Grant received in 2022
DCCC has funded 200.000 DKK to the project.
For decades, the imaging criteria "RECIST" have been used as a primary tool for assessing the effect of treatment and deciding whether to change treatment, end or continue palliative antineoplastic treatment for solid tumors. However, it is well known that the RECIST classification is an insufficient surrogate measure of survival. Better tools could contribute to sparing patients unnecessary chemotherapy, and at the same time offer an earlier switch to a more effective treatment regimen. In addition, resources from radiology will be freed up, and patients will avoid unnecessary repeated scans.
This project aims to show that ctDNA in the blood can be used to assess the effect of systemic treatment in patients with widespread metastatic cancer instead of scans. This is carried out in the form of randomised clinical studies within several cancer types, which the project is the first to do. The studies will examine ctDNA RECIST in relation to whether it is a better measure of survival.
The project contributes to the fact that, in the long term, ctDNA can be a far more rational evaluation of the effect of systemic treatment in metastatic cancer disease compared to the currently used response criteria based on measurements of lesions on scans.
In this way, patients will be spared ineffective treatment and at the same time have the opportunity to switch to more effective treatment earlier. In addition, it will be possible to free up resources for radiological examinations in other contexts.
Multidisciplinary organisation
The first study will be implemented by endorsement from Danish Colorectal Cancer Group (DCCG), as well as under CFA4 in the ctDNA research center. After that, work will be done to establish multiple DMCGs, as ctDNA-RECIST will be a pan-cancer concept.
Project stakeholders
The DMCG structure will enable a close national collaboration, and the project haas the strong national ctDNA center initiatives to support networking and dissemination.
The group taking the primary initiative to the ctDNA-RECIST program include participants from
- Central Denmark Region (Professor Karen-Lise Garm Spindler, Aarhus University Hospital, primary contact, e-mail: k.g.spindler@rm.dk)
- The Region of Southern Denmark (Professor Anders Jakobsen, Hospital Lillebælt, Professor Torben Hansen, department of Oncology, Hospital Lillebælt, Senior scientist Rikke Fredslund Andersen, Laboratory center, Hospital Lillebælt)
- Region Zealand (Professor Niels Pallisgaard, Department of Pathology, Zealand Universityhospital)
Thus, fulfilling the DCCC requirements for national involvement.
The aim of the application is to ensure support to develop the ctDNA-RECIST-program with the:
- Different DMCGs to enhance national inclusion in clinical protocols and validations.
- ctDNA performing laboratories under the DCCC ctDNA center, including Region Sjælland (Niels Pallisgaard) and South (Rikke Fredslund Andersen, and Karen-Lise Garm Spindler, Aarhus University Hospital).
- International collaboration will be sought.