Colorectal Cancer Clinical Trial
Official title:
A Cohort Study Evaluating the Effectiveness of the Somatic Mutation Spectrum Model in CRC Prognosis and Prediction Stratification
By analyse the tissue/blood variant spectrum model using NGS, the present clinical trial aims to elucidate the genetic basis of CRC in Chinese; to establish of CRC genetic map in Chinese patients; to identification new genetic biomarkers, drug and pathways; and to subtyping for precision treatment and management for Chinese CRC patients.
Colorectal cancer (CRC), as one of the common malignant tumors with high morbidity and
mortality, is a major health threat in China. Surgical resection is the conventional
treatment for early and intermediate stage CRC, chemotherapy is the main treatment for late
stage CRC.
Circulating tumor DNA (ctDNA) is tumor-derived fragmented DNA with an average size of 170bp,
mixed with cell free DNA (cfDNA) of other sources in blood circulation. Although the
mechanisms of its release have not been fully addressed, apoptosis and/or necrosis of tumor
cells and serum exosome are considered as its main source, which makes it a genomic reservoir
of different tumor clones. Also, as its half-life is up to hours, ctDNA is reflecting the
most up-to-date status of tumor genome. Hence, it allows for noninvasive molecular
characterization of tumors,which can be qualitative, quantitative and used for disease
monitoring. The possibility of that ctDNA could be used to detect micrometastatic disease in
patients received surgical resection was suggested in several studies. Using Next Generation
Sequencing (NGS), Newman et al. have shown that the serum level of ctDNA was correlated with
tumor progress and prognosis in NSCLC. Isaac et al. demonstrated the postoperative ctDNA
level was associated with breast cancer progression, and it was more sensitive compared to CT
scan for predicting the early relapse. Tie et al. examined the postoperative ctDNA level of
1046 plasma samples from a prospective cohort of 230 patients with resected stage II CRC by
NGS, and their results demonstrated that recurrence happened in 79% of the patients with
positive postoperative ctDNA at median follow-up of 27 months, versus 9.8% in the negative
postoperative ctDNA group.
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