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Liver Metastases From Colorectal Cancer (mCRC)NCT06779734

Radiomics of Colorectal Liver Metastases: Identification of New Prognostic Biomarkers.

An observational study of Liver Metastases From Colorectal Cancer (mCRC), run by Istituto Clinico Humanitas at 1 site in Italy.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Background: Liver metastases (CLM) affect about half of patients with colorectal cancer and dictate patients' prognosis. Prediction of prognosis is of paramount importance for patients allocation to the most adequate treatment, but available parameters do not adequately fulfil this role. Read more about this study

Who is it for?
Ages 18 years and older
How many people
400 participants
Where
1 siteItaly
Study dates
1 Jan 2020to 31 Dec 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients who underwent liver resection for colorectal liver metastases at the IRCCS Humanitas Research Centre, Milan, Italy between January 2021 and December 2024.

Who may be able to join

  • Patients undergoing liver surgery for CLM confirmed at final pathology
  • At least 1 CLM with diameter >10 mm
  • Preoperative CT imaging available for radiomic analysis.
  • Age >18 years
  • No other malignancies in the previous 5 years
  • Interval CT-surgery ≤60 days

Who cannot join

  • Loco-regional treatments of CRLM before liver resection
  • Inadequate portal phase of the CT or high-density material artifacts affecting the analysis
  • Incomplete clinical data

Trial locations and contacts

1 site in 1 country.

Italy1 site
  • Humanitas Research Hospital

    Rozzano, Milan, 20089

Other trials in Italy

About this study

Official title: Radiomic Features of Tumor and of Liver-Tumor Interface in Patients With Colorectal Liver Metastases. Identification of New Prognostic Biomarkers.

Background: Liver metastases (CLM) affect about half of patients with colorectal cancer and dictate patients' prognosis. Prediction of prognosis is of paramount importance for patients allocation to the most adequate treatment, but available parameters do not adequately fulfil this role. Tumor pathology and molecular data and liver-tumor interface characteristics showed a major prognostic impact, but they are not included in standard prognostic scores and standard imaging modalities are poorly informative about them. Radiomic analyses demonstrated a very good prediction of pathology data and of patients outcome in several tumor, but their application to CLM remains to explore.

Hypothesis The preoperative identification of CLM and liver-tumor interface characteristics would improve prognosis prediction and patients allocation to treatments. As in other tumors, radiomic analyses could allow a major refinement in prediction of pathology data. Radiomic features per se could have a major association with prognosis.

Read more

Aims

The study has the following end-points:

  • to assess whether radiomic features of tumor and of liver-tumor interface improve prognosis prediction in CLM patients undergoing liver surgery in comparison with standard prognostic scores.
  • to explore if radiomic features are associated with pathology data.
  • to explore performances of radiomic features in comparison with standard radiologic criteria to assess tumor response to chemotherapy.
  • to merge radiomic and detailed pathology data in a single prognostic score.

Experimental Design The study will combine a retrospective (n=300 patients) and a prospective (n=400) series of patients undergoing liver resection at authors institution. Retrospectively collected patients will represent the training dataset for the prognostic model including standard prognostic factors plus radiomic features, while the first half of the prospective cohort (n=200) will be the validation dataset (minimum follow-up 30 months). For the analysis of association of radiomic features with pathology details and tumor response to chemotherapy, the prospective cohort of patients (n=400, ≈800 CLMs) will be used as training and validation dataset (data about liver-tumor interface cannot be reliably assessed in the retrospective series). Finally, all prospectively collected patients with adequate follow-up will contribute to build a composite prognostic score combining radiomic features and detailed pathology data. Per-patient evaluation will be performed in prognostic analyses; per-lesion evaluation will be performed while evaluating the association between radiomic and pathology data. The LifeX ® software will be used to perform radiomic analyses. The volume of interest (VOI) of the tumor will be tracked. An automatic volume expansion will be applied to the tumor VOI to track the liver-tumor interface (expansion of 5 mm).

Expected Results The present study has the solid expectancy to demonstrate that radiomic features of CLM and of liver-tumor interface have a major prognostic role and a good association with pathology data. We further believe that a prognostic score combining radiomic and pathology data may further optimize prognosis prediction.

Impact On Cancer Our analysis aims to improve CLM prognosis prediction by identifying radiomic features that impact prognosis and predict pathology data, and to propose a combined prognostic model of radiomic and pathology data. These are the basis for a precision medicine based on a preoperative prognostic-driven treatment allocation.

Keywords
radiomics, computed tomography, liver metastases

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Prognosis prediction

    To asses if radiomic features of tumor and of liver-tumor interface in patients with CLM improve prediction of prognosis after complete resection in comparison with standard prognostic parameters

    Measured: 2020-2024

  2. Association with pathology data

    To explore if radiomic features of tumor and of liver-tumor interface in patients with CLM are associated with pathology data, including TRG, percentage of viable cells, tumor growth pattern, tumor thickness at the interface, peritumoral micrometastases, and immune infiltrate in the tumor and the peritumoral area, and molecular status. In addition any association among pathology data will be explored

    Measured: 2020-2024

  3. Prognostic score

    To implement radiomic features and detailed pathology data of tumor and of liver-tumor interface in a single prognostic score for patients with CLM

    Measured: 2020-2024

Secondary outcomes (1)
  1. Comparison with radiological criteria

    To explore performances of radiomic features in comparison with standard radiologic criteria (i.e. RECIST and mRECIST criteria) for prediction of tumor response to chemotherapy

    Measured: 2020-2024

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Jan 2025
  2. Study start1 Jan 2020
  3. Primary completion31 Dec 2024
  4. Study completion31 Dec 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
400 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06779734
Sponsor's protocol ID
AIRC grant #2019-23822
Status last verified
Jan 2025
First submitted
13 Jan 2025
Last updated
16 Jan 2025
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Vigano L, Jayakody Arachchige VS, Fiz F. Is precision medicine for colorectal liver metastases still a utopia? New perspectives by modern biomarkers, radiomics, and artificial intelligence. World J Gastroenterol. 2022 Feb 14;28(6):608-623. doi: 10.3748/wjg.v28.i6.608.

    PubMed 35317421
  • Costa G, Cavinato L, Fiz F, Sollini M, Chiti A, Torzilli G, Ieva F, Vigano L. Mapping Tumor Heterogeneity via Local Entropy Assessment: Making Biomarkers Visible. J Digit Imaging. 2023 Jun;36(3):1038-1048. doi: 10.1007/s10278-023-00799-9. Epub 2023 Feb 27.

    PubMed 36849835
  • Laino ME, Fiz F, Morandini P, Costa G, Maffia F, Giuffrida M, Pecorella I, Gionso M, Wheeler DR, Cambiaghi M, Saba L, Sollini M, Chiti A, Savevsky V, Torzilli G, Vigano L. A virtual biopsy of liver parenchyma to predict the outcome of liver resection. Updates Surg. 2023 Sep;75(6):1519-1531. doi: 10.1007/s13304-023-01495-7. Epub 2023 Apr 5.

    PubMed 37017906
  • Vigano L, Ammirabile A, Zwanenburg A. Radiomics in liver surgery: defining the path toward clinical application. Updates Surg. 2023 Sep;75(6):1387-1390. doi: 10.1007/s13304-023-01620-6. Epub 2023 Aug 5. No abstract available.

    PubMed 37543527
  • Blazer DG 3rd, Kishi Y, Maru DM, Kopetz S, Chun YS, Overman MJ, Fogelman D, Eng C, Chang DZ, Wang H, Zorzi D, Ribero D, Ellis LM, Glover KY, Wolff RA, Curley SA, Abdalla EK, Vauthey JN. Pathologic response to preoperative chemotherapy: a new outcome end point after resection of hepatic colorectal metastases. J Clin Oncol. 2008 Nov 20;26(33):5344-51. doi: 10.1200/JCO.2008.17.5299. Epub 2008 Oct 20.

    PubMed 18936472
  • Torzilli G, Procopio F, Vigano L, Cimino M, Costa G, Del Fabbro D, Donadon M. Hepatic vein management in a parenchyma-sparing policy for resecting colorectal liver metastases at the caval confluence. Surgery. 2018 Feb;163(2):277-284. doi: 10.1016/j.surg.2017.09.003. Epub 2017 Nov 21.

    PubMed 29169612
  • Vigano L, Procopio F, Cimino MM, Donadon M, Gatti A, Costa G, Del Fabbro D, Torzilli G. Is Tumor Detachment from Vascular Structures Equivalent to R0 Resection in Surgery for Colorectal Liver Metastases? An Observational Cohort. Ann Surg Oncol. 2016 Apr;23(4):1352-60. doi: 10.1245/s10434-015-5009-y. Epub 2015 Dec 29.

    PubMed 26714946
  • Vigano L, Darwish SS, Rimassa L, Cimino M, Carnaghi C, Donadon M, Procopio F, Personeni N, Del Fabbro D, Santoro A, Torzilli G. Progression of Colorectal Liver Metastases from the End of Chemotherapy to Resection: A New Contraindication to Surgery? Ann Surg Oncol. 2018 Jun;25(6):1676-1685. doi: 10.1245/s10434-018-6387-8. Epub 2018 Feb 27.

    PubMed 29488188
  • Vigano L, Rubbia-Brandt L, De Rosa G, Majno P, Langella S, Toso C, Mentha G, Capussotti L. Nodular Regenerative Hyperplasia in Patients Undergoing Liver Resection for Colorectal Metastases After Chemotherapy: Risk Factors, Preoperative Assessment and Clinical Impact. Ann Surg Oncol. 2015 Dec;22(13):4149-57. doi: 10.1245/s10434-015-4533-0. Epub 2015 Apr 7.

    PubMed 25845431
  • Sollini M, Cozzi L, Antunovic L, Chiti A, Kirienko M. PET Radiomics in NSCLC: state of the art and a proposal for harmonization of methodology. Sci Rep. 2017 Mar 23;7(1):358. doi: 10.1038/s41598-017-00426-y.

    PubMed 28336974
  • Kirienko M, Cozzi L, Rossi A, Voulaz E, Antunovic L, Fogliata A, Chiti A, Sollini M. Ability of FDG PET and CT radiomics features to differentiate between primary and metastatic lung lesions. Eur J Nucl Med Mol Imaging. 2018 Sep;45(10):1649-1660. doi: 10.1007/s00259-018-3987-2. Epub 2018 Apr 6.

    PubMed 29623375
  • Kirienko M, Cozzi L, Antunovic L, Lozza L, Fogliata A, Voulaz E, Rossi A, Chiti A, Sollini M. Prediction of disease-free survival by the PET/CT radiomic signature in non-small cell lung cancer patients undergoing surgery. Eur J Nucl Med Mol Imaging. 2018 Feb;45(2):207-217. doi: 10.1007/s00259-017-3837-7. Epub 2017 Sep 24.

    PubMed 28944403
  • Cozzi L, Dinapoli N, Fogliata A, Hsu WC, Reggiori G, Lobefalo F, Kirienko M, Sollini M, Franceschini D, Comito T, Franzese C, Scorsetti M, Wang PM. Radiomics based analysis to predict local control and survival in hepatocellular carcinoma patients treated with volumetric modulated arc therapy. BMC Cancer. 2017 Dec 6;17(1):829. doi: 10.1186/s12885-017-3847-7.

    PubMed 29207975
  • Chun YS, Vauthey JN, Boonsirikamchai P, Maru DM, Kopetz S, Palavecino M, Curley SA, Abdalla EK, Kaur H, Charnsangavej C, Loyer EM. Association of computed tomography morphologic criteria with pathologic response and survival in patients treated with bevacizumab for colorectal liver metastases. JAMA. 2009 Dec 2;302(21):2338-44. doi: 10.1001/jama.2009.1755.

    PubMed 19952320
  • Donadon M, Hudspeth K, Cimino M, Di Tommaso L, Preti M, Tentorio P, Roncalli M, Mavilio D, Torzilli G. Increased Infiltration of Natural Killer and T Cells in Colorectal Liver Metastases Improves Patient Overall Survival. J Gastrointest Surg. 2017 Aug;21(8):1226-1236. doi: 10.1007/s11605-017-3446-6. Epub 2017 May 23.

    PubMed 28536806

Questions about this trial

What is this clinical trial studying?

An observational study of Liver Metastases From Colorectal Cancer (mCRC), run by Istituto Clinico Humanitas at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prognosis prediction (time frame: 2020-2024). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06779734, which also lists 37 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jan 2025.

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