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Biliary Tract Cancer (BTC)NCT07830628

Bile ctDNA Genomic Profiling and Concordance With Tumor Tissue in Biliary Tract Cancer

An observational study of Biliary Tract Cancer (BTC), run by CHA University at 1 site in South Korea.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study is being done to find out whether bile fluid can be used to detect genetic changes in tumors of patients with advanced biliary tract cancer (BTC), such as cancer of the bile ducts or gallbladder. Read more about this study

Who is it for?
Ages 19 years and older
Conditions the study is for
Biliary Tract Cancer (BTC)
What is being tested?
Bile Sampling for ctDNA Analysis
How many people
100 participants
Where
1 siteSouth Korea
Study dates
1 Oct 2026to 31 Aug 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 19 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: The study population consists of adult patients with advanced (unresectable or metastatic) biliary tract cancer, including intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and gallbladder cancer, who are treated at 4 tertiary hospitals in South Korea. Eligible patients are those who are about to undergo clinically indicated biliary drainage (ERCP or PTBD) prior to first-line systemic anti-cancer therapy, from whom residual bile can be collected without any additional invasive procedure. Patients may be enrolled at the time of bile collection even before histologic confirmation of biliary tract cancer; however, only patients with subsequently confirmed histologic diagnosis are included in the final analysis. Enrollment is conducted on a competitive basis across participating sites, with a target of approximately 50% of enrolled patients having intrahepatic cholangiocarcinoma, given the higher frequency of actionable mutations in this subtype.

Who may be able to join

  • Adult male or female patients aged 19 years or older
  • Histologically confirmed advanced biliary tract cancer (intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, or gallbladder cancer), or clinically suspected biliary tract cancer pending histologic confirmation
  • Prior to first-line systemic anti-cancer therapy (patients who relapsed ≥6 months after curative surgery or adjuvant chemotherapy are eligible)
  • Tumor tissue next-generation sequencing (NGS) already performed or planned
  • Willing to provide blood and bile samples for ctDNA analysis

Who cannot join

  • Patients from whom a bile sample cannot be obtained during clinically indicated biliary drainage (ERCP or PTBD)
  • Patients who decline blood sampling for ctDNA testing
  • Patients unable to provide informed consent

Trial locations and contacts

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

Hong Jae Chon, MD. PhD contact

82-31-780-3928

hongjaechon@gmail.com

South Korea1 site
  • CHA Bundang Medical Center

    Seongnam-si, Gyeonggi-do, 13496

    Hong Jae Chon, MD. PhD, 82-31-780-3928, hongjaechon@gmail.com

    Hong Jae Chon

Other trials in South Korea

About this study

Official title: A Prospective Multicenter Observational Study to Evaluate Genomic Profiling of Bile-Derived Circulating Tumor DNA (Bile ctDNA) and Its Concordance With Tumor Tissue DNA in Patients With Advanced Biliary Tract Cancer (BTC)

This study is being done to find out whether bile fluid can be used to detect genetic changes in tumors of patients with advanced biliary tract cancer (BTC), such as cancer of the bile ducts or gallbladder.

Currently, doctors often use a sample of tumor tissue to look for genetic changes that can help guide treatment decisions, including the use of targeted therapies. However, in biliary tract cancer, it can be difficult or risky to collect enough tumor tissue for this kind of testing.

Read more

This study will collect a small amount of leftover bile (about 20 mL) during a procedure that patients are already having for medical reasons (such as endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD), which are used to drain bile). A blood sample (about 20 mL) will also be collected at the same time patients are already having blood drawn as part of their regular care. No additional needle sticks or procedures will be done only for this study.

Researchers will analyze the genetic material found in the bile and blood samples and compare the results with the genetic testing already done on the patient's tumor tissue. The main goal is to see how closely the genetic changes found in bile match those found in tumor tissue. The study will also look at whether bile testing can detect genetic changes that may help guide treatment, and whether these results are related to how patients respond to treatment and their long-term outcomes.

About 100 patients with advanced biliary tract cancer will take part in this study at 4 hospitals in South Korea.

Read the detailed description

Biliary tract cancer (BTC) is a heterogeneous and aggressive malignancy with poor prognosis, especially in advanced or metastatic stages where surgical resection is not feasible. The current standard first-line therapy with gemcitabine and cisplatin, now combined with immune checkpoint inhibitors, still provides limited long-term survival. Targeted therapies - including FGFR inhibitors for FGFR2 fusions, IDH1 inhibitors, and HER2-directed agents - have improved outcomes in molecularly selected subsets of patients. However, tumor tissue acquisition remains challenging in BTC due to the anatomically inaccessible location of many tumors and frequently insufficient tumor content, limiting the ability to perform comprehensive genomic profiling in a substantial proportion of patients.

Circulating tumor DNA (ctDNA) has emerged as a promising, minimally invasive biomarker for molecular profiling in BTC. While plasma-based ctDNA has shown acceptable concordance with tissue-based next-generation sequencing (NGS) in prior studies, its sensitivity is reduced in patients with locally advanced disease due to lower circulating DNA concentrations. Because bile is in direct contact with biliary tumors, it may harbor tumor-derived DNA at substantially higher concentrations and variant allele frequencies than plasma, suggesting the potential for improved sensitivity and reliability in mutation detection. Preliminary data support higher bile DNA yield and higher concordance with tumor tissue NGS compared with plasma ctDNA, and bile ctDNA alterations have also shown associations with survival outcomes. However, evidence supporting the clinical utility of bile ctDNA remains limited, and no large-scale prospective study has systematically evaluated its concordance with tumor tissue genomic profiling.

This prospective, multicenter, observational study will enroll 100 Korean patients with advanced or metastatic BTC from 4 hospitals, using a competitive enrollment strategy with a target of approximately 50% intrahepatic cholangiocarcinoma. Eligible patients provide a single blood sample (approximately 20 mL) and a single bile sample (approximately 20 mL, collected as residual fluid during clinically indicated biliary drainage via endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic biliary drainage (PTBD)) prior to first-line systemic anti-cancer therapy; no additional invasive procedure is performed solely for research purposes. Collected samples are sent to an external laboratory for ctDNA extraction and NGS-based genomic analysis.

The primary objective is to evaluate the concordance of genetic variants between bile ctDNA and tumor tissue DNA in patients with advanced BTC. Secondary objectives include:

  • Assessing the frequency of actionable genomic alterations (FGFR2 fusion, IDH1 mutation, HER2 amplification) detected in bile ctDNA
  • Evaluating the concordance of genetic variants between bile ctDNA and plasma ctDNA
  • Comparing mutation detection rates among bile ctDNA, plasma ctDNA, and tumor tissue DNA Exploratory analyses will examine the association between bile ctDNA maximum variant allele frequency (max VAF) and tumor burden/clinical prognosis, characterize additional genetic variants uniquely detected in bile ctDNA, and explore potential therapeutic targets identified through bile ctDNA-based genomic analysis.

This study is expected to provide evidence for the clinical utility of bile ctDNA as a complementary or alternative molecular diagnostic tool in BTC, particularly for patients in whom tumor tissue acquisition is difficult, and to contribute to the development of precision medicine strategies for patient-tailored treatment selection.

Being tested
Bile Sampling for ctDNA Analysis
Keywords
Biliary Tract Cancer, Biomarker, Circulating Tumor DNA (ctDNA)
Medical subject headings
Biliary Tract Neoplasms

What participants receive

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

  • Bile Sampling for ctDNA AnalysisOther

    Also called Liquid Biopsy; Bile Collection

    Bile (approximately 20 mL) is collected once from patients with advanced biliary tract cancer, prior to first-line systemic therapy. The sample is obtained as residual fluid during a clinically indicated biliary drainage procedure (ERCP or PTBD); no additional invasive procedure is performed for research purposes. The sample is sent to an external laboratory for circulating tumor DNA (ctDNA) extraction and next-generation sequencing (NGS)-based genomic analysis, to evaluate concordance of genetic variants with tumor tissue DNA and, where available, plasma ctDNA.

Study groups in NCT07830628
Study groupRoleWhat they receive
Advanced Biliary Tract Cancer PatientsPatients with histologically confirmed advanced or metastatic biliary tract cancer (intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, or gallbladder cancer). Participants will provide bile samples for circulating tumor DNA (ctDNA) analysis before systemic therapy or prior to subsequent treatment.
Receives: Other: Bile Sampling for ctDNA Analysis

What is being measured

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

  1. Concordance rate of genetic variants between bile ctDNA and tumor tissue DNA

    Genetic variants detected by next-generation sequencing (NGS) of bile-derived circulating tumor DNA (ctDNA) will be compared with variants identified by tumor tissue NGS performed as part of standard clinical care. Concordance will be assessed using sensitivity and positive predictive value (PPV), with 90% confidence intervals.

    Measured: Baseline

Secondary outcomes (3)
  1. Frequency of actionable genomic alterations detected in bile ctDNA

    Frequency of FGFR2 fusion, IDH1 mutation, and HER2 amplification detected by NGS-based analysis of bile-derived ctDNA.

    Measured: Up to 24 months

  2. Concordance rate of genetic variants between bile ctDNA and plasma ctDNA

    Concordance of genetic variants detected by NGS between bile ctDNA and plasma ctDNA, assessed using sensitivity and positive predictive value where applicable.

    Measured: Up to 24 months

  3. Mutation detection rate comparison among bile ctDNA, plasma ctDNA, and tumor tissue DNA

    Proportion of genetic variants detected in each of the three sample types (bile ctDNA, plasma ctDNA, tumor tissue DNA), compared across sample sources.

    Measured: Up to 24 months

Timeline

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

  1. First posted21 Sep 2026
  2. Study start1 Oct 2026 (estimated)
  3. Primary completion31 Aug 2028 (estimated)
  4. Study completion31 Aug 2028 (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
Cohort
Time perspective
Prospective
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07830628
Sponsor's protocol ID
CHAMC 2026-06-033
Status last verified
Sep 2026
First submitted
15 Sep 2026
Last updated
13 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Han JY, Ahn KS, Kim TS, Kim YH, Cho KB, Shin DW, Baek WK, Suh SI, Jang BC, Kang KJ. Liquid Biopsy from Bile-Circulating Tumor DNA in Patients with Biliary Tract Cancer. Cancers (Basel). 2021 Sep 12;13(18):4581. doi: 10.3390/cancers13184581.

    PubMed 34572808
  • Gou Q, Zhang CZ, Sun ZH, Wu LG, Chen Y, Mo ZQ, Mai QC, He J, Zhou ZX, Shi F, Cui W, Zou W, Lv L, Zhuang WH, Xu RD, Li WK, Zhang J, Du HW, Xiang JX, Wang HZ, Hou T, Li ST, Li Y, Chen XM, Zhou ZJ. Cell-free DNA from bile outperformed plasma as a potential alternative to tissue biopsy in biliary tract cancer. ESMO Open. 2021 Dec;6(6):100275. doi: 10.1016/j.esmoop.2021.100275. Epub 2021 Oct 12.

    PubMed 34653800
  • Li Z, Liu Y, Fu J, Mugaanyi J, Yan J, Lu C, Huang J. Bile is a reliable and valuable source to study cfDNA in biliary tract cancers. Front Oncol. 2022 Aug 26;12:961939. doi: 10.3389/fonc.2022.961939. eCollection 2022.

    PubMed 36091112
  • Hwang S, Woo S, Kang B, Kang H, Kim JS, Lee SH, Kwon CI, Kyung DS, Kim HP, Kim G, Kim C, Chon HJ. Concordance of ctDNA and tissue genomic profiling in advanced biliary tract cancer. J Hepatol. 2025 Apr;82(4):649-657. doi: 10.1016/j.jhep.2024.10.020. Epub 2024 Oct 21.

    PubMed 39442892

Questions about this trial

What is this clinical trial studying?

An observational study of Biliary Tract Cancer (BTC), run by CHA University at 1 site in South Korea.

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 5 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 13 Oct 2026. 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 South Korea. 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 Hong Jae Chon, MD. PhD (82-31-780-3928, hongjaechon@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Concordance rate of genetic variants between bile ctDNA and tumor tissue DNA (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 NCT07830628, 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 13 Oct 2026.

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