The CIRCPAC study was represented at DKS 2023
The RESPONSE project was chosen for oral presentation at the “Dansk Kirurgisk Selskab” 2023 in November.
One of ACROBATIC’s recently affiliated projects “CIRCPAC: Implementing non-invasive circulating tumor DNA and circular DNA analysis in patients with localized pancreatic cancer to optimize pre- and postoperative treatment” was presented by Post Doc and surgeon Mai-Britt Worm Ørntoft’.
Background: Patients with pancreatic cancer (PC) have a dismal prognosis with a 5-year overall survival (OS) of 10%. Less than 20% of patients with PC are eligible for curative resection, and ~80% of resected patients experience relapse within the first few years. Circulating tumor DNA (ctDNA) and extrachromosomal circular DNA (eccDNA) in blood are emerging new tools for monitoring disease progression and recurrence. To explore ctDNA/eccDNA as diagnostic, prognostic, and predictive markers in PC, we have initiated CIRCPAC.
Method: CIRCPAC is a national trial consisting of two studies: Study I includes ~700 patients with suspected PC and will retrospectively explore whether ctDNA/eccDNA aberrations in pre-operative blood samples can predict pathological diagnosis and early recurrence. Further, it investigates whether postoperative ctDNA/eccDNA tests are prognostic for OS. From study I, patients with pancreatic ductal adenocarcinoma (PDAC) will be eligible for study II (n=410), a prospective randomized controlled trial (RCT), if they are recurrence-free at 6 months. The RCT randomizes PDAC patients to either standard follow-up (current guidelines) or an intensive follow-up program with longitudinal ctDNA measurements every 3 months to identify patients with high recurrence risk. ctDNA positive patients will be offered EUS/CT imaging every 3 months, whereas ctDNA negative patients will be offered EUS/CT imaging every 6 months. Endpoints will be time to recurrence; OS; quality of life; number of patients in experimental/palliative oncological treatment; and health economic costs compared between groups after three years of follow-up.
Conclusion: We foresee that ctDNA/eccDNA biomarkers will reveal much needed diagnostic, predictive, and prognostic discriminatory abilities, and can be identify high-risk patients suspected of PC in daily clinical practice. Further we hope that an intensive follow-up strategy for patients with PC will lead to better treatment of recurrence, with the potential for improvement of OS and quality of life.