Clinical Trials Logo

Clinical Trial Summary

The proposal seeks to establish:

- A comprehensive compilation (database) of clinical information comprising clinical, histopathological, treatment and follow-up characteristics of past and future gastrointestinal cancer (GIC) cases in Singapore that can be shared by investigators. The characteristics will include clinical (eg age, sex, stage), histopathological (eg. grade, type), treatment (eg. treatment status, regimens) and outcome data (eg. survival, toxicity) from medical records.

- A collection (bank) of corresponding frozen and fixed tissue, blood and processed samples (enriched blood mononuclear cells, protein, RNA, DNA, tissue arrays) in Singapore that can be shared by the investigators.

- A gastrointestinal cancer co-operative group (GCCG) of clinicians and scientists researching prognostic and predictive markers in GIC, which will benefit from the multidisciplinary knowledge, information and samples of its members.


Clinical Trial Description

One of the current difficulties in the management of GIC is the decision to treat and the type of treatment to select. Tumour staging and histopathological assessment provides some indication of the likely aggressiveness of a cancer and hence the need to treat; however even within specific disease stages and histopathological types there is much variability in disease outcomes and further sub-categorization is desirable. For the type of treatment to select, there are currently no established criteria, despite the fact there is much inter-individual variability in response rates and the occurrence of drug toxicity. Currently this has also become an increasingly important issue as the numbers of available regimens for GIC chemotherapy such as 5-FU, capecitabine, irinotecan, oxaliplatin, gefitinib, erlotinib, cetuximab, and bevacuzimab either alone or in combination has recently increased, making the treatment selection even more difficult. There is clearly a need for additional prognostic (predictive of disease aggressiveness) and predictive (predictive of likely response to treatment) indicators for GIC.

In over 10 years devoted to developing prognostic and predictive markers in different laboratories and clinics in Australia, Singapore, Europe and USA, the PI has gained deep experience in what it takes to run a successful program for the development of prognostic and predictive markers (Soong et al. 1996, Soong et al. 2000, Mattison et al. 2002).

Firstly needed is a comprehensive database linking clinical, histopathological, treatment and outcome characteristics of each case. This provides multiple functional endpoints to understand the significance of the candidate marker and a complete overview of likely influencing factors.

Secondly needed is a collection of samples linked to the database that are suitable for the testing of candidate markers. In this regard, the types of samples analyzed are also critical:

In the last few years, the distinction between prognostic and predictive markers has been found to be increasingly important (Elsaleh et al. 2000). Some cancers may be aggressive (poor prognosis) but respond well to treatment giving the appearance of good outcome, while others may be relatively benign (good prognosis) but resistant to treatment, giving a poor outcome. Without taking this into consideration, some markers considered to be markers of poor prognosis may be actual markers of poor treatment response but good prognosis, and all the other possible misleading permutations. The methods to clearly delineate prognostic and predictive significance have now been defined: Prognostic significance for a marker is determined by examining its associations with survival in patients without treatment. Predictive significance is determined by comparing the survival of patients with treatment against those without in patient subgroups with and without the candidate marker. The significance of this is that to clearly develop prognostic and predictive markers, investigators need a group of cases that has not received treatment. Since the mid-1990s, chemotherapy became a mainstay for advanced GIC cancer and it is now considered unethical not to treat, implying the only way to accurately assess a marker on its prognostic or predictive significance is to analyze samples pre-mid 1990s with a recording of their treatment status, and this can be obtained from archived fixed tissue collections.

The other sample consideration is that to integrate well into clinical practice, prognostic and predictive markers preferably are analyzable on non-invasive samples and are able to be proven in prospective analysis. The collection of minimally-inconveniencing blood samples would serve this purpose, and to have sufficient sample size available for the validation of future prognostic and predictive markers, it would be provident to begin collection as early as possible.

Thirdly, to have sufficient statistical power and understand the complexity of the disease from various angles of expertise in the management of GIC, cross-department and -institutional collaboration is necessary.

These factors have gone into the proposal of the specific objectives of this current protocol given above. ;


Study Design

Time Perspective: Prospective


Related Conditions & MeSH terms


NCT number NCT00539318
Study type Observational
Source Sidney Kimmel Comprehensive Cancer Center
Contact
Status Terminated
Phase N/A
Start date August 2007
Completion date July 2009

See also
  Status Clinical Trial Phase
Enrolling by invitation NCT00068003 - Harvesting Cells for Experimental Cancer Treatments
Not yet recruiting NCT05044312 - Sleep Disturbances in Surgical Patients With GI Cancers: A Quantitative and Qualitative Analysis N/A
Active, not recruiting NCT05053191 - Advancing Nursing Practices in Hospital Oncology Care N/A
Completed NCT03611309 - Perioperative Palliative Care Surrounding Cancer Surgery for Patients & Their Family Members N/A
Recruiting NCT03602677 - Indocyanine Green Fluorescence Imaging in Prevention of Colorectal Anastomotic Leakage N/A
Recruiting NCT03190941 - Administering Peripheral Blood Lymphocytes Transduced With a Murine T-Cell Receptor Recognizing the G12V Variant of Mutated RAS in HLA-A*11:01 Patients Phase 1/Phase 2
Not yet recruiting NCT06398314 - Palliative Radiotherapy in Symptomatic Pelvic Soft Tissue Tumors N/A
Withdrawn NCT04030624 - Remote Electronic Patient Monitoring in Gastrointestinal Cancer N/A
Completed NCT02222259 - A Feasibility Trial of Geriatric Assessment and Management for Older Cancer Patients N/A
Completed NCT02140593 - The Laparotomy Study Phase 4
Active, not recruiting NCT00716209 - Infrastructure for Developing Gastrointestinal Cancer Prognostic and Predictive Markers N/A
Recruiting NCT01484444 - Biomarker Analysis of Gastrointestinal Cancer N/A
Completed NCT02130427 - A Volume, Motion, and Anatomically Adaptive Approach to Photon and Proton Beam Radiotherapy N/A
Active, not recruiting NCT00710632 - Screening to Predict Weight Loss in Patients With Cancer N/A
Completed NCT00094965 - Oxaliplatin With FOLFOX4 in Patients With Normal and Abnormal Renal Function Phase 2
Terminated NCT04077372 - Assessment of a Serious Illness Conversation Guide (SICG) in Advanced Gastro-Intestinal Cancers N/A
Recruiting NCT04899908 - Stereotactic Brain-directed Radiation With or Without Aguix Gadolinium-Based Nanoparticles in Brain Metastases Phase 2
Recruiting NCT05429866 - Immunological Variables Associated to ICI Toxicity in Cancer Patients Phase 2
Recruiting NCT05226221 - Gastrointestinal Emergency Surgery: Evaluation of Morbidity and Mortality
Recruiting NCT03286348 - Analysis of Nutrition During Chemoradiotherapy in Patients With Gastrointestinal Cancer N/A