MTG: Innovative Approach to Detect Recurrent Colorectal Lesions With Surveillance Via Mutation Analysis & Clinical Phenotype

Sponsor

Military University Hospital, Prague (Other)

Overall Status

Recruiting

CT.gov ID

NCT05929365

Collaborator

(none)

200

Enrollment

Location

Anticipated Duration (Months)

3.6

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

It is known that the development of colorectal adenoma is dependent on the appearance of somatic mutations in protooncogenes and tumor suppressor genes. Based on our previous mutation analyses of 120 patients with high-risk adenoma removed by enbloc resection with subsequent colonoscopy after 1 year, there is a correlation between mutation in exon 7 of the TP53 gene and risk of early metachronous lesions development. The results also indicate that mutation phenotype (mutation profile and burden) of all lesions detected on index colonoscopy can determine risk of metachronous lesions. As not all synchronous lesions were analyzed and the surveillance colonoscopy interval was less than 3 years, this assumption could not be confirmed. In this study it is planned to perform mutation analysis of all synchronous lesions in 200 patients and correlate the data with appearance of metachronous lesions after 1, 3 and 5 years. Moreover, the mutation profile of all metachronous lesions developed during the 5 years of surveillance will be determinated and compared with mutation profile of index lesions from the same localization to verify their common biological origin. This all could help personalize the surveillance program in terms of reduction of the burden on the patient and endoscopic workplaces and risk of developing colorectal cancer in a particular patient.

Condition or Disease	Intervention/Treatment	Phase
Predictive Cancer Model	Procedure: colonoscopy

Detailed Description

The aim of this prospective study is to identify patients with recurrent colorectal lesions risk and try to design an optimal intervals of surveillance colonoscopies, especially in the high-risk group of patients, using mutation and clinical-pathologic phenotype. The partial goals are: 1. Determination of the mutation profile and mutation burden in 200 patients based on examination of all their index and synchronous lesions found during index colonoscopy using an established PCR/DCE-based heteroduplex method. 2. Clinical and histopathological evaluation and mutational profiling of all metachronous lesions found during five-year surveillance period. 3. Correlation of clinical and histopathological parameters with mutational phenotype of patient. 4. Correlation of patient's mutational phenotype with an occurrence of metachronous lesion/s during surveillance period. 5. Comparison of the mutation profile of lesions from the index period withthe mutation profile of metachronous lesions. 6. Analysis of the similarity of the mutation profile of lesions found in the same / close areas of the colorectum.

Study Design

Study Type:

Observational [Patient Registry]

Anticipated Enrollment :

200 participants

Observational Model:

Cohort

Time Perspective:

Prospective

Official Title:

Development and Clinical Utility of a New Method to Identify Patients With Risk of Recurrent Colorectal Lesions and Personalization of Their Surveillance Based on Mutation Burden and Clinical-pathological Phenotype

Actual Study Start Date :

May 1, 2022

Anticipated Primary Completion Date :

Dec 31, 2026

Anticipated Study Completion Date :

Dec 31, 2026

Outcome Measures

Primary Outcome Measures

Development and Clinical Utility of a New Method to Identify Patients With Risk of Recurrent Colorectal Lesions and Personalization of Their Surveillance Based on Mutation Burden and Clinical-pathological Phenotype [5 years]
To identify patients with high risk of metachronous colorectal lesions and try to design and optimal intervals of surveillance colonoscopies, especially in the high-risk group of patients, using mutation and clinical-pathologic phenotype.

Secondary Outcome Measures

Determination of the mutation profile colorectal lesions [5 years]
Determination of the mutation profile and mutation burden in 200 patients based on examination of all their index and synchronous lesions found during index colonoscopy using an established PCR/DCE-based heteroduplex method.
Mutational profil of colorectal lesions [5 years]
Clinical and histopathological evaluation and mutational profiling of all metachronous lesions found during five-year surveillance period.

Other Outcome Measures

Mutational phenotype of patient. [5 years]
Correlation of clinical and histopathological parameters with mutational phenotype of patient.
Metachronous lesions [5 years]
Correlation of patient's mutational phenotype with an occurrence of metachronous lesion/s during surveillance period.
Similarity of the mutation profile of lesions found in the same area [5 years]
Analysis of the similarity of the mutation profile of lesions found in the same / close areas of the colorectum.

Eligibility Criteria

Criteria

Ages Eligible for Study:

18 Years to 75 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

Inclusion Criteria:

Colorectal polyp larger than 10mm removed by colonoscopy therapeutic method (EPE, EMR, ESD)
Signed informed consent with the study and with colonoscopy

Exclusion Criteria:

FAP, HNPCC and other hereditary CRC syndromes probands
Colonoscopy contraindication
Severe acute inflammatory bowel disease
Severe comorbidities; likely non-compliance of the patient

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Military University Hospital	Prague		Czechia	16902

Sponsors and Collaborators

Military University Hospital, Prague

Investigators

Principal Investigator: Stepan Suchanek, assoc. prof., Military University Hospital, Prague
Study Director: Ondrej Ngo, Mgr., Institute of Biostatistics and Analyses Brno
Study Director: Lucie Benesova, RNDr., Genomac Research Institute Prague
Study Chair: Ondrej Majek, RNDr., Institute of Biostatistics and Analyses Brno
Study Chair: Tereza Halkova, Mgr., Genomac Research Institute Prague