A Clinical Study to Evaluate ctDNA Testing for Early Detection and Monitoring of Liver Cancer and Colorectal Cancer Liver Metastases
After Liver Surgery or Transplantation, and Its Impact on Treatment and Survival
Led by Medical University of Warsaw · Updated on 2025-06-03
300
Participants Needed
1
Research Sites
64 weeks
Total Duration
AI-Summary
What this Trial Is About
Researchers are studying the use of a blood test called circulating tumor DNA ctDNA to monitor liver cancer and colorectal cancer that has spread to the liver. This prospective observational study aims to validate whether ctDNA testing can help detect cancer recurrence early, track disease progression, predict treatment outcomes, and monitor therapy in patients undergoing liver surgery or transplantation. The study involves patients with colorectal liver metastases, hepatocellular carcinoma HCC, and a control group without ctDNA testing.
Participants will be divided into groups based on their cancer type and whether they receive ctDNA testing. Tumor tissue samples collected during surgery will undergo genetic analysis using Next-Generation Sequencing NGS to identify mutations. Blood samples will be collected one day before surgery, one month after, and six months after surgery. Plasma will be used to isolate ctDNA, which is analyzed with droplet digital PCR ddPCR to detect mutations. Control group patients will have blood samples collected but without molecular testing.
During the study, patients will have physical exams, quality of life assessments, laboratory tests, and imaging as part of regular oncological follow-up. Researchers will compare ctDNA levels with imaging and tumor marker results to assess cancer progression and recurrence. The main outcomes include evaluating ctDNA levels and mutation status before and after surgery up to six months, with additional quality of life and imaging comparisons over four years. The study will monitor patients for up to 18 months after the first ctDNA blood collection to understand the clinical value of ctDNA monitoring.
CONDITIONS
Brief Title
ctDNA Monitoring in Patients With HCC and mCRC
Research Team
I
Izabela Górzyńska, Associate Professor
I
Iazbela Górzyńska, Msc
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Patients with colorectal cancer metastases limited to the liver after complete removal of the primary tumor
Patients with resectable or unresectable hepatocellular carcinoma scheduled for liver resection or transplantation
Negative history of other cancers
Negative virological status for metastatic colorectal cancer patients
Patients may have received any type of liver surgery and/or chemotherapy compatible with adjuvant therapy
You will not qualify if you...
Age under 18 or over 75 years
Pregnancy
Presence of cancer spread outside the liver on imaging studies
Metabolic or autoimmune diseases or chronic immunosuppressive treatment except for liver transplant patients
Positive virological status except in hepatocellular carcinoma patients
History of other cancers
Chronic steroid therapy or diagnosed active autoimmune diseases
Previous radiotherapy
Participation in other clinical trials involving oncological or non-oncological drugs
Legal incapacity
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Pre-Surgery Assessment
Duration - 1 day
Participants undergo assessments including physical examination, quality of life questionnaire, laboratory and imaging tests, and blood collection for ctDNA testing immediately before surgery.
1 visit (in-person)
Surgery and Immediate Post-operative Care
Duration - Hospital stay until discharge
Participants undergo liver resection or liver transplantation followed by monitoring in the surgical intensive care unit and hospital room until discharge.
Continuous inpatient monitoring until discharge
Post-operative Follow-up
Duration - 12 months
Participants attend follow-up visits for assessment of post-surgical recovery, blood collection for ctDNA testing, and monitoring for cancer recurrence.
3 visits: at 30 days, 6 months, and 12 months after surgery (in-person)
How is the study designed?
Study Type
INTERVENTIONAL
Masking
SINGLE
Allocation
RANDOMIZED
Model
SINGLE_GROUP
Primary Purpose
HEALTH_SERVICES_RESEARCH
Number of Arms
4
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Published Research Related To This Trial
Circulating tumor DNA-based assessment of disease progression after liver resection or transplantation for metastatic colorectal cancer or hepatocellular carcinoma-study protocol for a randomized, controlled trial.