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CompletedNCT06342427DESTINEXUpdated Jul 8, 2024

Stomach Cancer Exosome-based Detection

An observational study in Gastric Cancer, Gastric Adenocarcinoma and Gastric Cancer Stage, sponsored by City of Hope Medical Center. Completed at 3 sites in 2 countries. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-07-08.

Sponsored by City of Hope Medical Center · Observational

Study type
Observational
Model
Case-control
Time perspective
Retrospective
Enrollment
809
Ages
18 Years and older
Sex
All
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Study summary

Gastric cancer continues to have a poor prognosis primarily due to the inability to detect it in its early stages. This study will develop and validate a blood assay to facilitate the non-invasive detection of gastric cancer.

Read the detailed description

Gastric cancer continues to have a poor prognosis primarily due to the inability to detect it in its early stages. Because conventional endoscopy is invasive and costly, gastric cancer is currently not considered to be screenable at a population level. However, if one could find less invasive and cheaper tools that accurately detect gastric cancer in its early stages, it could make a significant difference. Accurate biomarkers could help identify patients with gastric cancer before it becomes incurable.

This study aims to develop a non-invasive test to detect gastric cancer early. It consists of four phases:

  1. Discovering potential biomarkers with a comprehensive and genome-wide transcriptomic sequencing analysis that will involve gastric cancer tissue, normal tissue, and serum samples from patients with gastric cancer, as well as samples from people without the disease.
  2. Using machine learning to develop a combination "signature" of cell-free (cf) and exosomal (exo)-miRNA in serum specimens from a training cohort.
  3. A validation of this signature in an independent cohort to confirm its accuracy.
  4. An evaluation of the temporal trend of this signature in paired samples collected pre-surgery and post-surgery to investigate their potential and specificity as indicators of minimal residual disease.

In summary, this study aims to develop a highly accurate and cost-effective blood test for detecting gastric cancer early. Success could lead to significant improvements in clinical practice by catching cancer when it is most treatable. By combining different genetic markers (cell-free microRNA and exosomal microRNA) for accuracy, this study has the potential to reduce gastric cancer deaths and could lead to new screening methods in the future.

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Conditions studied

  • Gastric Cancer
  • Gastric Adenocarcinoma
  • Gastric Cancer Stage
  • Gastric Neoplasm
  • Gastric Lesion
  • Gastric Cancer in Situ
  • Gastric Cancer Stage IV
  • Gastric Cancer Stage IIIB
  • Gastric Cancer Stage III
  • Gastric Cancer Stage IB
  • Gastric Cancer Stage IA
  • Gastric Cancer, Stage 0
  • Gastric Cancer Stage IIIA
  • Gastric Cancer Stage II
  • Gastric Cancer TNM Staging
  • Gastric Cancer Metastatic to Lung
  • Gastric Cancer Metastatic to Liver
  • Gastric Cancer Stage I
  • Gastric Cancer TNM Staging Primary Tumor (T) T2B
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In context

Stomach Neoplasms

2,851 studies on the registry are indexed under Stomach Neoplasms; 864 are open to participants now.

This study's enrollment of 809 is above the median of 274 across 670 observational studies indexed under Stomach Neoplasms.

Browse Stomach Neoplasms studies →

Lead sponsor

City of Hope Medical Center is the lead sponsor of 670 studies on the registry; 181 are open to participants now.

Of its 30 completed or terminated interventional studies of FDA-regulated products, 12 (40%) have results posted.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Two cohorts of individuals with and without gastric cancer (cases and controls, respectively)

Inclusion criteria

  • Histological diagnosis of stage I, II, III, IV gastric cancer (TNM classification, 8th edition) (cases).
  • Received standard diagnostic and staging procedures as per local guidelines, and at least one sample was drawn before receiving any curative-intent treatment.
  • Confirmed cancer-free status at the time of study inclusion (Non-disease controls).

Exclusion criteria

Exclusion Criteria:

  • Lack of written informed consent.
  • Systemic therapy before sampling.
  • Synchronous gastric and non-gastric cancer diagnosed at or before surgery.
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Study design

Observational model
Case-control
Time perspective
Retrospective
Enrollment
809 participants (actual)
Patient registry
No
Biospecimen retention
Samples without dna

Groups and cohorts

  • Patients with Gastric Cancer (Training)

    Individuals with a pathologically confirmed diagnosis of gastric cancer

    Diagnostic Test: DESTINEX

  • Patients without Gastric Cancer (Training)

    Individuals without cancer at the time of blood sampling

    Diagnostic Test: DESTINEX

  • Patients with Gastric Cancer (Validation)

    Individuals with a pathologically confirmed diagnosis of gastric cancer

    Diagnostic Test: DESTINEX

  • Patients without Gastric Cancer (Validation)

    Individuals without cancer at the time of blood sampling

    Diagnostic Test: DESTINEX

Interventions

  • Diagnostic testDESTINEX

    A panel of microRNA, whose expression level is tested in serum samples.

    Also known as: DESTINEX (DEtection of STomach NEoplasia in circulating eXosomes)

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What researchers measure

Primary outcomes

  1. Sensitivity

    True positive rate: the probability of a positive test result, conditioned on the individual truly being positive

    Time frame: Through study completion, an average of 1 year

Secondary outcomes

  1. Specificity

    True negative rate: the probability of a negative test result, conditioned on the individual truly being negative

    Time frame: Through study completion, an average of 1 year

  2. Proportion of correct predictions (true positives and true negatives) among the total cases (i.e., accuracy)

    A measure of trueness: proportion of correct predictions (both true positives and true negatives) among the total number of cases examined

    Time frame: Through study completion, an average of 1 year

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Study locations

3 sites
  • City of Hope Medical Center
    Duarte, California 91010, United States
  • Nagoya University
    Nagoya, Japan
  • Mie University
    Tsu, Japan
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References and documents

Publications

  • Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet. 2020 Aug 29;396(10251):635-648. doi: 10.1016/S0140-6736(20)31288-5. PubMed 32861308 ↗
  • Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4. PubMed 33538338 ↗
  • Nishiwada S, Cui Y, Sho M, Jun E, Akahori T, Nakamura K, Sonohara F, Yamada S, Fujii T, Han IW, Tsai S, Kodera Y, Park JO, Von Hoff D, Kim SC, Li W, Goel A. Transcriptomic Profiling Identifies an Exosomal microRNA Signature for Predicting Recurrence Following Surgery in Patients With Pancreatic Ductal Adenocarcinoma. Ann Surg. 2022 Dec 1;276(6):e876-e885. doi: 10.1097/SLA.0000000000004993. Epub 2021 Jun 16. PubMed 34132691 ↗
  • Pasechnikov V, Chukov S, Fedorov E, Kikuste I, Leja M. Gastric cancer: prevention, screening and early diagnosis. World J Gastroenterol. 2014 Oct 14;20(38):13842-62. doi: 10.3748/wjg.v20.i38.13842. PubMed 25320521 ↗
  • Lee JH, Kim JG, Jung HK, Kim JH, Jeong WK, Jeon TJ, Kim JM, Kim YI, Ryu KW, Kong SH, Kim HI, Jung HY, Kim YS, Zang DY, Cho JY, Park JO, Lim DH, Jung ES, Ahn HS, Kim HJ. Clinical practice guidelines for gastric cancer in Korea: an evidence-based approach. J Gastric Cancer. 2014 Jun;14(2):87-104. doi: 10.5230/jgc.2014.14.2.87. Epub 2014 Jun 30. PubMed 25061536 ↗
  • Shimada H, Noie T, Ohashi M, Oba K, Takahashi Y. Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association. Gastric Cancer. 2014 Jan;17(1):26-33. doi: 10.1007/s10120-013-0259-5. Epub 2013 Apr 10. PubMed 23572188 ↗
  • Heitzer E, Haque IS, Roberts CES, Speicher MR. Current and future perspectives of liquid biopsies in genomics-driven oncology. Nat Rev Genet. 2019 Feb;20(2):71-88. doi: 10.1038/s41576-018-0071-5. PubMed 30410101 ↗
  • Siravegna G, Mussolin B, Venesio T, Marsoni S, Seoane J, Dive C, Papadopoulos N, Kopetz S, Corcoran RB, Siu LL, Bardelli A. How liquid biopsies can change clinical practice in oncology. Ann Oncol. 2019 Oct 1;30(10):1580-1590. doi: 10.1093/annonc/mdz227. PubMed 31373349 ↗
  • Jung G, Hernandez-Illan E, Moreira L, Balaguer F, Goel A. Epigenetics of colorectal cancer: biomarker and therapeutic potential. Nat Rev Gastroenterol Hepatol. 2020 Feb;17(2):111-130. doi: 10.1038/s41575-019-0230-y. Epub 2020 Jan 3. PubMed 31900466 ↗
  • Rupaimoole R, Slack FJ. MicroRNA therapeutics: towards a new era for the management of cancer and other diseases. Nat Rev Drug Discov. 2017 Mar;16(3):203-222. doi: 10.1038/nrd.2016.246. Epub 2017 Feb 17. PubMed 28209991 ↗
  • Schwarzenbach H, Nishida N, Calin GA, Pantel K. Clinical relevance of circulating cell-free microRNAs in cancer. Nat Rev Clin Oncol. 2014 Mar;11(3):145-56. doi: 10.1038/nrclinonc.2014.5. Epub 2014 Feb 4. PubMed 24492836 ↗
  • Shigeyasu K, Toden S, Zumwalt TJ, Okugawa Y, Goel A. Emerging Role of MicroRNAs as Liquid Biopsy Biomarkers in Gastrointestinal Cancers. Clin Cancer Res. 2017 May 15;23(10):2391-2399. doi: 10.1158/1078-0432.CCR-16-1676. Epub 2017 Jan 31. PubMed 28143873 ↗
  • Toiyama Y, Okugawa Y, Goel A. DNA methylation and microRNA biomarkers for noninvasive detection of gastric and colorectal cancer. Biochem Biophys Res Commun. 2014 Dec 5;455(1-2):43-57. doi: 10.1016/j.bbrc.2014.08.001. Epub 2014 Aug 13. PubMed 25128828 ↗
  • Okugawa Y, Grady WM, Goel A. Epigenetic Alterations in Colorectal Cancer: Emerging Biomarkers. Gastroenterology. 2015 Oct;149(5):1204-1225.e12. doi: 10.1053/j.gastro.2015.07.011. Epub 2015 Jul 26. PubMed 26216839 ↗
  • Nik Mohamed Kamal NNSB, Shahidan WNS. Non-Exosomal and Exosomal Circulatory MicroRNAs: Which Are More Valid as Biomarkers? Front Pharmacol. 2020 Jan 20;10:1500. doi: 10.3389/fphar.2019.01500. eCollection 2019. PubMed 32038230 ↗
  • Lopez K, Lai SWT, Lopez Gonzalez EJ, Davila RG, Shuck SC. Extracellular vesicles: A dive into their role in the tumor microenvironment and cancer progression. Front Cell Dev Biol. 2023 Mar 21;11:1154576. doi: 10.3389/fcell.2023.1154576. eCollection 2023. PubMed 37025182 ↗
  • Zhu L, Li J, Gong Y, Wu Q, Tan S, Sun D, Xu X, Zuo Y, Zhao Y, Wei YQ, Wei XW, Peng Y. Exosomal tRNA-derived small RNA as a promising biomarker for cancer diagnosis. Mol Cancer. 2019 Apr 2;18(1):74. doi: 10.1186/s12943-019-1000-8. PubMed 30940133 ↗
  • Miyazaki K, Wada Y, Okuno K, Murano T, Morine Y, Ikemoto T, Saito Y, Ikematsu H, Kinugasa Y, Shimada M, Goel A. An exosome-based liquid biopsy signature for pre-operative identification of lymph node metastasis in patients with pathological high-risk T1 colorectal cancer. Mol Cancer. 2023 Jan 6;22(1):2. doi: 10.1186/s12943-022-01685-8. PubMed 36609320 ↗
  • Lane JS, Hoff DV, Cridebring D, Goel A. Extracellular Vesicles in Diagnosis and Treatment of Pancreatic Cancer: Current State and Future Perspectives. Cancers (Basel). 2020 Jun 10;12(6):1530. doi: 10.3390/cancers12061530. PubMed 32532129 ↗
  • Lennon KM, Wakefield DL, Maddox AL, Brehove MS, Willner AN, Garcia-Mansfield K, Meechoovet B, Reiman R, Hutchins E, Miller MM, Goel A, Pirrotte P, Van Keuren-Jensen K, Jovanovic-Talisman T. Single molecule characterization of individual extracellular vesicles from pancreatic cancer. J Extracell Vesicles. 2019 Nov 4;8(1):1685634. doi: 10.1080/20013078.2019.1685634. eCollection 2019. PubMed 31741725 ↗
  • Akers JC, Gonda D, Kim R, Carter BS, Chen CC. Biogenesis of extracellular vesicles (EV): exosomes, microvesicles, retrovirus-like vesicles, and apoptotic bodies. J Neurooncol. 2013 May;113(1):1-11. doi: 10.1007/s11060-013-1084-8. Epub 2013 Mar 2. PubMed 23456661 ↗
  • Chaput N, Thery C. Exosomes: immune properties and potential clinical implementations. Semin Immunopathol. 2011 Sep;33(5):419-40. doi: 10.1007/s00281-010-0233-9. Epub 2010 Dec 21. PubMed 21174094 ↗
  • Nakamura K, Zhu Z, Roy S, Jun E, Han H, Munoz RM, Nishiwada S, Sharma G, Cridebring D, Zenhausern F, Kim S, Roe DJ, Darabi S, Han IW, Evans DB, Yamada S, Demeure MJ, Becerra C, Celinski SA, Borazanci E, Tsai S, Kodera Y, Park JO, Bolton JS, Wang X, Kim SC, Von Hoff D, Goel A. An Exosome-based Transcriptomic Signature for Noninvasive, Early Detection of Patients With Pancreatic Ductal Adenocarcinoma: A Multicenter Cohort Study. Gastroenterology. 2022 Nov;163(5):1252-1266.e2. doi: 10.1053/j.gastro.2022.06.090. Epub 2022 Jul 16. PubMed 35850192 ↗
  • Li A, Yu J, Kim H, Wolfgang CL, Canto MI, Hruban RH, Goggins M. MicroRNA array analysis finds elevated serum miR-1290 accurately distinguishes patients with low-stage pancreatic cancer from healthy and disease controls. Clin Cancer Res. 2013 Jul 1;19(13):3600-10. doi: 10.1158/1078-0432.CCR-12-3092. Epub 2013 May 22. PubMed 23697990 ↗

Individual participant data

Plan to share: Undecided — Data collected for the study will be made available to others, including de-identified participant data, at publication, via a signed data access agreement and at the discretion of the investigators' approval of the proposed use of such data

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 8, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06342427
Lead sponsor
City of Hope Medical Center
Responsible party
Sponsor
First posted
Apr 2, 2024
Start date
Mar 15, 2023
Primary completion
Jun 15, 2024
Completion
Jun 15, 2024
Last update
Jul 8, 2024

Study contacts

Ajay Goel, PhD
principal investigator · City of Hope Medical Center

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jul 2024. You cannot join it, but the record below documents what was studied.

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