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ctDNA and TEP Levels in Colon Cancer

2026년 7월 8일 업데이트: Institute of Oncology Ljubljana

Determination of ctDNA and TEP Levels in Patients With Colon Cancer Receiving Neoadjuvant Systemic Therapy

This interventional cohort study will evaluate circulating tumor DNA (ctDNA) and tumor-educated platelets (TEP) as blood-based biomarkers in adults with stage III colon cancer who are planned to receive neoadjuvant systemic therapy followed by surgical resection.

Treatment will be given according to routine clinical practice and will depend on the biological characteristics of the tumor, including mismatch repair status. Participants will provide additional blood samples at predefined time points before, during, and after treatment and surgery. These samples will be used to analyze ctDNA and TEP and to assess whether changes in these biomarkers are associated with radiological response, pathological response, and disease-free outcomes.

Approximately 80 participants will be enrolled at the Institute of Oncology Ljubljana. Participants will not receive experimental drugs as part of this study.

연구 개요

상세 설명

This is a prospective interventional longitudinal cohort study of adult patients with histologically confirmed stage III colon adenocarcinoma who are planned to receive neoadjuvant systemic therapy followed by surgical resection with curative intent.

The study will evaluate the dynamics of circulating tumor DNA (ctDNA) and tumor-educated platelets (TEP) during neoadjuvant treatment and follow-up. Neoadjuvant systemic therapy will be selected according to routine clinical practice and tumor biology, including mismatch repair status. Patients with pMMR tumors may receive chemotherapy, while patients with dMMR tumors may receive immunotherapy, according to standard clinical decision-making.

The research intervention consists of additional peripheral venous blood sampling at predefined time points before treatment, during systemic treatment, before surgery, and after surgery. Blood samples will be analyzed for ctDNA and TEP-based biomarkers. Clinical, radiological, pathological, and follow-up data will be collected from routine medical documentation.

The primary objective is to determine whether the presence of ctDNA after completion of neoadjuvant systemic therapy is associated with pathological tumor response, defined as major pathological response (MPR), in patients with stage III colon cancer. Secondary and exploratory objectives include evaluation of the association between ctDNA, TEP profiles, radiological response, recurrence-free outcomes, and disease-free outcomes.

Approximately 80 participants will be enrolled. The study is academic and non-commercial. Participants will not receive experimental drugs as part of this study, and all therapeutic and diagnostic procedures will follow established clinical practice.

연구 유형

중재적

등록 (추정된)

80

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

  • 이름: Tanja Mesti, MD
  • 전화번호: +386 1 5879 287
  • 이메일: tmesti@onko-i.si

연구 장소

      • Ljubljana, 슬로베니아, 1000
        • Institute of Oncology Ljubljana
        • 연락하다:
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

  • 성인
  • 고령자

건강한 자원 봉사자를 받아들입니다

아니

설명

Inclusion Criteria:

  • Age 18 years or older at the time of enrollment.
  • Histologically confirmed adenocarcinoma of the colon.
  • Stage III colon cancer, defined according to the applicable TNM classification based on clinical and imaging assessment.
  • Confirmed mismatch repair (MMR) status, determined by immunohistochemistry and/or molecular methods.
  • Planned neoadjuvant systemic therapy according to MMR status, followed by surgical resection with curative intent.
  • ECOG performance status 0-2.
  • Ability to understand the study and provide written informed consent.

Exclusion Criteria:

  • Stage I, II, or IV colon cancer.
  • Concurrent active malignant disease, except adequately treated non-melanoma skin cancer or carcinoma in situ.
  • Severe comorbidities or medical conditions that prevent or substantially limit neoadjuvant systemic therapy or surgical resection.
  • Known autoimmune disease requiring active immunosuppressive treatment in patients with dMMR tumors.
  • Pregnancy or breastfeeding.
  • Inability or unwillingness to provide written informed consent.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 특수 증상
  • 할당: 해당 없음
  • 중재 모델: 단일 그룹 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
다른: Biomarker Assessment Cohort
Participants with stage III colon cancer receiving neoadjuvant systemic therapy according to routine clinical practice will undergo additional peripheral venous blood sampling at predefined time points for ctDNA and TEP biomarker analysis.
Additional peripheral venous blood samples will be collected at predefined time points before treatment, during systemic treatment, before surgery, and after surgery. Samples will be analyzed for circulating tumor DNA (ctDNA) and tumor-educated platelets (TEP).

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Percentage of Participants With Major Pathological Response in the Post-Neoadjuvant ctDNA Assessment
기간: From completion of neoadjuvant systemic therapy to pathological assessment after surgical resection, approximately 3 to 6 months.
Major pathological response will be assessed by histopathological evaluation of the surgical resection specimen after completion of neoadjuvant systemic therapy. The unit of measure will be the percentage of participants with major pathological response. ctDNA status after completion of neoadjuvant systemic therapy will be used as a pre-specified stratification variable in the statistical analysis.
From completion of neoadjuvant systemic therapy to pathological assessment after surgical resection, approximately 3 to 6 months.

2차 결과 측정

결과 측정
측정값 설명
기간
Percentage of Participants With Objective Radiological Response According to RECIST 1.1
기간: From baseline to preoperative radiological assessment, approximately 3 to 6 months.
Radiological response will be assessed according to RECIST version 1.1 using routine preoperative imaging. Objective radiological response will include complete response and partial response. The unit of measure will be the percentage of participants with objective radiological response. ctDNA status after completion of neoadjuvant therapy will be used as a pre-specified stratification variable in the statistical analysis.
From baseline to preoperative radiological assessment, approximately 3 to 6 months.
Percentage of Participants Alive and Disease-Free at 12 Months After Surgical Resection
기간: 12 months after surgical resection.
Disease-free status will be assessed using routine clinical, radiological, and follow-up documentation. The outcome will be defined as being alive and without disease recurrence at 12 months after surgical resection. The unit of measure will be the percentage of participants alive and disease-free at 12 months. ctDNA status after completion of neoadjuvant therapy will be used as a pre-specified stratification variable in the statistical analysis.
12 months after surgical resection.
Percentage of Participants With Early Disease Recurrence Within 12 Months After Surgical Resection in the Postoperative ctDNA Assessment
기간: Up to 12 months after surgical resection.
Early disease recurrence will be assessed using routine clinical, radiological, and follow-up documentation. The unit of measure will be the percentage of participants with disease recurrence within 12 months after surgical resection. Postoperative ctDNA status will be used as a pre-specified stratification variable in the statistical analysis.
Up to 12 months after surgical resection.
Percentage of Participants With Early Disease Recurrence Within 12 Months After Surgical Resection in the Postoperative TEP Assessment
기간: Up to 12 months after surgical resection.
Early disease recurrence will be assessed using routine clinical, radiological, and follow-up documentation. The unit of measure will be the percentage of participants with disease recurrence within 12 months after surgical resection. Postoperative tumor-educated platelet status will be used as a pre-specified stratification variable in the statistical analysis.
Up to 12 months after surgical resection.
Percentage of Participants With Major Pathological Response in the Baseline ctDNA Assessment
기간: From baseline to pathological assessment after surgical resection, approximately 3 to 6 months.
Major pathological response will be assessed by histopathological evaluation of the surgical resection specimen. The unit of measure will be the percentage of participants with major pathological response. Baseline ctDNA status will be used as a pre-specified stratification variable in the statistical analysis.
From baseline to pathological assessment after surgical resection, approximately 3 to 6 months.
Percentage of Participants With Pathological Complete Response After Surgical Resection
기간: From baseline to pathological assessment after surgical resection, approximately 3 to 6 months.
Pathological complete response will be assessed by histopathological evaluation of the surgical resection specimen. The unit of measure will be the percentage of participants with pathological complete response. Baseline ctDNA status will be used as a pre-specified stratification variable in the statistical analysis.
From baseline to pathological assessment after surgical resection, approximately 3 to 6 months.

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 8월 1일

기본 완료 (추정된)

2028년 6월 1일

연구 완료 (추정된)

2028년 6월 1일

연구 등록 날짜

최초 제출

2026년 6월 18일

QC 기준을 충족하는 최초 제출

2026년 7월 8일

처음 게시됨 (실제)

2026년 7월 14일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 7월 14일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 7월 8일

마지막으로 확인됨

2026년 6월 1일

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