Colorectal Cancer Clinical Trial
Official title:
"High Levels of EMT-TFs for the Diagnosis of Colorectal Cancer (CRC)"
The present study is aimed at detecting and measuring mRNA levels of genes involved in epithelial to mesenchymal transition (EMT) in biological samples, i.e. in peripheral blood samples of colorectal cancer (CRC) patients and healthy controls, to determine the presence of disease, its progression and risk of recurrence.
The investigators first provided evidence that human colorectal cancer (CRC) cells can
undergo EMT during local invasion, and that EMT transcription factors (i.e.Twist family basic
helix-loop-helix transcription factor 1 (TWIST1)) are increased in the blood of CRC patients.
In addressing the relevance of EMT in the metastatic process, the prognostic role of M-like
cancer cells entering into the circulation remains to be determined.
Currently, the notion that cancer disseminates via the circulation led to increased attention
on the identification of circulating tumor cells (CTCs) in blood samples ("liquid biopsy";
LB), so far mostly based upon epithelial (E) markers. However, an un-biased evaluation of
CTCs, providing meaningful information for cancer diagnosis up to therapy, cannot exclude
cells with M features. LB data show that circulating TWIST1 mRNAs are significantly and
steadily increased in the blood of CRC patients. These findings indicate that EMT players in
the circulation change during different phases of CRC progression.
The present study is aimed at detecting and measuring messenger ribonucleic acid (mRNA)
levels of genes involved in epithelial to mesenchymal transition in biological samples, i.e.
in peripheral blood samples of tumor patients, to determine the presence of disease, its
progression and possibly the risk of recurrence, even in patients who will be treated with
adjuvant therapy on clinical ground.
Aim of this study is to depict the molecular profile of EMT transcription factor (EMT-TFs)
variations in the blood of patients with early, intermediate or advanced CRC, with respect to
disease progression and delivered treatments.
Primary endpoint: To determ the stage, the remission or the progression of a colorectal
cancer in a colorectal cancer affected subject not administered with an appropriate antitumor
treatment (e.g., neo-adjuvant therapy) comprising the step of assaying a biological sample
from said subject for the presence of a panel of mRNAs encoding for transcription factors
involved in epithelial to mesenchymal transition.
Secondary endpoint: To identify biomarkers suitable for the selection of patients amenable of
responsiveness to medical and surgical treatment.
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