RM Partners is investigating whether a new blood test, often called a liquid biopsy, can help identify recurrence of colorectal cancer earlier.

The TRACC (Tracking mutations in cell free tumour DNA to predict Relapse in eArly Colorectal Cancer) study uses innovative technology called droplet digital polymerase chain reaction, which may identify which patients will relapse before they are aware of any symptoms or tumours are detectable on scans.

The majority of patients presenting with stage I colorectal cancer can be cured by surgery alone. For patients with stage II and stage III disease, adjuvant chemotherapy has been shown to reduce the risk of relapse, but local or distant recurrence remains a significant cause of mortality.

During the study, blood samples will be collected at specific intervals over the duration of the patient’s treatment and follow up for up to five years. These samples contain circulating cell free tumour DNA (ctDNA), which is isolated and analysed for mutations. Mutations identified in the blood samples will then be compared to the ones found in the tumour tissue removed during surgery, post-operatively, and while the patient is disease-free. A blood sample will also be collected when the patient’s cancer has returned.

The study aims to assess whether using this non-invasive method to detect ctDNA in blood samples and any mutational signatures from the cancer tissue, can predict relapse as early detection may offer opportunities for curative treatment.

The lead organisation for TRACC is The Royal Marsden, which began recruiting patients in December 2016. Other RM Partner Trusts currently recruiting include Chelsea and Westminster, Croydon, Epsom and St Helier, and Kingston. We are continuing to work with local acute Trust research teams across London to recruit patients with stage II and stage III colorectal cancer.

For more information please contact Michelle Chen, research manager, at Michelle.Chen@nhs.net