NIPD of CFTC by WGA Coupled to Mini-exome Sequencing

Monogenic Diseases Clinical Trial

— DIAFEXOME  

Official title:

Non Invasive Prenatal Diagnosis on Isolated Circulating Fetal Trophoblastic Cells (CFTC) for Monogenic Diseases

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03743948
• Other study ID #: RECHMPL18_0281
• Status: Active, not recruiting
• Phase: N/A
• Start date: December 19, 2018
• Est. completion date: December 30, 2019

Study information

• Verified date: November 2018
• Source: University Hospital, Montpellier
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purprose of this study is to develop a single test based on circulating fetal trophoblastic cells (CFTC) analysis from maternal blood, searching for the familial mutation for a wide range of monogenic diseases.

Description:

Context:

Non Invasive Prenatal Diagnosis (NIPD), based on the analysis of circulating cell-free fetal DNA (cff-DNA) is very promising for early diagnosis of monogenic diseases. Such an approach is a safer alternative to invasive methods of prenatal testing (amniocentesis or choriocentesis) which entails a significant risk of miscarriage (0.5%-1%). However, technical issues related to the characteristics of cff-DNA remain, and NIPD techniques require long process development which are specific for a gene and/or a particular mutation.

Objectives:

The objective of this study is to complete our offer of NIPD by developing an approach on isolated Circulating Trophoblastic Fetal Cells (CFTC) adapted to the analysis of the genes and mutations involved in current prenatal testing requests.

Methodology :

The blood of pregnant women from 9 weeks of gestation for which a prenatal testing is requested will be collected.

CFTC isolation using Circulating Tumor Cells (CTCs) enrichment systems will be followed by whole genome amplification coupled to mini-exome sequencing and bioinformatic filtering that will be specific to the prenatal testing indication.

The study will be carried out in 2 stages:

• analytical validation of the method by studying the data quality of the sequencing of targeted genes that are frequently subject to prenatal testing (see prenatal testing diseases list from "ABM DPN 2014" in Appendix 2).

• clinical evaluation of the method by checking the concordance between the results obtained by our new approach versus those obtained by standard procedure (amniocentesis or choriocentesis) for 15 pregnant women.

Expected results and perspectives:

The purpose of this study is to establish the proof of concept of a semi-universal NIPD method based on a simple maternal blood test that could be applied on most rare diseases requiring prenatal testing.

This NIPD approach would reduce the number of invasive procedures and thus eliminate the risk of miscarriage due to amniocentesis or choriocentesis. It would also enable national access to this NIPD test for a wide range of rare diseases.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 18
• Est. completion date: December 30, 2019
• Est. primary completion date: August 27, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• older than 18 years old

• pregnant woman between 9 and 34 weeks of gestation

• Couple undergoing prenatal diagnosis for a monogenic disease caused by point mutation(s)

• Written informed consent was obtained for the study

• Prenatal diagnosis has been programmed for the current pregnancy during which maternal blood is collected

• Couple molecular diagnosis results for a monogenic disease caused by point mutation(s) MUST BE AVAILABLE.

Exclusion criteria:

• Couple Genomic DNA are unavailable

• Subjects at risk of transmitting the family disease, but not wishing to know their molecular status

• Individuals under guardianship by court order

Related Conditions & MeSH terms

• Monogenic Diseases

Intervention

Genetic:
• Non invasive prenatal diagnosis
15 pregnant women and their spouses Search for the familial mutation on isolated circulating fetal trophoblastic cells from maternal blood

Locations

Country	Name	City	State
France	INSERM-Hospital,	Montpellier	Herault

Sponsors (2)

Lead Sponsor	Collaborator
University Hospital, Montpellier	ABM Industries

Country where clinical trial is conducted

France, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Concordance rate between cell-based genetic non invasive prenatal test and gold standard prenatal test (choriocentesis or amniocentesis).	Analysis of the concordance of the prenatal results obtained by our new NIPD (Non-Invasive Prenatal Diagnosis) approach and those blindly obtained during the gold-standard prenatal genetic test will be carried out for each pregnant woman participating in the study.	at 36 month
Secondary	Non Invasive Prenatal Diagnostic test failure rate.	Count of the women enrolled for whom NIPD test will be inconclusive (because of insufficient circulating fetal cells isolation or allele drop out making accurate genotyping impossible).	at 36 month