Precision1: Precision Medicine for Liver Tumours With Quantitative Magnetic Resonance Imaging and Whole Genome Sequencing
Study Details
Study Description
Brief Summary
This will be a prospective, observational, cohort study to determine the impact of integrated diagnostics using quantitative magnetic resonance imaging, whole genome sequencing and digital pathology on intended patient management for liver cancer patients referred for liver resection.
Participants with primary or secondary liver cancer will be recruited from Hampshire Hospitals NHS Foundation Trust in Basingstoke or Oxford University Hospitals NHSFoundation Trust in Oxford. The incidence of treatable liver tumours is on the rise globally, driven by obesity, viral hepatitis and metastases from colorectal cancers. Survival rates can be improved with optimised allocation of treatment options including surgical resection, radiofrequency ablation, embolisation, chemotherapy and targeted molecular therapies (including immunotherapy).
The key motivation of this study is to help patients access the most suitable treatment combinations, based on integrating clinical, radiological and genomic data. A similar integrated approach, integrating radiology and pathology, has been shown to improve outcomes in breast cancer care. Detailed pathologic analysis of the surgical specimen from breast carcinoma biopsy provides valuable feedback to the radiologist, establishes the completeness of surgical intervention, and generates predictive information for therapeutic decisions. Whole genome sequencing (WGS) has discovered cancer driver mutations and the complex molecular profile of liver cancer. In many metastatic solid tumours, WGS has been used to identify a significant patient population (31%) who present with a biomarker that predicts sensitivity to a drug and lacked any known resistance biomarkers for the same drug. Identifying which patients possess druggable mutations will allow clinicians to make the optimal treatment decisions. The next challenge is integrating WGS into scalable clinical practice
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Study Design
Outcome Measures
Primary Outcome Measures
- Proportion of patients for whom clinically-actionable data is provided by whole genome sequencing at the time of surgery. [36 months]
This will be evaluated retrospectively, with clinically-actionable data defined as data which would result in a clinician choosing a different medical intervention to the current standard of care.
Secondary Outcome Measures
- Proportion of patients for whom clinically-actionable data is provided by LiverMultiScan. [36 months]
. To determine the utility of quantitative multiparametric MRI with LiverMultiScan to aid clinical decision making in patients referred for liver resection.
- Correlation of computationally-derived digital pathology results with human pathologist assessments of the tumour and non-tumour tissue, along with assessment of intra- and inter-rater variability. [36 months]
To compare computationally-derived digital pathology results with human pathologist assessments of the tumour and non-tumour tissue.
- Correlation of MR measurements of steatosis and fibroinflammation with digital pathology and human pathology. [36 months]
To compare histopathological assessments of liver fat and fibroinflammation with quantitative MRI metrics (cT1, PDFF)
- Performance of WGS and LiverMultiScan for predicting post-surgery length of stay in hospital, post-operative liver function, 1-year mortality and recurrence rates. [36 months]
To evaluate the long term outcomes and recurrence rates and recurrence patterns of patients as it relates to imaging and whole genome sequencing.
- Proportion of patients for whom actionable biomarkers of drug sensitivity are identified with WGS. [36 months]
To evaluate whether whole genome sequencing enables better stratification of patients prior to surgery.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Male or female 18 years of age and older willing and able to give informed consent to participate in the study
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Patients being considered for liver resection for primary or secondary liver cancer.
Exclusion Criteria:
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The participant may not enter the study with any known contraindication to magnetic resonance imaging (including but not limited to pregnancy, a pacemaker or other metallic unfixed implanted device, metallic fragments, extensive tattoos, severe claustrophobia).
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Any other cause, including a significant underlying disease or disorder which, in the opinion of the investigator, may put the participant at risk by participating in the study or limit the participant's ability to participate.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Basingstoke and North Hampshire Hospital | Basingstoke | Hampshire | United Kingdom | RG249NA |
Sponsors and Collaborators
- Perspectum
Investigators
- Principal Investigator: Rajarshi Banerjee, Perspectum Ltd
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 20/PR/0222