View clinical trials related to Colorectal Cancer.
Filter by:The PREEMPT CRC study is a prospective multi-center observational study to validate a blood-based test for the early detection of colorectal cancer by collecting blood samples from average-risk participants who will undergo a routine screening colonoscopy.
In the past decade, the demand for colonoscopy procedures has increased significantly since the introduction of population-based colorectal cancer (CRC) screening in many western countries. Post-polypectomy surveillance will increase the number of colonoscopy procedures conducted each year even further. The invasive nature of colonoscopy and the associated health-care costs warrant the development of a new non-invasive test to reduce the number of unnecessary colonoscopies. These days, many countries use a non-invasive fecal test for CRC screening which is easy to perform at home, but test characteristics such as sensitivity and specificity are suboptimal. Multiple studies have already shown that volatile organic compound (VOC) analysis has a high diagnostic accuracy for CRC and Advanced Adenomas. An additional VOC analysis, for example through breath testing, in patients with a positive fecal immunochemical test (FIT) may reduce the number of unnecessary colonoscopies. The aim of this study is to validate the diagnostic accuracy of the AeonoseTM to distinguish patients with CRC from healthy controls, and to assess reproducibility of test results.
This is a study of Axitinib versus placebo as monotherapy for people with colorectal cancer who have liver metastases and who have relapsed within 6 months of their last chemotherapy regime. The research will also look at the potential of CEHPI (Contrast Enhanced Hepatic Perfusion Index) reduction, a technique developed for this research to measure the changes in how the blood vessels pump blood into the different liver metastases (tumours) and therefore to assess and predict response to treatment.
Primary, this study aims to develop and validate a computer-aided diagnosis (CADx) system for the characterization of colorectal polyps. Second, this study evaluates the effect of using a clinical classification model Blue Light Imaging Adenoma Serrated International (BASIC) on the diagnostic accuracy of the optical diagnosis of colorectal polyps compared to intuitive optical diagnosis for both expert endoscopists and novices.
This is a single arm study to evaluate the efficacy and safety of CEA-targeted CAR-T cells therapy for patients with relapsed/refractory CEA+ Cancer,and obtain the recommended dose and infusion plan.
In 2018, colorectal cancer is the third most common malignant tumor in terms of morbidity and second mortality in the world. Surgical resection is still the main treatment for colorectal cancer.With the introduction of the ERAS, the latest international and domestic guidelines for fasting before surgery all advocate shortening the fasting time. For example, 2 hours before surgery, oral take cleared fluids, including water, sugar water, fruit juice, tea and black coffee (without milk) is allowed.Solid food can be consumed 4 hours before surgery, and oral diet should be resumed as soon as possible after surgery. Changes in diet, nutritional status, and physical activity are closely related to the incidence of colorectal cancer. Therefore, we believe that the intestine may be very sensitive to different fasting times during the perioperative period. Prolonging the fasting time may improve the prognosis by improving postoperative insulin resistance, reducing inflammation and protecting anti-tumor immune function in patients with colorectal cancer.Prolonged fasting time seems to be contrary to the results of some studies, and whether it is applicable to patients with tumor surgery is unclear. Therefore, there is an urgent need to conduct large-scale, prospective, randomized controlled clinical studies to clarify the most suitable perioperative fasting strategy (including composition, interval, and amount) for cancer patients, which can not only reduce surgical stress and speed up postoperative rehabilitation,reduce postoperative metastasis and recurrence and improve mid- and long-term prognosis.
This is a first-in-human Phase 1a/1b, multicenter, open-label, dose-escalation, dose and schedule optimization, and expansion study of TPST-1495 as a single agent and in combination with pembrolizumab to determine its maximum tolerated dose (MTD) and or recommended Phase 2 dose (RP2D), safety, tolerability, pharmacokinetics, pharmacodynamics and preliminary anti-tumor activity in subjects with advanced solid tumors. Subjects with all histologic types of solid tumors are eligible for the escalation and dose-finding portions of the study. However, the preferred tumor types for enrollment are colorectal cancer (CRC), non-small cell lung cancer (NSCLC), squamous cell carcinoma of the head and neck (SCCHN), urothelial cancer, endometrial cancer, and gastroesophageal junction (GEJ) or gastric adenocarcinoma. Enrollment in the expansion cohorts is limited to the following tumor types: endometrial, SCCHN, CRC, and a basket cohort in subjects selected for an activating mutation in PIK3Ca.
The aim of this project is to assess the impact on health and economics of the implementation of text messaging (SMS) in cancer screening programs. Three interventions with SMS will be evaluated through community trials. In the colorectal cancer screening program the following interventions will be tested: a) Participation reminder: six weeks after sending the invitation letter of the colorectal cancer program if there has not been a response, a reminder SMS will be sent in front of the usual method by letter; b) Reminder to return the fecal occult blood test: SMS reminder of test delivery versus no intervention. This reminder will be sent to the individuals who have gone to the pharmacy to pick up a fecal occult blood test and they have not returned it after 14 days. The impact on participation will be analyzed and, if applicable, the proportion of advanced neoplasms will be calculated by increase in participation. In the breast cancer screening program, the invitation by SMS versus the usual invitation by letter will be studied in women who had participated in the previous screening round. The impact on participation will be analyzed. A cost-effectiveness analysis of the three interventions will be carried out. The incremental cost ratio of the interventions between cost variation and effectiveness variation will be calculated.
The current standard treatment for locally advanced rectal cancer is still fluorouracil-based neoadjuvant radiotherapy and chemotherapy followed by TME surgery, followed by adjuvant chemotherapy. Fluorouracil single-agent simultaneous sensitization of radiotherapy and chemotherapy has a pCR of about 15-20% and a tumor downgrade (ypStage 0-I) rate of about 35%. However, about 30% of patients still have distant metastasis, which is the main obstacle affecting the survival prognosis of patients with locally advanced rectal cancer. About 50% -65% of patients was still stage II-III after neoadjuvant therapy. The long-term follow-up shows that for patients with ypT4 after surgery, the 3-year DFS is about 50%. For patients with ypN2, the 3-year DFS is less than 40%. Therefore, it is necessary to strengthen postoperative adjuvant chemotherapy to improve the survival prognosis for these patients. Although FOLFOX adjuvant chemotherapy improved survival benefit than 5FU as adjuvant treatment in ypStage II-III patients after neoadjuvant treatment in ADORE trial. However, with the progress of neoadjuvant therapy research, more and more studies have proposed to move part or all of postoperative adjuvant chemotherapy to preoperative neoadjuvant therapy due to low compliance of adjuvant chemotherapy. During neoadjuvant treatment, induction chemotherapy with FOLFOX / CAPEOX or consolidation therapy after CRT with FOLFOX / CAPEOX had been investigated a lot. The pCR rate was 19% -38%, and the tumor downstaging rate was about 50%. Another 50% of patients still had ypstage II-III postoperatively. The 3-year DFS for ypStage III was only 55% even with FOLFOX as adjuvant chemotherapy. And for ypT4N0 patients with ypstage IIB-IIC, there is also a higher risk of recurrence and metastasis. And it is urgent to explore new treatment strategies to improve this part of patients Survival prognosis. For locally advanced colon cancer, surgery combined with postoperative adjuvant chemotherapy is currently the standard treatment mode for stage II-III colon cancer. About 30% of patients with locally advanced disease will relapse within 3 years, of which distant metastases are more common and eventually become the main cause of death of patients. For locally advanced colon cancer with a preoperative staging of T4b, the NCCN guidelines recommend surgery after neoadjuvant chemotherapy with FOLFOX or CAPOX regimens. In the FOxTROT study of neoadjuvant treatment of locally advanced colon cancer, for patients with T3> 5mm or T4, after 4 courses of neoadjuvant chemotherapy with FOLFOX regimen, 20.5% of patients still have T4 after surgery, and 15.2% of patients had N2 disease. For this part of patients, new postoperative treatment options should also be explored to improve patient survival and prognosis. In view of the high efficiency of the three-agent FOLFOXIRI regimen in advanced colorectal cancer and the success in adjuvant chemotherapy after pancreatic cancer surgery, 5FU, oxaliplatin combined with irinotecan may have a synergistic effect. At present, a phase III randomized controlled study (IROCAS study) in Europe is underway. For high-risk phase III patients, the mFOLFOXIRI regimen is compared with mFOLFOX6 regimen adjuvant chemotherapy. Based on the above reasons, our center plans to further carry out "multi-center, randomized, controlled phase III clinical study of mFOLFOXIRI versus mFOLFOX6 adjuvant chemotherapy after neoadjuvant oxaliplatin in locally advanced colorectal cancer." Improve the survival prognosis of postoperative high-risk colorectal cancer patients after neoadjuvant therapy.
Only 59% of Alaska Native people have been adequately screened for colorectal cancer (CRC) despite having the highest reported incidence of CRC in the world. A new at-home multi-target stool DNA screening test (MT-sDNA; Cologuard®) with high sensitivity for pre-cancerous polyps and CRC is now available. MT-sDNA has not been tested for feasibility or acceptability within the Alaska tribal health care delivery system, and it is unknown whether use of this new test will increase Alaska Native CRC screening rates. The long-term study goal is to improve screening and reduce CRC-attributable mortality. The objective of this application is to test the effectiveness of MT-sDNA for increasing CRC screening in Alaska Native communities using a mixed methods, community-based participatory research (CBPR) approach. The study will be conducted in collaboration with regional Tribal health organizations responsible for providing health care to geographically remote Alaska Native communities. Although the proposed implementation strategy is evidence-informed and promising, it is novel in that MT-sDNA has not been evaluated in the tribal health setting or among rural/remote populations. Using the Social Ecological Model, the research will be multi-level, examining influence on patients, providers, and tribal health organizations (THOs). This research study will pursue two specific aims: (1) Identify patient-, provider-, and system-level factors associated with CRC screening preferences, uptake, and follow-up; and (2) test the effectiveness of graded intensity MT-sDNA intervention in the Alaska Native community setting. For the first aim, focus groups with Alaska Native people who are not adherent to CRC screening guidelines and interviews with healthcare providers will be used to identify factors for future intervention. For the second aim, a three-arm cluster randomized controlled trial (high intensity with patient navigation, medium intensity with mailed reminders, usual care) will provide evidence on the MT-sDNA usefulness (MT-sDNA sample quality and neoplastic yield) as well as the first data on MT-sDNA follow up adherence rates in the Alaska Native population, which will inform plans to scale-up the intervention model. This research has the potential to sustainably improve public health by increasing CRC screening rates among a rural/remote tribal population as well as provide a model for other integrated health systems that provide care to high-risk or underserved populations in the U.S. and worldwide.