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| ID | Type | Description | Link |
|---|---|---|---|
| 2019-A02479-48 | Other Identifier | ANSM IDRCB Number | |
| ML41112 | Other Identifier | Roche ID |
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COPE is a biology driven protocol with 2 independent, multicentric, two-arm non-comparative randomized (2:1) phase II trials in 2 distinct populations: colorectal cancer patients and non-small-lung cancer patients.
For each phase II trial, patient will be randomized between two arms with two patients randomized in arm A for one patient randomized in arm B:
Primary tumor tissue, if accessible at all, does not always provide enough information to stratify individual patients to the most promising therapy. Re-analysis of metastatic lesions by needle biopsy is possible but invasive, and limited by the known intra-patient heterogeneity of individual lesions. These hurdles might be overcome by analyzing circulating tumor DNA (liquid biopsy), which in principle might reflect all subclones present at that specific time point and allow sequential monitoring of disease evolution.
Once tumor's genetic profiling is available, patients will be discussed within a multidisciplinary tumor board (MTB) which aims at discussing the genomic profiles and at providing a therapeutic decision for each patient. This MTB involves clinical oncologists, molecular biologists and clinical or biological project manager.
All the patients carrying an actionnable alteration will be proposed to receive a matched drug or to enter in a matched clinical trial depending on the possibility of inclusion at the time of molecular report.
the investigators hypothesize that implementing sequential circulating tumor DNA analysis can improve management of patients with advanced cancer and therefore their survival.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental procedure for colorectal cancer | Experimental | Patients with Advanced colorectal cancer will be managed by initial MTB providing therapeutic recommendation based on tumor sequencing and then follow-up combining standard imaging and ctDNA analysis (subsequent MTBs at each radiological assessment) |
|
| Standard procedure for colorectal cancer | No Intervention | Patients with Advanced colorectal cancer will be managedby initial MTB providing therapeutic recommendation based on tumor sequencing and then follow-up based on standard imaging. | |
| Experimental procedure for non-small cell lung cancer | Experimental | Patients with Advanced non-small cell lung cancer will be managed by initial MTB providing therapeutic recommendation based on tumor sequencing and then follow-up combining standard imaging and ctDNA analysis (subsequent MTBs at each radiological assessment) |
|
| Standard procedure for non-small cell lung cancer | No Intervention | Patients with Advanced non-small cell lung cancer will be managed by initial MTB providing therapeutic recommendation based on tumor sequencing and then follow-up based on standard imaging. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Liquid biopsy | Genetic | Liquid biopsy will be performed at cycle 1 day 1 and cycle 2 day of each line of systemic treatment, at each tumor evaluation by Imaging and at confirmation of progression |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of cancer outcome in terms of overall survival (2 distincts population) | Overall Survival (OS) is defined as the time interval between the date of randomization and the date of death (of any cause). | 18 months |
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients with at least one actionable alteration (in 2 distincts populations) | An actionable alteration is determined according to the molecular tumor board. | Throughout the study: an average of 18 months |
| Proportion of patients treated with a targeted therapy (in 2 distincts populations) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Antoine ITALIANO, MD, PhD | Contact | 5.56.33.33.33 | +33 | a.italiano@bordeaux.unicancer.fr |
| Simone MATHOULIN-PELISSIER, MD, PhD | Contact | s.mathoulin@bordeaux.unicancer.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre hospitalier de la Côte Basque | Recruiting | Bayonne | 64109 | France |
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| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D009362 | Neoplasm Metastasis |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
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| ID | Term |
|---|---|
| D000073890 | Liquid Biopsy |
| ID | Term |
|---|---|
| D001706 | Biopsy |
| D003581 | Cytodiagnosis |
| D003584 | Cytological Techniques |
| D019411 | Clinical Laboratory Techniques |
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For each distinct population of patients with Advanced solid tumor (colorectal cancer and non-small-cell lung cancer), patients will be randomized between two arms:
Experimental procedure: initial MTB providing therapeutic recommendation based on tumor sequencing and then follow-up combining standard imaging and ctDNA analysis (subsequent MTBs at each radiological assessment).
Standard procedure: initial MTB providing therapeutic recommendation based on tumor sequencing and then follow-up based on standard imaging.
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A profiling-based targeted therapy corresponds to a therapy targeting an actionable alteration |
| Throughout the study: an average of 18 months |
| Clinique Tivoli-Ducos | Recruiting | Bordeaux | 33000 | France |
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| Institut Bergonie | Recruiting | Bordeaux | 33076 | France |
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| Polyclinique Bordeaux Nord Aquitaine | Recruiting | Bordeaux | 33077 | France |
|
| CHRU Brest | Recruiting | Brest | 29200 | France |
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| Polyclinique Marzet | Recruiting | Pau | 64000 | France |
|
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D009385 | Neoplastic Processes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019937 |
| Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D013048 | Specimen Handling |
| D008919 | Investigative Techniques |