Official Title
Evaluating the Predictive and Prognostic Power of the Early Breast canceR gEnetic and Epigenetic Abnormalities Through Liquid biopSy and neTwOrk MEdicine Algorithm: the BR(E)2ASTOME Phase II Randomized Controlled Trial
Brief Title
Breast Cancer, Omics, and Precision Medicine
Protocol ID
NCT04996836
Lead Sponsor
University of Campania Luigi Vanvitelli
Brief Summary
The standard tissue biopsy strategy for cancer detection is not comprehensive enough to
profile the whole epi-genomic signatures of breast cancer (BC) and ensure an accurate
prognosis and prediction of drug response. Liquid-based assays have the potential to
reduce the molecular heterogeneity of BC and a possible utility for improving disease
management. In particular, genomic DNA (gDNA) and circulating tumor (ctDNA) can be
sequenced for genetic and epigenetic (DNA methylation) profiling of the BC patients to
enhance personalized prognosis and prediction of drug therapy. We describe a study
protocol for evaluating the clinical utility of the early use of the network-oriented
BR(E)2ASTOME algorithm which combine the power of liquid-based assays, advanced
epi-genomics platform, and network analysis to identify improve precision medicine and
personalized therapy of BC.
Detailed Description
The BR(E)2ASTOME study will be performed at the U.O.C. Patologia Molecolare e Clinica,
University of Campania "L. Vanvitelli", Naples (Italy) with a long-standing experience in
diagnosis and treatment of BC (Refs.). From each study participant, total of 10 mL of
pheripheral blood in EDTA tubes will be collected at time of BC diagnosis. Blood-based
assays will be performed to obtain genetic and/or epigenetic big data from ct-DNA and
gDNA, respectively. A network-oriented algorithm combined with patient-level clinical
information will be applied to big data in order to identify clusters of genes
(BC-modules) harboring novel genetic mutations, in the NGS-ctDNA BC-group, and
differentially methylated regions (DMRs), in the RRBS-gDNA group, with a potential
predictive and prognostic role in BC management. In the NGS-ctDNA-RRBS-gDNA group, we
will evaluate whether the multi-omics approach is more informative as compared to the
single-omic paradigm.
BC patients (males and females) will be randomized to the 2 study arms: ctDNA-NGS +
gDNA-RRBS, and standard of care alone. No modifications of intervention assignment will
be possible after randomization process of patients. The BR(E)2ASTOME study will provide
evidence about the potential clinical utility of early use liquid-based assays and
network-oriented biomarkers in prognosis and prediction of drug response in BC
management.
Thus, results from BR(E)2ASTOME study will bring to identify not only new molecular
mechanisms associated with BC, but also non-invasive biomarkers that can direct towards
an early diagnosis, contribute to monitor the cancer progression and the response to
therapeutic treatment.
Enrollment Count
200 participants
Eligibility Criteria
Inclusion Criteria:
- Sporadic BC
- Inherited BC
- 18 years old
- Males and Females
Exclusion Criteria:
- Inflammatory diseases
- Cardiovascular diseases
Filters
Breast Cancer
PHASE2
UNKNOWN
ADULT
OLDER_ADULT