PRecision Oncology Evidence Development in Cancer Treatment - Liquid (PREDiCTl)

  • STATUS
    Recruiting
  • End date
    Jun 1, 2023
  • participants needed
    1500
  • sponsor
    British Columbia Cancer Agency
Updated on 9 August 2022
cancer treatment
primary cancer

Summary

The current standard of care for molecular characterization of tumors is tissue based next generation sequencing (NGS) panel. Liquid biopsies (ie blood) are of increasing interest and have been implemented as a diagnostic tool in some countries. This study compares tissue based and liquid based testing to evaluate the detection rate and cost consequence of using this new tool in BC.

Description

Part A - Simultaneous - Patients will be randomized 1:1 to FoundationOne liquid CDx or no additional testing simultaneously at initiation of request for standard based tissue based next generation sequencing (NGS) panel testing. The objective of Part A is to evaluate the cost-consequence of the liquid ctDNA biopsy technology, FoundationOne liquid CDx, for first line molecular characterization of advanced colorectal cancer, gastrointestinal stromal tumor (GIST), melanoma, non small cell lung cancer (NSCLC) and ovarian cancer with simultaneous molecular characterization by tissue based NGS panel

Part B - Sequential - Patients will undergo standard tissue based NGS panel testing and if there are no somatic tier 1 variant of strong clinical significance identified the patients will then be eligible for FoundationOne liquid CDx. The objective of Part B is to determine the benefit of a sequential approach with molecular characterization by tissue based NGS panel testing followed by liquid based FoundationOne liquid CDx for patients who do not have an actionable tissue based oncogenic driver, across British Columbia.

The development and access to next generation sequencing (NGS) technologies on tumour tissue and blood allows the ability to profile the genomic landscape of the tumour within reasonable turn-around times and costs. The promise of precision oncology is the ability to 'match the right drug to the right patient at the right time'. Despite considerable excitement at the prospect of genome-informed therapy to improve oncologic outcomes, there has been little empirical assessment of its benefit from an overall population perspective and its true impact on cancer care delivery in 'real-world' scenarios.

While the enthusiasm for liquid biopsies has increased, the understanding of the cost implications lags behind. We propose to assess the true clinical impact on both individual patients and on a population-based cancer system of precision oncology via ctDNA analyses in metastatic solid tumors in a real-world scenario.

Details
Condition Cancer
Treatment Quality of Life Questionnaires, FoundationOne liquid CDx
Clinical Study IdentifierNCT05057234
SponsorBritish Columbia Cancer Agency
Last Modified on9 August 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Age > 18
Patients with metastatic malignancy
Patients undergoing tissue based molecular characterization by tissue based NGS panel
Part A - Simultaneous
Tissue based NGS panel requested or reported within 4 weeks of enrolment
Patients receiving treatment at BC Cancer
Part B - Sequential
Tissue based NGS oncopanel does NOT identify a somatic tier 1 variant of strong clinical significance OR fails/not feasible due to insufficient tissue
BC Cancer - Provincial (not including Vancouver Centre)

Exclusion Criteria

Patients not available for follow up
Patients who are not willing to consider systemic treatment options
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