Chemotherapy, host response and molecular dynamics in periampullary cancer: the CHAMP study.
Ampulla of Vater
/ drug effects
Antineoplastic Agents
/ administration & dosage
Carcinoma, Pancreatic Ductal
/ drug therapy
Chemotherapy, Adjuvant
DNA, Neoplasm
/ blood
Female
Gene Expression Regulation, Neoplastic
/ drug effects
High-Throughput Nucleotide Sequencing
Humans
Male
Palliative Care
Pancreatic Neoplasms
/ drug therapy
Prognosis
Prospective Studies
Sequence Analysis, DNA
Tissue Array Analysis
Chemotherapy
Immune response
Pancreatic cancer
Periampullary cancer
ctDNA
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
15 Apr 2020
15 Apr 2020
Historique:
received:
23
01
2020
accepted:
30
03
2020
entrez:
16
4
2020
pubmed:
16
4
2020
medline:
19
12
2020
Statut:
epublish
Résumé
Pancreatic cancer is a devastating disease with a dismal prognosis. Despite profound medical advances in systemic therapies for other types of aggressive tumours during recent years, a diagnosis of pancreatic cancer is still often synonymous with a fatal outcome. The term periampullary cancer includes pancreatic cancer and applies to the group of tumours found in proximity to the ampulla of Vater. Molecular events and immune response in the host during chemotherapy remain largely unexplored in this group of tumours. Therefore, the "Chemotherapy, Host Response and Molecular Dynamics in Periampullary Cancer (CHAMP)" study aims to monitor these processes to gain new insight into this perplexing disease. The CHAMP study is a prospective, single-arm observational study. All patients diagnosed with pancreatic or other periampullary adenocarcinoma undergoing adjuvant or palliative chemotherapy treatment in the Department of Oncology, Skåne University Hospital, are invited to participate. Clinical and pathological data will be compiled at study entry. A single tissue microarray (TMA) block is constructed for each patient with a resected tumour and blood samples are drawn before, during and after chemotherapy in order to sample peripheral blood mononuclear cells (PBMC), cytokines and circulating tumour DNA (ctDNA). Next generation sequencing will be performed on tumour tissue and ctDNA to detect changes in the clonal landscape over space and time. Despite the recent emergence of some promising biomarkers for periampullary cancer, there has been a lack of success in clinical implementation. Cancer cells continuously adapt and become resistant to treatment during chemotherapy. To be able to keep pace with and hopefully overtake this rapid evolution we must, with the help of new diagnostic tools, be ready to adapt and alter treatment accordingly. It seems to us that the only way forward is to gain a better understanding of the dynamics of the disease during treatment. With insights gained from the CHAMP study we hope to find answers to key questions in this largely unexplored territory. This study has been registered 30th October 2018 at clinicaltrials.gov as NCT03724994.
Sections du résumé
BACKGROUND
BACKGROUND
Pancreatic cancer is a devastating disease with a dismal prognosis. Despite profound medical advances in systemic therapies for other types of aggressive tumours during recent years, a diagnosis of pancreatic cancer is still often synonymous with a fatal outcome. The term periampullary cancer includes pancreatic cancer and applies to the group of tumours found in proximity to the ampulla of Vater. Molecular events and immune response in the host during chemotherapy remain largely unexplored in this group of tumours. Therefore, the "Chemotherapy, Host Response and Molecular Dynamics in Periampullary Cancer (CHAMP)" study aims to monitor these processes to gain new insight into this perplexing disease.
METHODS
METHODS
The CHAMP study is a prospective, single-arm observational study. All patients diagnosed with pancreatic or other periampullary adenocarcinoma undergoing adjuvant or palliative chemotherapy treatment in the Department of Oncology, Skåne University Hospital, are invited to participate. Clinical and pathological data will be compiled at study entry. A single tissue microarray (TMA) block is constructed for each patient with a resected tumour and blood samples are drawn before, during and after chemotherapy in order to sample peripheral blood mononuclear cells (PBMC), cytokines and circulating tumour DNA (ctDNA). Next generation sequencing will be performed on tumour tissue and ctDNA to detect changes in the clonal landscape over space and time.
DISCUSSION
CONCLUSIONS
Despite the recent emergence of some promising biomarkers for periampullary cancer, there has been a lack of success in clinical implementation. Cancer cells continuously adapt and become resistant to treatment during chemotherapy. To be able to keep pace with and hopefully overtake this rapid evolution we must, with the help of new diagnostic tools, be ready to adapt and alter treatment accordingly. It seems to us that the only way forward is to gain a better understanding of the dynamics of the disease during treatment. With insights gained from the CHAMP study we hope to find answers to key questions in this largely unexplored territory.
TRIAL REGISTRATION
BACKGROUND
This study has been registered 30th October 2018 at clinicaltrials.gov as NCT03724994.
Identifiants
pubmed: 32293352
doi: 10.1186/s12885-020-06807-3
pii: 10.1186/s12885-020-06807-3
pmc: PMC7161011
doi:
Substances chimiques
Antineoplastic Agents
0
DNA, Neoplasm
0
Banques de données
ClinicalTrials.gov
['NCT03724994']
Types de publication
Clinical Trial
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
308Subventions
Organisme : Vetenskapsrådet
ID : 2018-02441
Organisme : Cancerfonden
ID : CAN2018-418
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