Clinical trial NCT04530890: Interest of Circulating Tumor DNA in Digestive and Gynecologic/Breast Cancer
Official title: Interest of Circulating Tumor DNA in Digestive and Gynecologic/Breast Cancer
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Breast Cancer
Digestive Cancer
Gynecologic Cancer
Circulating Tumor DNA
Exosomes
Lead sponsor: Poitiers University Hospital
Sponsor class: OTHER
First posted: 2020-08-28
Enrollment: 1000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: BASIC_SCIENCE

Brief summary: Circulating tumor DNA (ctDNA) offers the possibility of accessing the tumor genome from circulating blood through a simple blood test. It is currently used for diagnostic, prognostic and predictive purposes of response or resistance to oncological treatments. These advances in ctDNA have been made possible by major developments in molecular biology techniques in recent years, as the detection of ctDNA requires very sensitive techniques such as Next Generation Sequencing (NGS).

CtDNA overcomes this problem of very limiting tumor heterogeneity during a solid biopsy. All of these applications make circulating DNA an increasingly essential tool in the management of cancer patients. The studies are currently in most cases on small numbers and are retrospective.

In addition, exosomes are also a biomarker of the future that can also be detected in the bloodstream . Exosomes are nanovesicles 50 to 200 nm in diameter released into the extracellular environment via the endosomal pathway by fusion with the plasma membrane. They are very informative since they transport tumor genetic material in the form of DNA, mRNA and miRNA, but also adhesion proteins, immunostimulatory molecules and cytoskeleton, enzymes and Heats shock proteins ( HSP).

The aim of the ADIGYN study is to set up a large prospective cohort to assess the diagnostic, prognostic and predictive impact of ctDNA and exosomes in digestive and gynecological / breast cancers. From the circulating DNA, we characterize the ActDNA on the molecular level thanks to the study of different point mutations usually used but also of new described mutations having a therapeutic impact and the search for other genetic alterations having an impact on the therapeutic strategy (such as microsatellite instability) or the study of exosomes and their composition. To assess resistance to oncological treatments, ctDNA will be analyzed at the start of treatment, during treatment, during progression and / or relapse and also during monitoring or treatment break


Eligibility criteria: Inclusion Criteria:

* Digestive or gynecological / breast cancer proven or suspected, requiring oncological treatment (chemotherapy or immunotherapy)
* Major patient
* Patients benefiting from a Social Security scheme or benefiting through the intermediary of a third party
* Information note and collection of non-opposition after clear and fair information about the study

Exclusion Criteria:

* Linguistic or psychological refusal or inability to understand and / or sign the information and no-objection note
* History of a cancer other than that allowing inclusion in the 5 years preceding inclusion

Primary outcomes:
measure: To assess the prognostic impact of ctDNA (mortality) in digestive and gynecological / breast cancers.
timeFrame: Through study completion, an average of 12 months
Secondary outcomes:
measure: Evaluate the diagnostic value of ctDNA and exosomes
timeFrame: Through study completion, an average of 12 months
measure: Evaluate the prognostic impact of exosomes and their composition
timeFrame: Through study completion, an average of 12 months
measure: Evaluate the predictive benefit of response / resistance to ctDNA and exosome treatments
timeFrame: Through study completion, an average of 12 months
measure: Evaluate the possibility of detecting certain molecular alterations using ctDNA and exosomes
timeFrame: Through study completion, an average of 12 months
Other outcomes:
Locations:
city: Poitiers
country: France
facility: CHU POitiers
Study officials:
References: