Identification of Molecular Biomarkers for Thyroid Cancer

Study Overview
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Brief Summary
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This is a two part study; part A proposes to collect plasma samples to examine how ctDNA (circulating thyroid DNA) markers correlate with detection of recurrent disease, response to therapy, clinical outcome and pathological data. Part B aims to use tissue obtained from biopsies of primary or recurrent disease to establish cell lines and tumour explants to further investigate the biology of thyroid cancer in the preclinical setting

Detailed Description
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To collect blood and tumour tissue for Part A: molecular profiling, including extraction of DNA for sequencing, RNA for expression levels and to identify expressed fusion genes, and proteins for proteomic studies and Part B: for establishment of cell lines and patient derived xenograft (PDX) models of thyroid cancer. To correlate BRAF V600E, RAS, RET/PTC, RET, PAX8/PPARϒ, βcatenin, p53, PTEN and PI3K mutations in ctDNA with Formalin Fixed Paraffin Embedded tumour tissue (FFPE) mutational analysis. To correlate the quantity of ctDNA fragments 3 monthly in patients with advanced disease on routine follow up with conventional tumour markers (Tg, calcitonin, CEA). To correlate the quantity of ctDNA fragments 3 monthly once relapse suspected by conventional methods (Tg, Calcitonin, CEA, radiological) To correlate the quantity of ctDNA fragments with response (RECIST, Tg, Calcitonin and CEA) to targeted therapies To assess prognostic significance of ctDNA levels in metastatic/advanced thyroid cancer To isolate live tumor cells for studies of novel treatment strategies (combinatorial treatments), therapy resistance and thyroid cancer biology Retrieval and analysis of archival primary tissue blocks for comparison with metastatic tumour sites To collect blood for analysis of noninvasive tests of tumour phenotype

Official Title
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Exploratory Study of the Molecular Profile of Thyroid Cancer

Conditions
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Thyroid Cancer

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: T3-4, N0-1b, M0-M1 thyroid cancer (papillary, follicular, poorly differentiated, anaplastic and medullary thyroid carcinoma). Patient able to provide informed consent Patient attending the Royal Marsden Hospital for inpatient or outpatient review Sufficient tissue sample available to perform analysis (archived or fresh) Adults >16 years old Exclusion Criteria: Patients unable to provide informed consent Thyroid lymphoma Metastases to the thyroid No histological confirmed diagnosis Only cytology available

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Primary Objective | Part A: blood and tumour tissue will be measured to determine molecular profiling. | 3 Years (at the end of study) | 
| Primary Objective | Part B: blood and tumour tissue will be assessed to establish cell lines and to determine patient derived xenograft (PDX) models of thyroid cancer | 3 years (at end of study) |