Cell Free DNA, Colorectal Cancer (Diagnosis), DNA Methylation, Early Detection of Cancer, Non-cancer Controls
Conditions
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
Study design
Eligibility
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
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity for detecting colorectal cancer | Baseline (pre-treatment blood sample collection) | Proportion of true positive CRC cases correctly identified by the cfDNA methylation panel. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Specificity for detecting colorectal cancer | Frame: 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
City of Hope Medical Center