Detection of High Expression Levels of EMT-Transcription Factor mRNAs in Patients With Pancreatic Cancer and Their Diagnostic Potential

Sponsor
Istituto Clinico Humanitas (Other)
Overall Status
Recruiting
CT.gov ID
NCT04323917
Collaborator
IRCCS San Raffaele (Other)
850
1
60
14.2

Study Details

Study Description

Brief Summary

The present study is aimed at detecting and measuring mRNA levels of genes involved in epithelial to mesenchymal transition (EMT) in biological samples, i.e. in peripheral blood samples of pancreatic cancer (PC) patients and healthy controls, to determine the presence of disease, its progression and risk of recurrence.

Condition or Disease Intervention/Treatment Phase
  • Diagnostic Test: Liquid biopsy

Detailed Description

The investigators first provided evidence that human pancreatic cancer (PC) cells can undergo EMT during local invasion, and that EMT transcription factors (i.e.Twist family basic helix-loop-helix transcription factor 1 (TWIST1)) are increased in the blood of PC patients. In addressing the relevance of EMT in the metastatic process, the prognostic role of M-like cancer cells entering into the circulation remains to be determined.

Currently, the notion that cancer disseminates via the circulation led to increased attention on the identification of circulating tumor cells (CTCs) in blood samples ("liquid biopsy"; LB), so far exclusively based upon epithelial (E) markers. However, an un-biased evaluation of CTCs, providing meaningful information for cancer diagnosis up to therapy, cannot exclude cells with M features. LB data show that circulating TWIST1, zinc finger E-box binding homeobox 2 (ZEB2) and E-Cadherin (CDH1) messenger ribonucleic acids (mRNA) are significantly and steadily increased in the blood of PC patients.These findings indicate that high levels of EMT players in the circulation efficiently discriminate PC patients, irrespectively of tumor resectability.

The present study is aimed at detecting and measuring mRNA levels of genes involved in epithelial to mesenchymal transition in biological samples, i.e. in peripheral blood samples of tumor patients, to determine the presence of disease, its progression and risk of recurrence.

Aim of the study is to depict the molecular profile of EMT-Transcription factor (EMT-TFs) variations in the blood of patients with early, intermediate or advanced PC, with respect to disease progression and delivered treatments.

Primary endpoint: to determ the stage, the remission or the progression of a pancreatic cancer in a pancreatic cancer affected subjects. This end-point comprising the step of assaying a biological sample from said subject for the presence of a panel of mRNAs encoding for transcription factors involved in epithelial to mesenchymal transition.

Secondary endpoint: to identify biomarkers suitable for the selection of patients amenable of responsiveness to medical and surgical treatment.

Study Design

Study Type:
Observational
Anticipated Enrollment :
850 participants
Observational Model:
Case-Control
Time Perspective:
Prospective
Official Title:
Detection of High Expression Levels of EMT-Transcription Factor mRNAs in Patients With Pancreatic Cancer and Their Diagnostic Potential
Actual Study Start Date :
Nov 2, 2017
Anticipated Primary Completion Date :
Nov 1, 2021
Anticipated Study Completion Date :
Nov 1, 2022

Arms and Interventions

Arm Intervention/Treatment
Cases

Subjects affected by Pancreatic carcinoma (PC) confirmed by tissue biopsy

Diagnostic Test: Liquid biopsy
Detection and quantification of EMT-transcription factor mRNA levels in blood

Controls

Healthy Subject enrolled following colon cancer screening via colonoscopy

Diagnostic Test: Liquid biopsy
Detection and quantification of EMT-transcription factor mRNA levels in blood

Outcome Measures

Primary Outcome Measures

  1. Assessments of diagnosis of PC by EMT-TF mRNA levels in blood [Analysis at day 0: at diagnosis or before surgery for PC patients; before colonoscopy in controls]

    To determine the stage, the remission or the progression of a pancreatic cancer in a pancreatic cancer affected subject not administered with an appropriate antitumor treatment (e.g., neo-adjuvant therapy) comprising the step of assaying a biological sample from said subject for the presence of a panel of mRNAs encoding for transcription factors involved in epithelial to mesenchymal transition.

Secondary Outcome Measures

  1. Prediction of prognosis of PC by EMT-TF mRNA levels in blood [Analysis at least: 7-15 days from surgery (T1), 30 days (T2) from surgery, 6 months (T3) from surgery, 1 year (T4) from surgery]

    To identify biomarkers suitable for the selection of PC patients amenable of responsiveness to medical and surgical treatment.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years and Older
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  1. Males or females over 18 years of age capable of providing informed consent.

  2. Pancreatic carcinoma confirmed by tissue biopsy or colon mass, clinically consistent with cancer and eventually confirmed by pathology.

  3. Subject were enrolled following colon cancer screening via colonoscopy

Exclusion Criteria:
  1. Patients under the age of 18 years or over the age of 80 years.

  2. Patients with personal history of cancer, identification of large polyp or adenomatous pathology on previous or subsequent colonoscopy

  3. Patient with history of abdominal surgery within the past four months

  4. Patients unwilling to or unable to give informed consent.

  5. Patients with acute inflammatory diseases or under any emergency condition.

  6. Pregnant women.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Istituto Clinico humanitas Milan Italy 20089

Sponsors and Collaborators

  • Istituto Clinico Humanitas
  • IRCCS San Raffaele

Investigators

None specified.

Study Documents (Full-Text)

None provided.

More Information

Publications

Responsible Party:
Istituto Clinico Humanitas
ClinicalTrials.gov Identifier:
NCT04323917
Other Study ID Numbers:
  • EMT PC 1.1
First Posted:
Mar 27, 2020
Last Update Posted:
Aug 10, 2020
Last Verified:
Aug 1, 2020
Individual Participant Data (IPD) Sharing Statement:
No
Plan to Share IPD:
No
Studies a U.S. FDA-regulated Drug Product:
No
Studies a U.S. FDA-regulated Device Product:
No
Keywords provided by Istituto Clinico Humanitas
Additional relevant MeSH terms:

Study Results

No Results Posted as of Aug 10, 2020