NCT07617610

Brief Summary

This study prospectively investigates the molecular mechanisms of primary and acquired resistance to standard-of-care BRAF V600E-directed therapy in patients with metastatic colorectal cancer and aims to pre-clinically develop novel strategies to reverse therapy resistance. Clinically approved combination treatment with cetuximab, encorafenib and chemotherapy improves patient outcomes, yet patients eventually experience disease progression. In this prospective multicenter study, tumor tissue, blood, and stool samples will be collected before treatment and at progression, to identify genetic and non-genetic mechanisms of resistance. Additionally, tumor tissue-based in vitro models (patient-derived organoids, PDOs) will be generated and exploited for functional in vitro testing, including genomic and pharmacologic perturbation studies. The overarching goal is to generate knowledge that can help develop new and more effective treatment strategies for future patients.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
30

participants targeted

Target at below P25 for all trials

Timeline
49mo left

Started May 2025

Longer than P75 for all trials

Geographic Reach
1 country

13 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress23%
May 2025Sep 2030

Study Start

First participant enrolled

May 25, 2025

Completed
12 months until next milestone

First Submitted

Initial submission to the registry

May 22, 2026

Completed
10 days until next milestone

First Posted

Study publicly available on registry

June 1, 2026

Completed
4.3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2030

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2030

Last Updated

July 16, 2026

Status Verified

July 1, 2026

Enrollment Period

5.3 years

First QC Date

May 22, 2026

Last Update Submit

July 15, 2026

Conditions

Keywords

Metastatic Colorectal CancermCRCBRAF V600ETargeted therapy resistanceEncorafenibCetuximabEGFR inhibitionBRAF inhibitionLiquid biopsyPrecision oncologyPatient-derived organoidsCirculating tumor DNActDNAMicrobiomeComprehensive genomic profilingSCI/SAKK

Outcome Measures

Primary Outcomes (1)

  • Detection rate of molecular alterations associated with acquired resistance

    Proportion of patients with detectable molecular alterations associated with acquired resistance to combined BRAF and EGFR inhibition, identified in tumor tissue collected before treatment and at disease progression using molecular profiling.

    from baseline (pre-treatment) to disease progression (approximately 12 months)

Secondary Outcomes (6)

  • Detection rate of targetable resistance alterations

    Baseline to disease progression (approximately 12 months)

  • Detection rate of non-genomic resistance mechanisms

    Baseline to disease progression (approximately 12 months)

  • Comparison of resistance alterations in tissue versus liquid biopsies

    Baseline to disease progression (approximately 12 months)

  • Establishment rate of patient-derived organoids (PDOs)

    From baseline biopsy collection through PDO establishment (approximately 3 to 6 months per sample)

  • Longitudinal dynamics of circulating tumor DNA (ctDNA)

    Baseline, every 8 to 12 weeks during treatment, and at disease progression (up to approximately 24 months)

  • +1 more secondary outcomes

Study Arms (1)

Patients with BRAF V600E-mutated metastatic colorectal cancer

Patients with unresectable or metastatic BRAF V600E-mutated colorectal cancer receiving standard-of-care treatment with combined BRAF and EGFR inhibition (e.g., encorafenib and cetuximab), with or without concomitant chemotherapy. Participants are enrolled prior to treatment initiation and followed longitudinally with collection of tumor tissue, blood, and stool samples to study mechanisms of treatment resistance.

Other: Longitudinal translational sampling

Interventions

Longitudinal translational sampling (tumor tissue, plasma ctDNA, stool, PBMCs).

Patients with BRAF V600E-mutated metastatic colorectal cancer

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Participants will be recruited from oncology centers across Switzerland participating in the Swiss Group for Clinical Cancer Research (SAKK). The study population consists of adult patients with metastatic colorectal cancer treated in routine clinical practice at tertiary care and regional cancer centers. Eligible patients are identified by their treating oncologists at participating sites and enrolled prior to initiation of standard-of-care systemic therapy. Recruitment is limited to centers with access to molecular diagnostics and the capability to perform tumor biopsies and longitudinal sample collection.

You may qualify if:

  • Diagnosis of unresectable or metastatic BRAF V600E-mutated colorectal cancer
  • Planned initiation of treatment with combined anti-EGFR antibody and BRAF inhibitor
  • Patients receiving treatment in any line, with or without chemotherapy
  • At least one tumor lesion accessible for biopsy
  • ECOG performance status 0-2
  • Life expectancy of at least 3 months
  • Age ≥18 years
  • Ability to provide written informed consent

You may not qualify if:

  • Medical or surgical contraindication for tumor biopsy
  • Active second malignancy (except non-melanoma skin cancer)
  • Inability to comply with study procedures (e.g., due to language barriers or cognitive impairment)
  • Pregnancy or breastfeeding
  • Previous treatment with a BRAF inhibitor

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (13)

Kantonsspital Aarau

Aarau, CH-5000, Switzerland

RECRUITING

Kantonsspital Baden

Baden, 5404, Switzerland

RECRUITING

St. Claraspital

Basel, 4058, Switzerland

RECRUITING

Universitaetsspital Basel

Basel, CH-4031, Switzerland

RECRUITING

Inselspital Bern

Bern, 3010, Switzerland

RECRUITING

Spitalzentrum Biel - MEDIN La Tour

Biel, 2502, Switzerland

RECRUITING

Kantonsspital Graubünden

Chur, 7000, Switzerland

RECRUITING

Luzerner Kantonsspital

Lucerne, 6004, Switzerland

RECRUITING

HOCH Health Ostschweiz - Kantonsspital St. Gallen

Sankt Gallen, 9007, Switzerland

RECRUITING

Bürgerspital Solothurn

Solothurn, 4500, Switzerland

RECRUITING

HFR Freiburg - Kantonsspital

Villars-sur-Glâne, 1752, Switzerland

RECRUITING

Kantonsspital Winterthur

Winterthur, 8004, Switzerland

RECRUITING

Universitätsspital Zürich USZ

Zurich, 8091, Switzerland

RECRUITING

Biospecimen

Retention: SAMPLES WITH DNA

Tumor tissue biopsies (fresh and FFPE), whole blood, plasma for circulating tumor DNA (ctDNA), peripheral blood mononuclear cells (PBMCs), and stool samples for microbiome analyses will be collected and stored. Tumor tissue is processed for DNA and RNA extraction, histology, and organoid generation. Blood samples are processed for plasma and PBMC isolation. Tissue and plasma samples undergo central comprehensive genomic profiling (FoundationOne CDx and FoundationOne Liquid CDx). All biospecimens are coded and stored under controlled conditions for molecular and functional analyses.

MeSH Terms

Conditions

Colorectal Neoplasms

Condition Hierarchy (Ancestors)

Intestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal DiseasesRectal Diseases

Study Officials

  • Ralph Fritsch, MD

    University of Zurich

    STUDY CHAIR

Central Study Contacts

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 22, 2026

First Posted

June 1, 2026

Study Start

May 25, 2025

Primary Completion (Estimated)

September 1, 2030

Study Completion (Estimated)

September 1, 2030

Last Updated

July 16, 2026

Record last verified: 2026-07

Data Sharing

IPD Sharing
Will not share

This is a non-interventional observational study with translational research components. Individual participant data sharing is not planned. Aggregate study results, including de-identified molecular and clinical data summaries, will be disseminated through peer-reviewed publications and scientific meetings. De-identified data may be shared with collaborators on a case-by-case basis upon reasonable request to the Study Chair and subject to applicable Swiss data protection regulations, institutional review, and a data-transfer agreement.

Locations