Early detection of recurrence
The Monitoring Study
Inclusion of patients scheduled for resection of primary colorectal cancer: 2006–2008
—the follow-up study was finalized by the end of 2010
Although extensive follow-up of patients who have been curatively resected, approximately 35-40% develop
recurrence, often detected at a stage where renewed cure is far from always achievable—the prognosis of those patients is poor.
Definitely, detection of recurrence at an early stage will improve the overall survival of patients with CRC
To develop a blood-based biomarker test—combinations of proteomics, genomics, epigenomics, transcriptomics and metabolomics—that could identify patients with recurrence at an early stage
Inclusion of patients:
Bispebjerg, Hillerød and Hvidovre Hospital,
plus Randers and Århus Hospital, THG
Finsen Laboratory, Copenhagen; MOMA, Skejby; Abbott Laboratories Inc., Chicago, USA; Institute of Pharmacology, Josef Stefan University, Ljubljana, Slovenia
N = 614 with primary CRC—all stages scheduled for intended curative resection
Blood sample collections:
Rectal cancer patients:
blood collections before chemo-radiation therapy, preoperatively just before skin incision, and at day 8 and 30 postoperatively—followed by collections every third month for 36 months
Colonic cancer patients:
preoperatively just before skin incision, and at day 8 and 30 postoperatively—followed by collections every third month for 36 months.
Preoperatively at the time of blood collections, and subsequently, every day of postoperative blood collections.
- A model of combined serological protein biomarkers may identify early stages of recurrence.
The model is presently validated and additional protein biomarkers are included in the model.
- A test for tumor-derived, serological DNA mutations has been developed in samples from few patients.
The mutations was identified in tumor tissue and subsequently also identified in plasma samples from the Monitoring study.
The test could identify patients with recurrence at a very early stage—1 year before detected by CT/MRI.
The results are presently validated in samples from > 200 patients, who have been curatively resected.
- Combined protein and tumor-derived DNA mutation biomarkers may lead to an effective blood test for detection of early recurrence of CRC in patients
undergone curative resection of their primary tumor lesion.