Colorectal Cancer Clinical Trial
Official title:
Colorectal Cancer Immunomodulation Combined to Radiofrequency ablatIon
The primary objective of the study aims to compare soluble CD154 (CD40L) levels before and
after radiofrequency ablation (RFA) in patients with colorectal cancer (CRC) liver
metastases.
The secondary objectives aims:
- to compare soluble CD154 (sCD40-L) levels before and after treatment by RFA or surgery
alone in patients with CRC liver metastases;
- to study the feasibility and reliability of soluble CD154 (sCD40-L) levels to detect and
quantify the induction of immun response in CRC liver metastases patients after RFA;
- to study the impact of surgery on plasma soluble CD154 levels;
- to study association between CD154 expression level before and after RFA in CRC liver
metastases patients and relapses rate at 1 year.
Radiofrequency ablation (RFA) of colorectal liver metastases activates a specific T-cell
response that is ineffective in avoiding recurrence. Local immunomodulation garnered
interests as a way to improve the immune response. It was interesting in improving the RFA
immune response priming to propose a curative treatment of colorectal cancer (CRC) based on
antitumor immunity. Early study of the investigators demonstrated that the RFA did not
increase the tumor infiltrating lymphocytes in secondary distant tumors of patients and in
mice model and could not avoid relapse. The lack of an effective distant immune response in
patients treated with RFA confirmed the relevance of the combination strategy.
Another study on the predictive value of cytokines/chemokines in rectal cancer (RC) patients
receiving chemoradiation therapy (CRT) demonstrate that, the pre-CRT levels of soluble
CD40-ligand (sCD40L) and the post-CRT levels of chemokine ligand-5 (CCL-5) were significantly
associated with the depth of tumor invasion and with venous invasion. A significant
correlation between pre-CRT platelet counts and sCD40L was observed in patients with a
favorable response.
Today there is no validated biomarker for the indication of immunotherapy after local
treatment on metastases of colorectal cancer.
This is a prospective, monocentric study which will be realized with the routine care and
usual management. There will be any added intervention for enrolled patients during the
study. All eligible patients will be enrolled and followed in the Department of digestive
surgery of Ambroise Paré Hospital - APHP.
The duration of enrollment will last 6 months. The duration of follow-up for each patient
will be up to 12 month.
Data collection: the medical data will be collected and recorded by Doctor Malafosse in a
Excel file.
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