CRC (Colorectal Cancer)AIRC_ IG 34634NCT07497789
SMYD3-Driven Metabolic Rewiring in Colorectal Liver Metastases
An observational study of CRC (Colorectal Cancer) and Liver Metastases From Colorectal Primary Cancer, run by Azienda Ospedaliera Specializzata in Gastroenterologia Saverio de Bellis.
Trial summary
This study focuses on patients with colorectal cancer undergoing surgery for the primary tumor and/or liver metastases. Tumor samples collected during surgery will be used to generate patient-derived models (primary cultures, spheroids, and organoids) to study colorectal cancer stem cells. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- CRC (Colorectal Cancer), Liver Metastases From Colorectal Primary Cancer
- How many people
- 156 participants
- Where
- No sites listed yet
- Study dates
- 10 May 2026to 10 May 2028
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: This study is a multicenter prospective observational study and involves the collection of biological samples from patients undergoing surgery for CRC and/or liver metastases
Who may be able to join
- Common criteria
- Age ≥ 18 years.
- Availability of residual tumor tissue from the surgical procedure that is not required for diagnostic purposes.
- Signed written informed consent for the use of biological samples for research purposes.
- Cohort/Arm 1 (Colon-rectal tumor resection)
- Patients undergoing surgical resection of colorectal cancer.
Show all 9Show fewer
- Cohort/Arm 2 (Primary tumor and liver metastases resection) - Patients undergoing surgical resection of the primary colorectal tumor and liver metastases from colorectal carcinoma.
- Cohort/Arm 3 (Liver metastases resection only)
- Patients undergoing surgical resection of liver metastases from colorectal carcinoma previously resected at the primary site.
Who cannot join
- Age < 18 years.
- Undergoing surgical intervention for a malignancy other than those specified in the inclusion criteria.
- Lack of signed informed consent
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Targeting SMYD3-Driven Metabolic Rewiring and Oxidative Stress Adaptation in Colorectal Liver Metastases
This study focuses on patients with colorectal cancer undergoing surgery for the primary tumor and/or liver metastases. Tumor samples collected during surgery will be used to generate patient-derived models (primary cultures, spheroids, and organoids) to study colorectal cancer stem cells. The main objective is to investigate the role of the lysine methyltransferase SMYD3 in metabolic reprogramming and adaptation to oxidative stress that enable colorectal cancer cells to survive and grow in the liver. Previous work has shown that SMYD3 is overexpressed in colorectal cancer, promotes drug resistance, and regulates key oncogenic pathways, including c-MYC and the AMPK/mTOR axis. By identifying SMYD3-dependent pathways and pharmacologic vulnerabilities in cancer stem cells within liver metastases, this study aims to support the development of new therapeutic strategies that combine SMYD3 inhibitors with approved or experimental agents targeting tumor metabolism and oxidative stress responses
Read the detailed description
Colorectal cancer represents one of the leading causes of cancer-related mortality worldwide. A significant proportion of patients develop distant metastases during the course of the disease. Liver metastases are among the main causes of death in patients with colorectal cancer. Despite advances in the genetic characterization of colorectal carcinoma, the biological mechanisms that enable tumor cells to adapt to the hepatic microenvironment and establish metastases remain only partially understood. In particular, increasing evidence suggests that subpopulations of tumor cells with cancer stem cell-like properties play a key role in tumor progression, treatment resistance, and metastatic dissemination.
The study of tumor tissues directly derived from patients is a fundamental tool for understanding the molecular mechanisms underlying metastatic progression and for developing clinically relevant experimental models, such as primary cell cultures, spheroids, and tumor organoids.
The collection of tumor samples from patients undergoing surgical resection of primary colorectal cancer and/or hepatic metastases will allow molecular, cellular, and transcriptomic analyses aimed at identifying new potential therapeutic targets.
In this context, we aim to investigate the role of the methyltransferase SMYD3 in metabolic and oxidative stress adaptation mechanisms in colorectal cancer and its derived liver metastases. Indeed, SMYD3 has recently emerged as a significant oncogenic driver, overexpressed in several tumor types. Our recent studies have revealed its contribution to drug resistance in response to genotoxic stress. Targeting SMYD3, in combination with standard or targeted therapies, has shown promise in overcoming drug resistance across various cancer types, including colorectal carcinoma, supporting the integration of SMYD3 inhibition into cancer treatment regimens.
Moreover, we have identified several SMYD3-interacting partners implicated in molecular processes related to the hallmarks of cancer. Among these are AMPK and mTOR: AMPK acts as the cell's main metabolic guardian, rewiring energy fluxes to sustain survival under stress, while mTOR regulates anabolic growth in response to nutrient availability. In this context, SMYD3 emerges as a key factor mediating processes encompassed within two major functional clusters - one involved in DNA damage repair and the other in sustaining oncogenic signaling.
Our investigations into the involvement of SMYD3 in cancer progression have advanced through an extensive molecular and functional characterization of its role in the biology of cancer stem cells, as this population is responsible for chemoresistance, recurrence, and metastasis in colorectal carcinoma. We have demonstrated that SMYD3 inhibition or stable genetic ablation affects the clonogenic and self-renewal potential of cancer stem cells and patient-derived organoids by altering their molecular signature. Furthermore, we discovered that both stable ablation and pharmacological inhibition drastically reduce the metastatic potential of cancer stem cells, identifying SMYD3 as a promising therapeutic target acting directly on the oncogene c-MYC, with potential implications for counteracting cancer stem cell proliferation and metastatic spread.
Based on this novel role of SMYD3 in cancer stem cells and metastatic dissemination, this project aims to define its contribution to the reprogramming processes that enable metastatic cells to adapt to the hepatic microenvironment under new and stressful conditions. Therefore, by delineating SMYD3-dependent pathways that promote cancer stem cell survival in liver metastases, we aim to exploit their pharmacological vulnerabilities for the development of new therapeutic strategies integrating SMYD3 inhibitors with clinically available or experimental compounds targeting tumor metabolism and oxidative stress adaptation
- Keywords
- Colorectal cancer, liver metastases, liver metastases from colorectal cancer
- Medical subject headings
- Colorectal Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Patients with CRC (colorectal cancer) | Patients undergoing surgery for primary colorectal carcinoma, without liver metastases | |
| Patients with colorectal cancer (CRC) and liver metastase | Patients undergoing surgery for primary colorectal carcinoma who simultaneously present liver metastases from colorectal carcinoma. In this case, tissue samples will be taken from both the colorectal carcinoma and the liver metastases | |
| Patients with liver metastase | Patients undergoing surgery for the resection of liver metastases from previously operated colorectal cancer |
What is being measured
The primary outcome is the main question the study is designed to answer.
Molecular and Cellular mechanisms
Identification of the molecular and cellular mechanisms involved in metastatic progression that depend on the methyltransferase SMYD3
Measured: At the time of the surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Mar 2026
- Study start10 May 2026 (estimated)
- Primary completion10 May 2027 (estimated)
- Study completion10 May 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for CRC (Colorectal Cancer)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Other
- Time perspective
- Prospective
- Enrolment
- 156 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Azienda Ospedaliera Specializzata in Gastroenterologia Saverio de Bellis
- Sponsor type
- University, hospital or other
- Collaborators
- University of Bari
- Responsible party
- Principal investigator, Cristiano Simone, Azienda Ospedaliera Specializzata in Gastroenterologia Saverio de Bellis
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07497789
- Sponsor's protocol ID
- AIRC_ IG 34634
- Acronym
- AIRC_ IG 34634
- Status last verified
- Mar 2026
- First submitted
- 23 Mar 2026
- Last updated
- 6 Apr 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 6 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Targeting SMYD3-Driven Metabolic Rewiring and Oxidative Stress Adaptation in Colorectal Liver Metastases
- ClinicalTrials.gov ID
- NCT07497789
- Acronym / sponsor ID
- AIRC_ IG 34634 / AIRC_ IG 34634
- Keywords
- Colorectal cancer, liver metastases, liver metastases from colorectal cancer
- Study type
- Observational
- Recruitment status
- Not yet recruiting
- Enrolment
- 156 participants (estimated)
- Lead sponsor
- Azienda Ospedaliera Specializzata in Gastroenterologia Saverio de BellisUniversity, hospital or other
- Collaborators
- University of Bari
- Study start
- 10 May 2026 (estimated)
- Primary completion
- 10 May 2027 (estimated)
- Study completion
- 10 May 2028 (estimated)
- First posted
- 27 Mar 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study focuses on patients with colorectal cancer undergoing surgery for the primary tumor and/or liver metastases. Tumor samples collected during surgery will be used to generate patient-derived models (primary cultures, spheroids, and organoids) to study colorectal cancer stem cells. The main objective is to investigate the role of the lysine methyltransferase SMYD3 in metabolic reprogramming and adaptation to oxidative stress that enable colorectal cancer cells to survive and grow in the liver. Previous work has shown that SMYD3 is overexpressed in colorectal cancer, promotes drug resistance, and regulates key oncogenic pathways, including c-MYC and the AMPK/mTOR axis. By identifying SMYD3-dependent pathways and pharmacologic vulnerabilities in cancer stem cells within liver metastases, this study aims to support the development of new therapeutic strategies that combine SMYD3 inhibitors with approved or experimental agents targeting tumor metabolism and oxidative stress responses
Detailed description
Colorectal cancer represents one of the leading causes of cancer-related mortality worldwide. A significant proportion of patients develop distant metastases during the course of the disease. Liver metastases are among the main causes of death in patients with colorectal cancer. Despite advances in the genetic characterization of colorectal carcinoma, the biological mechanisms that enable tumor cells to adapt to the hepatic microenvironment and establish metastases remain only partially understood. In particular, increasing evidence suggests that subpopulations of tumor cells with cancer stem cell-like properties play a key role in tumor progression, treatment resistance, and metastatic dissemination.
The study of tumor tissues directly derived from patients is a fundamental tool for understanding the molecular mechanisms underlying metastatic progression and for developing clinically relevant experimental models, such as primary cell cultures, spheroids, and tumor organoids.
The collection of tumor samples from patients undergoing surgical resection of primary colorectal cancer and/or hepatic metastases will allow molecular, cellular, and transcriptomic analyses aimed at identifying new potential therapeutic targets.
In this context, we aim to investigate the role of the methyltransferase SMYD3 in metabolic and oxidative stress adaptation mechanisms in colorectal cancer and its derived liver metastases. Indeed, SMYD3 has recently emerged as a significant oncogenic driver, overexpressed in several tumor types. Our recent studies have revealed its contribution to drug resistance in response to genotoxic stress. Targeting SMYD3, in combination with standard or targeted therapies, has shown promise in overcoming drug resistance across various cancer types, including colorectal carcinoma, supporting the integration of SMYD3 inhibition into cancer treatment regimens.
Moreover, we have identified several SMYD3-interacting partners implicated in molecular processes related to the hallmarks of cancer. Among these are AMPK and mTOR: AMPK acts as the cell's main metabolic guardian, rewiring energy fluxes to sustain survival under stress, while mTOR regulates anabolic growth in response to nutrient availability. In this context, SMYD3 emerges as a key factor mediating processes encompassed within two major functional clusters - one involved in DNA damage repair and the other in sustaining oncogenic signaling.
Our investigations into the involvement of SMYD3 in cancer progression have advanced through an extensive molecular and functional characterization of its role in the biology of cancer stem cells, as this population is responsible for chemoresistance, recurrence, and metastasis in colorectal carcinoma. We have demonstrated that SMYD3 inhibition or stable genetic ablation affects the clonogenic and self-renewal potential of cancer stem cells and patient-derived organoids by altering their molecular signature. Furthermore, we discovered that both stable ablation and pharmacological inhibition drastically reduce the metastatic potential of cancer stem cells, identifying SMYD3 as a promising therapeutic target acting directly on the oncogene c-MYC, with potential implications for counteracting cancer stem cell proliferation and metastatic spread.
Based on this novel role of SMYD3 in cancer stem cells and metastatic dissemination, this project aims to define its contribution to the reprogramming processes that enable metastatic cells to adapt to the hepatic microenvironment under new and stressful conditions. Therefore, by delineating SMYD3-dependent pathways that promote cancer stem cell survival in liver metastases, we aim to exploit their pharmacological vulnerabilities for the development of new therapeutic strategies integrating SMYD3 inhibitors with clinically available or experimental compounds targeting tumor metabolism and oxidative stress adaptation
Study design
- Observational model
- Other
- Time perspective
- Prospective
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Patients with CRC (colorectal cancer) | – | –Patients undergoing surgery for primary colorectal carcinoma, without liver metastases |
| Patients with colorectal cancer (CRC) and liver metastase | – | –Patients undergoing surgery for primary colorectal carcinoma who simultaneously present liver metastases from colorectal carcinoma. In this case, tissue samples will be taken from both the colorectal carcinoma and the liver metastases |
| Patients with liver metastase | – | –Patients undergoing surgery for the resection of liver metastases from previously operated colorectal cancer |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- This study is a multicenter prospective observational study and involves the collection of biological samples from patients undergoing surgery for CRC and/or liver metastases
Key inclusion criteria (9 listed)
- Common criteria
- Age ≥ 18 years.
- Availability of residual tumor tissue from the surgical procedure that is not required for diagnostic purposes.
- Signed written informed consent for the use of biological samples for research purposes.
- Cohort/Arm 1 (Colon-rectal tumor resection)
Key exclusion criteria (3 listed)
- Age < 18 years.
- Undergoing surgical intervention for a malignancy other than those specified in the inclusion criteria.
- Lack of signed informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Molecular and Cellular mechanisms
Time frame: At the time of the surgery
Identification of the molecular and cellular mechanisms involved in metastatic progression that depend on the methyltransferase SMYD3
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Apr 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Questions about this trial
What is this clinical trial studying?
An observational study of CRC (Colorectal Cancer) and Liver Metastases From Colorectal Primary Cancer, run by Azienda Ospedaliera Specializzata in Gastroenterologia Saverio de Bellis.
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 9 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: opening soon, as of the sponsor's last update on 6 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
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 Cristiano Simone, MD (+390804994615, cristiano.simone@irccsdebellis.it), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Molecular and Cellular mechanisms (time frame: At the time of the surgery). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 6 Apr 2026.