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Gall Bladder CancerNCT07176962

A Cell-free DNA Methylation Blood-Based Test for Biliary Tract Cancers Screening

An observational study of Gall Bladder Cancer and Intrahepatic Cholangiocarcinoma (Icc), run by Yingbin Liu, MD, PhD, FACS at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Biliary tract carcinoma (BTC), including gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma, ranks sixth in incidence among gastrointestinal malignancies and tenth in cancer-related mortality worldwide. Read more about this study

Who is it for?
Ages 18 to 80 yearsHealthy volunteers can take part
How many people
1,800 participants
Where
1 siteChina
Study dates
1 Jan 2020to 1 May 2026
Phase
Observational
Are there results?
Not yet: the study is under way

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 to 80 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: The study population comprises individuals meeting inclusion criteria and not meeting any exclusion criteria.

Who may be able to join

  • BTC patients
  • Willing to voluntarily participate and able to comply with study procedures; if unable to read or sign, informed consent must be signed by a legally authorized representative (LAR).
  • Age 18-80 years (inclusive).
  • Able to provide required blood samples.
  • Pathologically confirmed biliary tract carcinoma (TNM stage I-IV).
  • Stable vital signs; ECOG performance status 0-1.
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  • Adequate organ function: AST/ALT ≤ 5 × ULN; Child-Pugh class A or B; WBC > 3 × 10⁹/L; ANC ≥ 1.5 × 10⁹/L; Platelets ≥ 75 × 10⁹/L; Hemoglobin ≥ 90 g/L; Creatinine clearance ≥ 60 mL/min; Total bilirubin ≤ 3 × ULN.
  • Other gastrointestinal malignancies (to exclude BTC non-specific signals)
  • Voluntary participation with signed informed consent (or by LAR).
  • Age 18-80 years (inclusive).
  • Able to provide required blood samples.
  • Pathologically confirmed gastrointestinal malignancies other than BTC, including hepatocellular carcinoma, gastric cancer, colorectal cancer, and pancreatic cancer (TNM stage I-IV).
  • Stable vital signs; ECOG performance status 0-1.
  • Non-cancer participants (benign biliary disease)
  • Able to provide written informed consent.
  • Able to provide required blood samples.
  • Age 18-80 years (inclusive).
  • Pathologically or clinically diagnosed benign biliary diseases, including cholecystitis, cholelithiasis, choledocholithiasis, adenomyomatosis, gallbladder polyps, xanthogranulomatous cholecystitis, or primary sclerosing cholangitis.
  • External Validation Cohorts
  • BTC patients
  • Voluntary participation with signed informed consent (or by LAR).
  • Imaging findings of malignant biliary stricture or mass, or serum CA19-9 > 100 U/mL, highly suspicious for BTC, with planned surgery or biopsy for pathological confirmation.
  • Age 18-80 years (inclusive).
  • Able to provide required blood samples.
  • Stable vital signs; ECOG performance status 0-1.
  • Adequate organ function: AST/ALT ≤ 5 × ULN; Child-Pugh class A or B; WBC > 3 × 10⁹/L; ANC ≥ 1.5 × 10⁹/L; Platelets ≥ 75 × 10⁹/L; Hemoglobin ≥ 90 g/L; Creatinine clearance ≥ 60 mL/min; Total bilirubin ≤ 3 × ULN.
  • Healthy volunteers
  • Able to provide written informed consent.
  • Able to provide required blood samples.
  • Age 18-80 years (inclusive).

Who cannot join

  • Cancer patients
  • Pregnant or breastfeeding women.
  • History of organ transplantation or prior allogeneic bone marrow/stem cell transplantation.
  • Blood transfusion within 7 days prior to blood collection.
  • History of curative cancer treatment within 3 years prior to blood collection.
  • Use of anti-tumor drugs within 30 days prior to blood collection.
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  • Known bleeding disorders.
  • Known autoimmune diseases.
  • Concurrent other malignancies or multiple primary tumors.
  • Non-cancer participants
  • Pregnant or breastfeeding women.
  • History of organ transplantation or prior allogeneic bone marrow/stem cell transplantation.
  • Blood transfusion within 7 days prior to blood collection.
  • History of any malignant tumor.
  • Known bleeding disorders.
  • Known autoimmune diseases.
  • Clinically significant abnormalities on routine examination (excluding hepatitis, hepatic cysts, or benign pulmonary nodules).
  • External Validation Cohorts
  • Cancer patients
  • Pregnant or breastfeeding women.
  • History of organ transplantation or prior allogeneic bone marrow/stem cell transplantation.
  • Blood transfusion within 7 days prior to blood collection.
  • History of or ongoing curative cancer treatment within 3 years prior to blood collection.
  • Use of anti-tumor drugs within 30 days prior to blood collection.
  • Known bleeding disorders or autoimmune diseases.
  • Concurrent other malignancies (including multiple primaries) or known cancer susceptibility gene carriers.
  • Pathology confirmed benign disease after biopsy/surgery.
  • Failure to confirm malignancy by pathology or imaging within 42 days after blood collection, or unclear lesion site/evidence.
  • Special exclusion criteria:
  • Pathology confirmed precancerous lesions.
  • Any local/regional or systemic anti-tumor therapy (including surgery, radiotherapy, targeted therapy, or immunotherapy) prior to blood collection.
  • Healthy volunteers
  • Pregnant or breastfeeding women.
  • History of organ transplantation or prior allogeneic bone marrow/stem cell transplantation.
  • Blood transfusion within 7 days prior to blood collection.
  • History of any malignant tumor.
  • Known bleeding disorders or autoimmune diseases.
  • Clinically significant abnormalities on health examination (excluding hepatitis, hepatic cysts, or benign pulmonary nodules).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Yingbin Liu, PhD contact

+86 13918803900

laoniulyb@163.com

China1 site, 1 recruiting
  • Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai

    Shanghai, Shanghai Municipality, 200127

    Yingbin Liu, PhD, +86 13918803900, laoniulyb@163.com

    Recruiting

Other trials in China

About this study

Official title: A Cell-free DNA Methylation Liquid Biopsy for Diagnosis and Management of Biliary Tract Cancers

Biliary tract carcinoma (BTC), including gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma, ranks sixth in incidence among gastrointestinal malignancies and tenth in cancer-related mortality worldwide. Due to the lack of specific early symptoms, high malignancy, and frequent recurrence and metastasis, the rate of curative resection is only about 16.5%, and the overall 5-year survival rate is less than 5%. Early and accurate detection is therefore critical for improving patient outcomes. Circulating tumor DNA (ctDNA), a fraction of circulating free DNA (cfDNA), carries genetic and epigenetic information from tumor cells and can be detected even at the early stages of cancer development. Among various liquid biopsy biomarkers, ctDNA methylation shows particular advantages in sensitivity and specificity for early cancer detection and monitoring. This study aims to evaluate the application of cfDNA methylation liquid biopsy in the diagnosis and management of BTC.

Read the detailed description

Biliary tract carcinoma (BTC), encompassing gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma, is an aggressive malignancy with poor prognosis. Globally, it ranks sixth in incidence among gastrointestinal cancers and tenth in cancer-related mortality. BTC is characterized by the absence of specific early symptoms, high degree of malignancy, and a strong tendency for recurrence and metastasis. The curative resection rate remains around 16.5%, and the overall 5-year survival rate is less than 5%.

Biliary tract inflammation (such as cholangitis, acute cholecystitis, sclerosing cholangitis, and autoimmune cholangitis) can lead to abnormal CA19-9 elevation. In addition, IgG4-related sclerosing cholangitis often affects elderly patients and may mimic hilar cholangiocarcinoma, creating diagnostic challenges. Imaging alone often lacks accuracy in differentiating benign from malignant biliary lesions, resulting in misdiagnosis and inappropriate clinical decision-making. The number of patients with incidentally detected BTC during surgery is rapidly increasing, and reoperations impose substantial trauma and socioeconomic burden.

Circulating tumor DNA (ctDNA) refers to DNA fragments released into the bloodstream from tumor cells through apoptosis, necrosis, or secretion. ctDNA carries genomic alterations (point mutations, indels, CNVs, fusions), epigenetic modifications (DNA methylation [5mC], hydroxymethylation [5hmC]), and structural features (fragment length, fragmentation patterns). Circulating free DNA (cfDNA) represents the total extracellular DNA in plasma or serum, of which ctDNA accounts for less than 1%. Accumulating evidence shows that ctDNA is detectable in the early stages of tumorigenesis, highlighting its clinical potential in early detection, diagnosis, treatment guidance, and post-treatment monitoring.

The choice of biomarker type is key to liquid biopsy applications, and ctDNA methylation offers distinct advantages. Liquid biopsy analytes include circulating tumor cells (CTCs), ctDNA, exosomes, and microRNAs (miRNAs), each with unique detection characteristics. ctDNA, directly derived from tumor cells, provides relatively high sensitivity for early detection and is currently the most widely used target in clinical practice. Research on ctDNA has focused mainly on methylation, somatic mutations, and copy number variations. Among these, ctDNA methylation balances both signal abundance and signal strength, offering clear advantages over other approaches. Methylation analysis methods include restriction enzyme digestion, affinity enrichment, and bisulfite conversion. Among them, bisulfite-based approaches are the most established and widely used.

Therefore, the application of cfDNA methylation liquid biopsy in BTC for early screening, differential diagnosis, prognostic monitoring, and therapeutic guidance holds great significance for improving diagnosis, treatment, and patient outcomes.

Keywords
ctDNA methylation, Early diagnosis, Liquid biopsy, Billiary Track Cancer
Medical subject headings
Gallbladder Neoplasms, Cholangiocarcinoma, Cirrhosis, Familial, with Pulmonary Hypertension, Klatskin Tumor, Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT07176962
Study groupRoleWhat they receive
control(Internal training and validation sets)Healthy individuals Patients with pathologically confirmed benign biliary lesions Patients with other gastrointestinal malignancies
malignant(Internal training and validation sets)patients with intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and gallbladder cancer
malignant (Independent validation set)patients with suspected biliary tract malignancies
control (Independent validation set)Healthy individuals

What is being measured

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

  1. Diagnostic performance of the ctDNA methylation model in biliary tract cancer

    Evaluate the overall sensitivity, specificity, and accuracy of the ctDNA methylation liquid biopsy model in the diagnosis of biliary tract cancer (BTC).

    Measured: Baseline

Secondary outcomes (3)
  1. Subtype-specific diagnostic performance

    Sensitivity, specificity, and accuracy of the ctDNA methylation model in gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma.

    Measured: Baseline

  2. Stage-specific diagnostic performance

    Sensitivity, specificity, and accuracy of the model across BTC stages I-IV (TNM staging).

    Measured: Baseline

  3. Differential diagnosis

    Sensitivity, specificity, and accuracy of the ctDNA methylation model in distinguishing BTC from benign biliary lesions.

    Measured: Baseline

Timeline

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

  1. First posted16 Sep 2025
  2. Study start1 Jan 2020
  3. Primary completion21 Mar 2026 (estimated)
  4. Study completion1 May 2026 (estimated)

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
Case-control
Time perspective
Other
Enrolment
1,800 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07176962
Sponsor's protocol ID
BTC_ctDNAm_LYB_2025
Status last verified
Sep 2025
First submitted
10 Sep 2025
Last updated
16 Sep 2025
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Chung DC, Gray DM 2nd, Singh H, Issaka RB, Raymond VM, Eagle C, Hu S, Chudova DI, Talasaz A, Greenson JK, Sinicrope FA, Gupta S, Grady WM. A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening. N Engl J Med. 2024 Mar 14;390(11):973-983. doi: 10.1056/NEJMoa2304714.

    PubMed 38477985
  • Nagino M, Hirano S, Yoshitomi H, Aoki T, Uesaka K, Unno M, Ebata T, Konishi M, Sano K, Shimada K, Shimizu H, Higuchi R, Wakai T, Isayama H, Okusaka T, Tsuyuguchi T, Hirooka Y, Furuse J, Maguchi H, Suzuki K, Yamazaki H, Kijima H, Yanagisawa A, Yoshida M, Yokoyama Y, Mizuno T, Endo I. Clinical practice guidelines for the management of biliary tract cancers 2019: The 3rd English edition. J Hepatobiliary Pancreat Sci. 2021 Jan;28(1):26-54. doi: 10.1002/jhbp.870. Epub 2020 Dec 23.

    PubMed 33259690
  • Yang M, Zhao Y, Li C, Weng X, Li Z, Guo W, Jia W, Feng F, Hu J, Sun H, Wang B, Li H, Li M, Wang T, Zhang W, Jiang X, Zhang Z, Liu F, Hu H, Wu X, Gu J, Yang G, Li G, Zhang H, Zhang T, Zang H, Zhou Y, He M, Yang L, Wang H, Chen T, Zhang J, Chen W, Wu W, Li M, Gong W, Lin X, Liu F, Liu Y, Liu Y. Multimodal integration of liquid biopsy and radiology for the noninvasive diagnosis of gallbladder cancer and benign disorders. Cancer Cell. 2025 Mar 10;43(3):398-412.e4. doi: 10.1016/j.ccell.2025.02.011.

    PubMed 40068597
  • Vogel A, Bridgewater J, Edeline J, Kelley RK, Klumpen HJ, Malka D, Primrose JN, Rimassa L, Stenzinger A, Valle JW, Ducreux M; ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org. Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2023 Feb;34(2):127-140. doi: 10.1016/j.annonc.2022.10.506. Epub 2022 Nov 10. No abstract available.

    PubMed 36372281

Questions about this trial

What is this clinical trial studying?

An observational study of Gall Bladder Cancer and Intrahepatic Cholangiocarcinoma (Icc), run by Yingbin Liu, MD, PhD, FACS at 1 site in China.

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 30 inclusion and 38 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: looking for participants now, as of the sponsor's last update on 16 Sep 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 China. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Yingbin Liu, PhD (+86 13918803900, laoniulyb@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Diagnostic performance of the ctDNA methylation model in biliary tract cancer (time frame: Baseline). 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 NCT07176962, which also lists 4 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 Sep 2025.

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