA level will be correlated to the oncological outcomes (time to clinical recurrence, disease-free survival, and overall survival).

Secondary objective 3 (S3) To investigate if time to Molecular recurrence determined using serial ctDNA analyses in longitudinally collected plasma samples is shorter than time to Clinical recurrence using standard-of-care radiological imaging.

Secondary objective 4 (S4) To investigate the correlation between ctDNA analysis results and findings on CT scans. ctDNA analysis will be restricted to blood sampling times that are coinciding with standard-of-care CT scans. If ctDNA analysis can predict the outcome of the CT scan, the potential is that ctDNA analysis in the future can guide when to perform CT scans.

Secondary objective 5 (S5) To investigate the prognostic power of ctDNA at the time point of indeterminate CT scans.

Patient identification Patients with PDAC are screened for eligibility by the involved physicians based on the protocol of the multidisciplinary tumor board (MDT). The screening will be done based on the electronic health record in the electronic journal (at present, for example, Take Care). The National Health Record may be accessed for some patients to complete the record.

Patient recruitment and informed consent The involved physicians screen patients meeting the inclusion criteria specified below. Eligible patients are approached in person or initially by phone, after they have been informed about the diagnosis and the planned surgery. Patients are given written and oral information about the project by a trained research nurse or by an involved physician. Informed consent will be obtained before the beginning of any study-related procedures.

The signed and dated consent forms are scanned into the project's electronic database and stored physically in a locked space.

• Study Type: Observational
• Enrollment (Estimated): 37

Contacts and Locations

• Study Contact: Name: Thomas BARDOL, M.D.; Phone Number: +33467339069; Email: t-bardol@chu-montpellier.fr
• Study Contact Backup: Name: Catherine ALIX-PANABIERES, Ph.D; Phone Number: +33411759931; Email: c-panabieres@chu-montpellier.fr

Study Locations

• France
  • Hérault
    • Montpellier, Hérault, France, 34295
      • Recruiting
      • CHU de Montpellier
      • Contact: Catherine PANABIERES; Phone Number: +33411759931; Email: panabieres@chu-montpellier.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients with resected PDAC

Description

Inclusion Criteria:

• Pancreatic ductal adenocarcinoma, according to the assessment of the MDT.
• Age 18 years or older.
• Scheduled for curative intent surgical resection.

Exclusion Criteria:

• Hereditary pancreatic cancer.
• Verified distant metastases.
• Patients who are unlikely to comply with the protocol (e.g. uncooperative attitude), inability to return for subsequent visits and/or otherwise considered by the Investigator to be unlikely to complete the study.
• Other cancers (excluding prior pancreatic cancer or skin cancer other than melanoma) within 3 years from eligibility screening.
• Pregnant or nursing woman, or in childbearing age and not willing to use contraception
• Adult subject to a legal protection
• Not covered by Health insurance
• Patient unable to understand and sign written informed consent.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Pancreatic Ductal Adenocarcinoma patients; Resectable PDAC patients	Biological: Blood sample/Liquid Biopsy; ctDNA analysis

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
3-year Disease-free survival (DFS)	Disease-free survival was defined as the time between the date of the baseline blood sampling/inclusion and the date of the first event among or recurrence or death from any cause.	3 years after the end of inclusion

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sensitivity (Se) of the ctDNA diagnostics	Sensitivity (Se) of the ctDNA diagnostics is calculated in subjects with a 3-year recurrence: Se = TP/(TP+FN) (a positive reference test)	3 years after the end of inclusion
Specificity (Sp) of the ctDNA diagnostics	Specificity (Sp) of the ctDNA diagnostics is calculated in subjects without a 3-year recurrence: Sp = TN/(TN+FP) (a negative reference test)	3 years after the end of inclusion
Positive predictive value of the ctDNA diagnostics	The predictive value of a positive test or positive predictive value (PPV): PPV = TP/(TP+FP).	3 years after the end of inclusion
Negative predictive value of the ctDNA diagnostics	The predictive value of a negative test or negative predictive value (NPV): NPV =TN/(TN+FN).	3 years after the end of inclusion
Time to clinical recurrence	Time to clinical recurrence was defined as the time between the date of the baseline blood sampling/inclusion [debut] and the date of the recurrence.	3 years after the end of inclusion
Overall survival	Overall survival was defined as the time between the date of the baseline blood sampling/inclusion [debut] and the date of death from any cause.	3 years after the end of inclusion
Time to molecular recurrence	Time to molecular recurrence was defined as the time between the date of the baseline blood sampling/inclusion [debut] and the date of the molecular recurrence (positive ctDNA test).	3 years after the end of inclusion
Are Under the Curve of the ctDNA diagnostics	Area Under the Curve of the of the ctDNA: AUC ≤0.75 = low classification accuracy,; 0.75 < AUC < 0.85 = moderate accuracy,; and AUC ≥0.85 = high accuracy	3 years atfer the end of inclusion

Collaborators and Investigators

• Sponsor: University Hospital, Montpellier
• Investigators: Study Director: Catherine Alix-Panabières, Ph.D., University Hospital, Montpellier; Principal Investigator: Thomas Bardol, M.D., University Hospital, Montpellier

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2024
• Primary Completion (Estimated): October 31, 2028
• Study Completion (Estimated): October 31, 2028

Study Registration Dates

• First Submitted: February 8, 2024
• First Submitted That Met QC Criteria: February 27, 2024
• First Posted (Actual): March 1, 2024

Study Record Updates

• Last Update Posted (Actual): July 10, 2025
• Last Update Submitted That Met QC Criteria: July 7, 2025
• Last Verified: July 1, 2025

More Information

Terms related to this study

• Keywords: Pancreatic Ductal Adenocarcinoma; Liquid Biopsy; ctDNA; Minimal Residual Disease; Pancreatic Cancer Resectable
• Additional Relevant MeSH Terms: Endocrine System Diseases; Pathologic Processes; Neoplasms by Site; Neoplasms; Neoplasms by Histologic Type; Digestive System Neoplasms; Digestive System Diseases; Endocrine Gland Neoplasms; Pancreatic Diseases; Neoplasms, Glandular and Epithelial; Neoplastic Processes; Carcinoma; Neoplasm, Residual; Pancreatic Neoplasms; Adenocarcinoma
• Other Study ID Numbers: RECHMPL23_0298

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No