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Epigenetic Signature for CRC Early Detection

A Model of Epigenetic Biomarkers Based on cfDNA 5mC/5hmC for Early Detection of Colorectal Cancer

Status
Active, not recruiting
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT07224854
Acronym
epiCED
Enrollment
500
Registered
2025-11-05
Start date
2024-06-21
Completion date
2028-06-18
Last updated
2026-07-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Cell Free DNA, Colorectal Cancer (Diagnosis), DNA Methylation, Early Detection of Cancer, Non-cancer Controls

Keywords

noninvasive screening, circulating cfDNA, 5mC, 5hmC, epigenetic biomarkers, machine learning, colorectal cancer, early detection

Brief summary

The epiCED is a noninvasive blood-based assay designed for early detection of colorectal cancer (CRC) using circulating cell-free DNA (cfDNA) 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) epigenetic markers. This study leverages retrospective, multi-center cohorts of CRC patients and non-cancer controls to discover and validate a robust cfDNA methylation signature. Small-scale sequencing and machine learning-based modeling will be applied to identify a minimal panel of methylation markers that can accurately discriminate CRC from non-cancer individuals, including early-stage disease. The ultimate goal is to develop a clinically practical, noninvasive screening tool that enables population-level early detection and improves patient outcomes.

Detailed description

The epiCED is a noninvasive, blood-based approach aimed at early detection of colorectal cancer (CRC) using circulating cell-free DNA (cfDNA) 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) epigenetic markers. Early detection of CRC is critical for improving patient outcomes, but current diagnostic tools-including colonoscopy, CT, and MRI-are either invasive, costly, or insufficiently sensitive for early-stage disease, limiting their use for population-wide screening. This study will utilize retrospective, multi-center cohorts comprising adult participants (≥18 years) with confirmed CRC and non-cancer controls, including healthy volunteers and individuals with benign gastrointestinal conditions. Blood samples will be subjected to cfDNA extraction and small-scale epigenetic sequencing to profile 5mC and 5hmC patterns. During the discovery phase, differential methylation analysis and machine learning-based feature selection will be applied to identify a minimal set of cfDNA methylation markers that optimally discriminate CRC from non-cancer individuals. In the training and validation phase, the identified signature will be evaluated across independent international multi-center cohorts to ensure reproducibility, robustness, and early-stage detection performance. The primary objectives are to: * Develop a cfDNA methylation panel capable of accurately distinguishing CRC patients from non-cancer controls. * Validate the panel's ability to detect early-stage CRC. * Secondary objectives include evaluating the association of the methylation signature with clinical parameters, tumor stage, and demographic factors. By integrating high-resolution cfDNA methylation profiling with advanced computational modeling, epiCED aims to provide a scalable, cost-effective, and clinically practical tool for noninvasive early detection of colorectal cancer.

Interventions

None listed

Sponsors

City of Hope Medical Center
Lead SponsorOTHER

Study design

Observational model
COHORT
Time perspective
RETROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

* Adults aged ≥18 years at the time of sample collection. * Patients with confirmed CRC or non-cancer controls. * Availability of retrospective blood samples collected according to institutional protocols. * Willingness to allow use of de-identified clinical and demographic data.

Exclusion criteria

* Concurrent malignancies outside the gastrointestinal tract (unless in complete remission ≥5 years). * Samples with insufficient volume or poor cfDNA quality. * Recent chemotherapy, radiotherapy, or major surgery within 4 weeks prior to blood collection (if prospective samples). * Any condition precluding reliable sample analysis or participation.

Design outcomes

Primary

MeasureTime frameDescription
Sensitivity for detecting colorectal cancerBaseline (pre-treatment blood sample collection)Proportion of true positive CRC cases correctly identified by the cfDNA methylation panel.

Secondary

MeasureTime frameDescription
Specificity for detecting colorectal cancerFrame: Baseline (pre-treatment blood sample collection)Proportion of true negative (non-cancer) individuals correctly classified by the cfDNA methylation panel.
Area Under the Receiver Operating Characteristic Curve (AUROC)Baseline (pre-treatment blood sample collection)AUROC of the cfDNA methylation panel for distinguishing CRC patients from non-cancer controls.

Countries

United States

Contacts

PRINCIPAL_INVESTIGATORAjay Goel, PhD

City of Hope Medical Center

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Jul 8, 2026