Liquid Biopsies for the Personalized Management of Patients With Hereditary Diffuse Gastric Cancer

Hereditary Diffuse Gastric Cancer Clinical Trial

— LISA-HDGC  

Official title:

Liquid Biopsies (Blood, Gastric Fluid) for the Personalized Management of Patients With Hereditary Diffuse Gastric Cancer: a Pilot Project

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT04253106
• Other study ID #: APHP190483
• Status: Active, not recruiting
• Phase: N/A
• Start date: November 26, 2020
• Est. completion date: November 26, 2024

Study information

• Verified date: January 2024
• Source: Assistance Publique - Hôpitaux de Paris
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Activating somatic mutations and methylation profiles identified by liquid biopsies could identify CDH1 and CTNNA1 pathogenic variants carriers with invasive diffuse gastric cancer undetectable by upper G-I endoscopy.

Description:

Carriers of germline pathogenic variants in the CDH1 and CTNNA1 genes have the Hereditary Diffuse Gastric Cancer Syndrome. Asymptomatic carriers have at high lifetime risk of diffuse gastric cancer (30-70%). Screening upper gastrointestinal endoscopy, even with multiple random biopsies, misses signet ring cell cancer foci. Invasive cancers can thus go undetected. There is therefore a recommendation of total risk-reducing gastrectomy, at least in carriers with a family history of gastric cancer. Novel screening strategies are needed. In this pilot project, the investigators will perform liquid biopsies of both blood and gastric fluid in asymptomatic carriers who refuse gastrectomy and in controls. The investigators aim to show that somatic mutations in a panel of genes involved in gastric cancer and methylation profiles are detected in a subset of carriers, and not in controls. These could be indicative of invasive cancer undetected by endoscopy, and would thus be a strong argument for risk-reducing gastrectomy. On the contrary, in the absence of somatic mutations in liquid biopsies, endoscopic surveillance could continue.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 16
• Est. completion date: November 26, 2024
• Est. primary completion date: November 26, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

Case:

• Patient>18 years old

• CDH1 or CTNNA1 germline pathogenic variant.

• No history of diffuse gastric cancer.

• French social security.

• Ability to understand and willingness to sign a written informed consent document.

Volunteers:

• Patients > 18years old

• Patients with no oncological history

Exclusion Criteria: for both arms

• Patients with cancer being treated

• Patients with metastatic cancer

• Medical contraindication to general anesthesia or FOGD (bleeding disorder, pregnant women )

• Patients under guardianship or curator

Related Conditions & MeSH terms

• Hereditary Diffuse Gastric Cancer
• Stomach Neoplasms

Intervention

Genetic:
• Liquid biopsies (blood, gastric fluid).
Next generation sequencing of a panel of diffuse gastric cancer genes, methylation analysis. Samples collected during routine screening endoscopy.

Locations

Country	Name	City	State
France	Hopital Pitié Salpetrière	Paris

Sponsors (1)

Lead Sponsor	Collaborator
Assistance Publique - Hôpitaux de Paris

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of subjects in whom somatic mutations or methylation profiles are detected.		Over two years of surveillance
Secondary	Replicability of observations over successive endoscopies. Correlation between blood and gastric fluid.		Over two years of surveillance