Circulating tumour DNA rectal cancer and the relationship to extramural venous invasion

In almost one third of rectal cancer patients, cancer spreads through the bowel wall into nearby veins which can be seen on MRI scans (mrEMVI). It has been observed that this is linked with worse survival due to the spread of cancer to the liver and other organs. We think that this may occur by spread of cancer cells in the blood stream and patients who are at risk of cancer spread to the liver and other organs may have increased levels of cancer cells in the blood (ctDNA). Using improved technology, we would like to find out whether patient with mrEMVI positive rectal tumours also have increased levels of ctDNA. If this is proven correct, this may then explain how cancer spreads to other organs.

The ctDNA study is a prospective multi-centre tissue study. To be eligible, patients must have rectal adenocarcinoma which is mrEMVI positive at baseline. 20 patients who re-main mrEMVI positive at the time of surgery and 20 patients who have become mrEMVI negative following pre-operative therapy, will have a blood sample taken pre-surgery and another taken during surgery following the removal of their tumour.

If difference is measured between the amount of cancer cells in the blood between the two cohorts, we may eventually be able to use this test to help guide treatment in the future. Additionally, if we can find a link between the number of cancer cells seen in blood mrEMVI status, we may be able to offer additional treatment to patients who are at higher risk of recurrence.

The ctDNA trial is open to new sites.

Please fill in the form below if you would like further information or have any questions about any aspect of the trial.