WP 3.14: CIRCPAC - Implementing plasma ctDNA analysis in patients with local pancreatic cancer to predict resectability, recurrence, and change prognosis

Patients diagnosed with pancreatic cancer (PC) have a dismal prognosis with a 5-year overall survival (OS) of only 10%. Less than 20% of patients with PC are eligible for curative resection, and around 80% of resected patients experience relapse within the first few years after surgery. Circulating tumor DNA (ctDNA) and extrachromosomal circular DNA (eccDNA) in blood are emerging new tools for monitoring disease progression and recurrence.
To explore the utility of ctDNA/eccDNA in PC, we have initiated CIRCPAC, a national multidisciplinary translational study.
We will include 700 patients with suspected PC and explore whether ctDNA/eccDNA are prognostic markers for OS. Of those, 410 will additionally be included in a randomized controlled trial, where the intervention is a new intensive follow-up program, with longitudinal ctDNA measurement, endoscopic ultrasound, and CT imaging. The endpoints, in terms of time to recurrence, OS, quality of life, and health economic costs, will be compared to standard-of-care after three years follow-up. The study includes all four Danish PC centers. Inclusion started in January 2023 and will expectedly run for three years.
We foresee that ctDNA/eccDNA biomarkers will reveal much needed diagnostic and predictive discriminatory abilities, that can be used to identify high-risk patients suspected of PC in the daily clinical practice. Further we hope that an intensive follow-up strategy will improve recurrence treatment, and thereby OS, as well as quality of life for patients with PC.

Awarded to: Claus Lindbjerg Andersen (MOMA) – CFA3

Awarded grant to support VIP and TAP personnel.