Multi-omics evaluation of peritoneal fluid in gastroesophageal cancer (OMEGCA): protocol for a prospective multicentre cohort study to detect occult peritoneal metastases in patients undergoing curative-intent treatment
Details
Publication Year 2025,Volume 20,Issue #4,Page e0318615
Journal Title
PLoS One
Publication Type
Protocol
Abstract
INTRODUCTION: Early detection of peritoneal disease, especially micro-metastases, in patients with gastroesophageal adenocarcinoma is critical as it alters therapeutic intent, providing a vital opportunity to personalise treatment. However, our ability to accurately stage the peritoneum is inadequate. Tumour-derived DNA in peritoneal lavage fluid (ptDNA) has been suggested to be more sensitive than current methods to stage the peritoneum. Accordingly, this study will determine whether ptDNA is a biomarker of peritoneal micro-metastasis and evaluate its prognostic value in patients with gastroesophageal adenocarcinoma undergoing curative-intent treatment. METHODS AND ANALYSIS: This will be an Australian multi-centre prospective observational cohort study enrolling patients undergoing routine staging laparoscopy and subsequent curative-intent treatment (either upfront surgery or perioperative chemo-/radiotherapy and surgery) for gastric and gastroesophageal junction adenocarcinoma. Tumour biopsies, blood and peritoneal lavage fluid will be collected at the time of staging laparoscopy for all patients. A subset of patients will have blood and peritoneal fluid collected at the time of surgical resection, and blood collected at the first post-operative clinic. These biospecimens will undergo genomic and methylomic analysis to detect tumour DNA. ptDNA status will be correlated to disease free survival, peritoneal-specific event free survival, overall survival, sites of treatment failure, histopathological features, and peritoneal lavage cytology status. REGISTRATION: This study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12624000451505p).
Publisher
PLOS
Keywords
Humans; *Stomach Neoplasms/pathology/genetics/therapy; Prospective Studies; *Esophageal Neoplasms/pathology/genetics/therapy; *Ascitic Fluid/metabolism; *Peritoneal Neoplasms/secondary/diagnosis/genetics; *Adenocarcinoma/pathology/genetics/therapy; Biomarkers, Tumor/genetics; Female; Male; Esophagogastric Junction/pathology; DNA, Neoplasm/genetics; Prognosis; Australia; Multiomics
Department(s)
Surgical Oncology; Laboratory Research; Medical Oncology
Open Access at Publisher's Site
https://doi.org/10.1371/journal.pone.0318615
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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