RecruitingNot ApplicableNCT04782557

EUS Guided HVA and PVA for Circulating Tumor DNA in Patients

Endoscopic Ultrasound Guided Hepatic and Portal Vein Aspiration for Circulating Tumor DNA in Patients Suffering From GI Cancers

Sponsor

Chinese University of Hong Kong

Enrollment

60 participants

Start Date

Jan 1, 2021

Study Type

INTERVENTIONAL

Conditions

Circulating Tumor Cell Gastrointestinal Cancer

Summary

The discovery of cell-free circulating tumor DNA (crDNA) in blood and the maturation of technologies for ctDNA analysis have presented an attractive opportunity for minimally invasive "liquid biopsy" genomic diagnostics. The investigators plan to perform EUS-guided portal vein and hepatic vein aspiration in GI cancers patients. The aim of the current study is thus to examine the concentration of ctDNA in portal vein (EUS-guided PVA), hepatic vein (EUS-guided HVA) and peripheral blood to understand the first pass effect of the liver with gastrointestinal (GI) cancers, and the possibility of using ctDNA as a marker for preoperative staging, restaging after neoadjuvant chemotherapy, and monitoring for recurrence.

Eligibility

Inclusion Criteria7

Age >= 18 years old
Newly diagnosed stage II-IV distal gastric cancer, pancreatic cancer or colorectal cancer
Undergoing treatment with either:
Surgery
Neoadjuvant chemotherapy
Neoadjuvant chemoirradiation
Palliative chemotherapy/ immunotherapy

Exclusion Criteria9

Synchronous cancer of other sites
Cardia, high lesser curve tumors, oesophagogastric junction tumors
Presence of bulky lymph nodes at lesser curve/ coeliac region precluding a clear EUS puncture site to portal vein and hepatic vein
Patients with coagulopathy (international normalized ratio >1.3, partial thromboplastin time greater than twice that of control), platelet count <50,000x103/uL
Patients unwilling to undergo follow-up assessments
Patients with liver cirrhosis, portal hypertension and/ or gastric varices
Patient refusal to participate
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