Deep Liver Phenotyping and Immunology Study (DELPHI)
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|ClinicalTrials.gov Identifier: NCT04946773|
Recruitment Status : Recruiting
First Posted : July 1, 2021
Last Update Posted : July 1, 2021
Hepatocellular carcinoma (HCC) and cholangiocarcinoma are the two most common causes of primary liver cancer and HCC is the second highest cause of cancer death worldwide. It is known that most of these cancers occur in patients who already have a liver condition. Despite close monitoring of many patients who have liver disease with regular ultrasound scans, HCC and cholangiocarcinoma are often discovered at a late stage. This is because they rarely cause symptoms until they have reached an advanced stage. Early identification of these cancers would enable more patients to have curative treatments such as surgery or liver transplantation.
The investigators want to collect blood and urine samples as well as small samples of cells directly from the liver. In some cases this will be done using a technique called liver fine needle aspiration. This technique is low risk and has been successfully used in other studies. The investigators will compare samples from patients with cancer to those of patients with other diseases of the liver who are at risk of developing cancer in the future.
The investigators aim to detect changes in the liver, blood, urine and/or bile of patients who have liver conditions that could tell us their risk of a future cancer. These changes could be in the types of white blood cells found within the liver, or, they may be in products secreted by liver cells. In the latter case the liver cells may release small pieces of their DNA that could be detected in the blood. When liver cells are dysfunctional, they may also change the types of metabolic products that they produce, and the investigators may be able to detect these changes in the urine or bile.
|Condition or disease|
|Hepatocellular Carcinoma Cholangiocarcinoma|
The purpose of this study is to perform a characterisation of the cancer predisposing 'field effect' that is associated with hepatic & hepato-biliary malignancy, and, to identify minimally invasive biomarkers that may detect this field effect. This will be achieved through collection of patient samples (Tissue/Blood/Urine/Bile). Comparisons will then be made between patients with hepatic & hepatobiliary cancer and patients with chronic liver disease and also longitudinally in individual patients who either develop or are cured of hepatic & hepato-biliary malignancy during the study. The investigators hope to exploit this knowledge to develop novel biomarker candidates that may ultimately form inputs to a multi-parametric early cancer detection model. The study aims are:
- Develop a cohort of patients with HCC, cholangiocarcinoma or liver metastases and a cohort of chronic liver disease patients representing all the commonly encountered aetiologies (viral, metabolic, autoimmune and alcohol related liver disease).
- Collect samples from directly within the non-cancerous liver (FNA liver/biopsy/ablation/resection specimens), blood and urine in addition tumour tissue (resection/biopsy/ablation), bile and bile duct brushings.
- Flow cytometric & molecular biologic analysis of tissue and peripheral blood and bile.
- Transcriptomic analysis of cell populations in liver and blood.
- Genetic & molecular biologic analysis of hepatic and immune cells and secreted products.
|Study Type :||Observational [Patient Registry]|
|Estimated Enrollment :||100 participants|
|Target Follow-Up Duration:||15 Years|
|Official Title:||Deep Liver Phenotyping and Immunology Study|
|Actual Study Start Date :||March 12, 2021|
|Estimated Primary Completion Date :||October 31, 2040|
|Estimated Study Completion Date :||October 31, 2040|
Patients with hepatic or hepatobiliary malignancy at enrolment
Patients with chronic liver disease but no hepatic or hepatobiliary malignancy at enrolment
- Defining the differences in the hepatic immune microenvironment that are associated with malignancy. [ Time Frame: At study enrolment ]Between group comparison of intra-hepatic and peripheral immune cell populations determined by single cell RNA sequencing.
- Long-term follow-up of patient cohorts [ Time Frame: 15 years ]Passive data collection on occurrence or recurrence of hepatic & hepatobiliary malignancy
- Identify candidate biomarkers [ Time Frame: 15 years ]Biomarkers for for early detection or early diagnosis of hepatic & hepatobiliary malignancy
- Fine needle aspiration in cirrhosis: safety [ Time Frame: 5 years ]Monitoring the safety of liver fine needle aspiration as a research procedure in cirrhotic patient cohorts. Determined through documentation of adverse events.
- Fine needle aspiration in cirrhosis: Tolerability [ Time Frame: 5 years ]Monitoring the tolerability of liver fine needle aspiration as a research procedure in cirrhotic patient cohorts. Evaluation of subjective post-procedure pain scores.
Biospecimen Retention: Samples With DNA
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04946773
|Contact: Rory J Peters||+441865220077||Rory.email@example.com|
|John Radcliffe Hospital||Recruiting|
|Oxford, Oxfordshire, United Kingdom, OX3 9DU|
|Contact: Rory J Peters +441865220077 Rory.firstname.lastname@example.org|
|Principal Investigator:||Rory J Peters||University of Oxford|