Clinical Trial Details
— Status: Not yet recruiting
Administrative data
NCT number |
NCT05752890 |
Other study ID # |
202212021RINB |
Secondary ID |
|
Status |
Not yet recruiting |
Phase |
|
First received |
|
Last updated |
|
Start date |
March 1, 2023 |
Est. completion date |
January 31, 2031 |
Study information
Verified date |
January 2023 |
Source |
National Taiwan University Hospital |
Contact |
Chia-Hsien Cheng |
Phone |
886-223123456 |
Email |
jasoncheng[@]ntu.edu.tw |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational [Patient Registry]
|
Clinical Trial Summary
The investigators will first use our previously collected serum samples and surgical/biopsied
tissues from HBV-related HCC patients undergoing radiotherapy. The consistency of junctional
clones by Capture NGS needs to be tested between both pre- and post-RT serums, and serial
changes in copy numbers of vh-DNA by ddPCR are quantified in the representative cases. The
same junction clones from pre-post-RT serums and surgical tissues will be confirmed and the
copy number changes of vh-DNA be correlated with RT response and disease-control status.
The investigators plan to identify HBV integrations by Capture NGS and quantify the specific
vh-DNA by ddPCR as personalized biomarkers from the same-patient serum samples. The
investigators will further correlate clinical response and recurrence/metastasis with serial
changes of vh-DNA copy numbers. The investigators have been prospectively collecting plasma
samples from HBV-related HCC patients before/after RT, at 1, 4, 7 months, and at
recurrence/metastasis. The investigators plan to confirm the viable role of pre-/post-RT
changes of plasma vh-DNA copies of the same junction clone in post-RT response and prognosis.
Moreover, The investigators will explore the recurrent/metastatic tumors arising from the
original or a de novo one by identifying their clonality with HBV integration patterns. The
true value of this novel HBV chimera vh-DNA will be revealed. The results will also support
the consolidative use of personalized vh-DNA for earlier evaluating treatment response after
RT, for post-RT disease monitoring, and for differentiating clonality at recurrence to design
future clinical trial on combinational treatment.
Description:
Residual tumors and early recurrence/metastasis after radiotherapy (RT) compromise the
patient survival with hepatocellular carcinoma (HCC). Timely detecting
residual/recurrence/metastasis and the clonality is required to implement salvage therapies
properly. The major unmet needs of radiotherapy to HCC are the difficulties in early
evaluating response by images and timely detection of intrahepatic recurrence and
extrahepatic metastasis. Thus, an accurate and personalized biomarker for response prediction
and disease monitoring is demanded. Cell-free tumor-specific DNA (ctDNA) has garnered
attention as a promising biomarker in cancer patients. However, in HCC, the detection rate is
low (9-21.2%), mainly due to the limited prevalence of traditional somatic mutations and the
difficult separation of ctDNA fragments from normal cells. The investigators aim to develop a
novel ctDNA, the virus-host chimera DNA (vh-DNA), as a biomarker for hepatitis B virus
(HBV)-related HCC patients undergoing RT. HBV vh-DNA presents in ~90% of HBV-related HCC
patients and can be differentiated from DNA released from the normal cells through enrichment
by capturing with HBV probes. vh-DNA might be advantageous to the traditional somatic
mutation type of ctDNA. The investigators hypothesize that HBV vh-DNA could accurately
diagnose residual tumor by 6-12 months earlier than contemporary images and predict early
recurrence/metastatsis, thus allows early intervention of salvage therapies.
The investigators will first use our previously collected serum samples and surgical/biopsied
tissues from HBV-related HCC patients undergoing radiotherapy. The consistency of junctional
clones by Capture NGS needs to be tested between both pre- and post-RT serums, and serial
changes in copy numbers of vh-DNA by ddPCR are quantified in the representative cases. The
same junction clones from pre-post-RT serums and surgical tissues will be confirmed and the
copy number changes of vh-DNA be correlated with RT response and disease-control status.
The investigators plan to identify HBV integrations by Capture NGS and quantify the specific
vh-DNA by ddPCR as personalized biomarkers from the same-patient serum samples. The
investigators will further correlate clinical response and recurrence/metastasis with serial
changes of vh-DNA copy numbers. The investigators have been prospectively collecting plasma
samples from HBV-related HCC patients before/after RT, at 1, 4, 7 months, and at
recurrence/metastasis. The investigators plan to confirm the viable role of pre-/post-RT
changes of plasma vh-DNA copies of the same junction clone in post-RT response and prognosis.
Moreover, The investigators will explore the recurrent/metastatic tumors arising from the
original or a de novo one by identifying their clonality with HBV integration patterns. The
true value of this novel HBV chimera vh-DNA will be revealed. The results will also support
the consolidative use of personalized vh-DNA for earlier evaluating treatment response after
RT, for post-RT disease monitoring, and for differentiating clonality at recurrence to design
future clinical trial on combinational treatment.