Minimal Residual Disease in Solid Malignancies

NCT07268469 | Not Yet Recruiting

• 2 other identifiers: UID 5046L2-397
• Study Type: interventional
• Target: 840
• Locations: 0 countries
• Sites: N/A

Brief Summary

The IMRD study is a single-centre, prospective observational study which will investigate the rate of ctDNA (circulating tumor DNA) detection from the start of adjuvant therapy following curative-intent surgery. The study will include patients of age 18 years old or older, who provided informed consent. Eligible patients are affected by one of the following non-metastatic resected tumors: i) breast cancer (BC), ii) non-oncogene addicted (EGFR/ALK-wild type) non-small-cell lung cancer (NSCLC), iii) high-risk and very high-risk prostate cancer, iv) high-grade serous ovarian cancer (HGSOC), and v) gastric cancer. Eligible patients will undergo surgery and receive adjuvant treatment(s) as per standard guidelines. Patients who underwent neoadjuvant treatments and had a complete pathological response (i.e., no residual tumor at surgery following neoadjuvant treatments) will not be eligible for the present study. During adjuvant treatment and following its conclusion, patients will be subjected to instrumental monitoring, as per standard guidelines and clinical practice. For eligible patients, a baseline plasma sample will be collected at the time of surgery (feasibility window) and prior to the start of adjuvant treatments (not prior to 28 from the date of surgery) for assessing the detection of ctDNA. Afterwards, plasma samples will be collected at 3, 6 and 9 months from the start of postoperative adjuvant treatments. For patient specific monitoring, a tumor-informed targeted sequencing panel, using tumor-specific mutations detected with WES, will be employed to gather the most sensitive diagnostic platforms, mitigating the risk of negative cases. At 6 months or upon positive ctDNA detection, either a thoracic-abdominal-pelvic or total-body CT scan will be performed to exclude the presence of overt metastatic disease. All patients included in the study will be monitored with longitudinal ctDNA assessment until one-year or follow-up or until the radiological detection of metastatic disease, whichever will occur first. Additional follow-up will be carried outside the IMRD study and will follow standard clinical protocols and schedules. Being an observational study, no treatment intervention will be applied as per protocol based on the detection or absence of ctDNA. For conducting exploratory analyses, the primary tumors will be retrieved and subjected to WES, and the study will aim to detect molecular tumor variables associated with a lack of ctDNA clearance following curative-intent treatment interventions. The study will be conducted in 2 phases. The first phase aims at verifying the feasibility and sustainability of such approach, based on the identification of at least 15% positive patients. This phase is predicted to be completed within 2 years, and is the object of the present application. If the first endpoint is achieved, we will expand the study to include the co-primary endpoint, which aims at estimating the fraction of patients with persistent ctDNA 6 months post-surgery despite adjuvant therapy.

Conditions

Breast Cancer; Non Small Cell Lung Cancer; Prostate Cancer; High Grade Serous Ovarian Cancer; Gastric Cancer

Keywords

ctDNA

Outcome Measures

Primary Outcomes (2)

• ctDNA detection after surgery

  To determine the rate of ctDNA detection after surgery (≤28 days) as a feasibility endpoint;

  28 days

• ctDNA detection at 6 months after the start of adjuvant therapy

  To determine the rate of ctDNA detection at 6 months following the initiation of adjuvant therapy in the overall study population.

  6 month

Secondary Outcomes (6)

• ctDNA detection at 6 months vs baseline

  6 months

• ctDNA detection end of adjuvant therapy

  up to 8 years

• ctDNA detection at 6 months and 12-month, 24-month, and 36-month

  36-month recurrence-free survival

• ctDNA detection and radiological diagnosis of metastatic disease

  up to 8 years

• Lack of ctDNA clearance

  up to 8 years

Study Arms (1)

ctDNA detection

OTHER

Biological: ctDNA detection

Interventions

ctDNA detection BIOLOGICAL

a baseline plasma sample will be collected at the time of surgery and prior to the start of adjuvant treatments forassessing the detection of ctDNA.

ctDNA detection

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Provision of informed consent
• Age ≥18 years
• Eligibility for potentially-curative surgery, regardless of previous neoadjuvant/pre-operative systemic treatment
• Completed adequate pre-surgical staging procedures as per standard clinical practice
• Diagnosis of one of the following:
• Clinical Stage II or III breast cancer
• Clinical Stage II or III NSCLC
• HGSOC, either relapsed after primary treatment, confirmed by biopsy, or suspected on the basis of radiological criteria
• Prostate cancer, with at least one of the following: Gleason Score ≥8, radiologically ≥cT2c, or PSA \>10
• Gastric cancer with at least one of the following: Radiological/ecoendoscopic/laparoscopic evidence of node-positive disease, infiltration of the serosa or the surrounding organs, diffuse subtype as histology.

You may not qualify if:

• Unable to provide informed consent
• Unable to undergo surgery
• Radiological evidence of metastatic disease
• Unwilling to be subjected to longitudinal plasma samples collection
• Prior diagnosis of a malignant tumor for which the patients underwent any type of anti-neoplastic treatment within 2 years prior to the study screening

Sponsors & Collaborators

• European Institute of Oncology: lead

MeSH Terms

Conditions

Breast Neoplasms; Carcinoma, Non-Small-Cell Lung; Prostatic Neoplasms; Stomach Neoplasms

Condition Hierarchy (Ancestors)

Neoplasms by Site; Neoplasms; Breast Diseases; Skin Diseases; Skin and Connective Tissue Diseases; Carcinoma, Bronchogenic; Bronchial Neoplasms; Lung Neoplasms; Respiratory Tract Neoplasms; Thoracic Neoplasms; Lung Diseases; Respiratory Tract Diseases; Genital Neoplasms, Male; Urogenital Neoplasms; Genital Diseases, Male; Genital Diseases; Urogenital Diseases; Prostatic Diseases; Male Urogenital Diseases; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases

Study Officials

• Giuseppe Curigliano

  European Institute of Oncology

  PRINCIPAL INVESTIGATOR

• Pier Giuseppe Pelicci, MD

  European Institute of Oncology

  PRINCIPAL INVESTIGATOR

• Luca Mazzarella, MD

  European Institute of Oncology

  PRINCIPAL INVESTIGATOR

• Antonio Marra, MD

  European Institute of Oncology

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Antonio Marra, MD

CONTACT

0257489266; antonio.marra@ieo.it

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: OTHER
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 14, 2025
• First Posted: December 5, 2025
• Study Start: December 1, 2025
• Primary Completion (Estimated): July 1, 2033
• Study Completion (Estimated): July 1, 2033
• Last Updated: December 5, 2025

Record last verified: 2025-10