A Gut Microbiome-based Diagnostic Tool for the Screening of Colorectal Cancer

Status: Recruiting
Location: See location...
Intervention Type: Diagnostic test
Study Type: Observational
SUMMARY

Colorectal cancer (CRC) is one of the most common cancer and cause of cancer death worldwide. Population-based screening programs for average risk populations have proven effective in reducing both incidence and mortality of CRC through early detection of cancer. The fecal immunochemical testing (FIT), has still a suboptimal diagnostic yield, with both missed adenomas and, mainly, unnecessary colonoscopies.The identification of novel, non-invasive biomarkers is currently one of the research areas driving most expenditure forces in the field of CRC.A large body of evidence shows that alterations of the gut microbiome and the enrichment of specific taxa(e.g. Fusobacterium nucleatum, Parvimonas micra, and others) are involved in the pathogenesis of CRC. Moreover, recent studies, have discovered common microbial signatures able to reproducibly discriminate between patients with CRC and healthy controls.The goal of this observational study to develop a gut microbiome based diagnostic tool for the identification of CRC and advanced colorectal adenomas in patients enrolled in the national colorectal cancer (CRC) screening program (50-69 year-old) and among who refer to all centers involved in this study for screening colonoscopy with positivity of FIT, of both sex. The primary endpoint of the study is to develop a gut microbiome-based diagnostic tool for the identification of CRC and advanced colorectal adenomas in patients involved in the national CRC screening program, using both statistical and machine learning approaches. The secondary endpoints are: * The association of clinical and colonoscopy outcomes with FIT results; * The characterization of gut microbiome from an ecological, taxonomic, phylogenetic and functional point of view; * The association between microbiome signatures with clinical and colonoscopy outcomes, through statistical and machine-learning algorithms. At baseline, enrolled patients will provide a fecal sample within 2 weeks from enrollment and demographic, clinical characteristics and laboratory data will be recorded. Enrolled patients will be scheduled for colonoscopy, as for clinical practice, within 4 weeks from the positive FIT and histology of resected lesions will be assessed by experienced pathologists according to the WHO classification and the Vienna criteria. Clinical, endoscopic and microbial data will be combined through statistical and machine learning algorithms to identify specific microbial biomarkers associated with CRC and develop a new diagnostic tool, based on a scoring system. This tool will be validated, and its diagnostic performances will be compared with traditional screening methods.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 50
Maximum Age: 74
Healthy Volunteers: f
View:

• Patients participating in the national CRC screening program (50-74 years old)

• Positivity to the FIT;

• Ability to provide written informed consent and to be compliant with the study procedures.

Locations
Other Locations
Italy
Catholic University of the Sacred Heart
RECRUITING
Rome
Contact Information
Primary
Gianluca Ianiro, MD, PhD
gianluca.ianiro@unicatt.it
0630159539
Backup
Serena Porcari, MD, PhD
serena.porcari@guest.policlinicogemelli.it
0630159539
Time Frame
Start Date: 2025-02-07
Estimated Completion Date: 2029-09-30
Participants
Target number of participants: 1202
Treatments
Groups/Cohorts
Study cohort consists of patients enrolled in the national colorectal cancer (CRC) screening program.Participants will be selected among those enrolled in the nationalcolorectal cancer (CRC) screening program and among who refer to all centers involved in this study for screening colonoscopy. Patients with all inclusion criteria and none of the exclusion criteria will be considered for this study. N=1202 patients will be enrolled, based on sample size calculation and including a validation group.~N=911 patients will be needed, and we will add 91 patients to cover a 10% potential drop-out and 200 patients as a validation group (20% of the study cohort).
Related Therapeutic Areas
Sponsors
Leads: Catholic University of the Sacred Heart

This content was sourced from clinicaltrials.gov