Minimal Residual Disease Clinical Trial
Official title:
Study About Contamination of Ovarian Tissue by RT-PCR in Children With Solid Tumors.
For prepubertal patients, cryopreservation of ovarian tissue is the only option available to preserve their fertility before cancer treatment. But ovarian autograft raises the issue of the risk of reintroduction of potentially malignant cells. The aim of our study is to develop a specific and sensitive method for residual disease detection in the ovarian tissue from patients treated for a solid tumor during infancy, whose fertility may have been compromised by treatments and who benefited of ovarian tissue cryopreservation.
Some solid tumors have high risk of metastatic localization including in ovaries. There is
concern over the possible presence of malignant cells in ovarian tissue that could cause a
recurrence of the primary disease after reimplantation. Thus, the possibility of ovarian
tissue involvement needs to be evaluated with sensitive molecular methods. Those techniques
are now available for leukaemia but histology is still the only way for solid tumors.
Based on our experience in detection by RT-PCR of minimal residual disease (MRD) in
neuroblastoma since 1994 [Tchirkov et al. 2003] and in ovarian tissue cryopreservation since
1995 [Schubert et al. 2005, Chambon in press], we want to develop a specific and sensitive
method for residual disease detection by RT-PCR in order to evaluate the tumor contamination
of ovarian harvested tissue.
Study population: We chose 3 models of pediatric solid tumors with high risk of metastases
and which often require sterilizing treatments (chemo and/or radiotherapy): neuroblastoma,
Ewing tumor and alveolar rhabdosarcoma. We will use four tumor cells lines: IMR32 and SK-NSH
for neuroblastoma; RD-ES for Ewing tumor; RH-30 for rhabdosarcoma. We plan to use 20
fragments per line.
Study duration: 12 months Study design: Ovarian tissue without known malignancy but with a
condition warranting laparoscopy (benign cysts) will be harvested during kystectomy
(perikystic tissue).
The harvested ovarian cortex will be cut: one half will be frozen according to our routine
protocol [Schubert et al. 2005] and the other half will be contaminated with tumor cells
lines. Then, detection of the specific transcript will be done by RT-PCR in fresh tissue and
after freeze/thaw. Total RNA will be extracted with the TRI-reagent and qRT-PCR will be
performed using the "TaqMan" technology.
Primary endpoint: to reach a sensitivity about 1/106 cells.
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