"Constitution of a Biological Collection to Establish Preclinical Translational Models for the Study of Tumors and Chronic Liver Diseases". (LivMOD)

Institut National de la Santé Et de la Recherche Médicale, France

Status: Enrolling

Conditions: Viral Hepatitis D; Viral Hepatitis B; Chronic Liver Disease and Cirrhosis; Liver Cancer; Viral Hepatitis C; Non-Alcoholic Steatohepatitis; Non-Alcoholic Fatty Liver Disease

Treatments: Procedure: Blood sample during surgery; Diagnostic Test: Blood sample during diagnostic test; Procedure: Taking an additional biopsy

Study type: Observational

Funder types: Other

Identifiers

NCT04690972

C19-76

Details and patient eligibility

About

Development of preclinical translational models for chronic liver tumors and diseases study, such as spheroids cultured in autologous medium and murine xenograft models to test the efficacy of new therapeutic strategies.

Full description

The Institute for Research on Viral and Hepatic Diseases, Inserm Unit UMR_S 1110, in Strasbourg, studies hepatic diseases such as non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), cirrhosis and hepatocellular carcinoma (CHC). These diseases can be induced by hepatitis viruses, B (HBV), C (HCV) and D (VHD), but also a poor lifestyle combining overeating and the sedentary lifestyle of our current living patterns.

To date, no treatment is available to cure non-alcoholic steatohepatitis (NASH), cirrhosis, and prevent the development of liver tumors. One of the reasons for the lack of specific treatment is the limited knowledge of the pathophysiology of the liver and the hepatic microenvironment. In addition, the heterogeneity of HCC and associated underlying liver diseases, and the lack of adequate preclinical models are at the root of the difficulties in identifying an effective therapeutic target for these diseases.

Thus, new molecular profiling techniques and strategies are needed to meet these medical needs, in particular the prediction of the response to treatment of HCC, which is still largely unsatisfactory, and the discovery of new therapeutic targets. Using innovative approaches, UMR_S 1110 utilizes single cell RNA sequencing, which is a high resolution technique to analyze gene expression at the individual cell level. This technique represents the most advanced tool for studying heterogeneous tissues such as cancerous tissue.

An in-depth knowledge of HCC and the liver tumor environment at the single-cell level is crucial for understanding the progression of liver disease, for identifying new therapeutic targets and improving clinical outcomes by allowing for estimate the response to treatment and thus improve the patient's vital prognosis, by offering him an adapted personalized treatment. In order to identify factors determining hepatocarcinogenesis, predictors of response to treatment and new therapeutic targets, the investigators propose to analyze tissues from patients with chronic liver disease.

The investigator aim :

1. / to establish ex vivo models of chronic hepatic disease and hepatic tumors, in order to study and validate the therapeutic targets identified in the laboratory from single cell RNA sequencing from hepatic tissues obtained from patients. These models include spheroid cultures and models of mice developing liver tumors from xenografts of tumors from patients. To ensure the successful establishment of these complex models, the use of autologous sera is necessary.
2. / profile the hepatic tumors and the hepatic tissue adjacent to the tumor, the site of chronic liver disease, using single-cell RNA sequencing in order to study the heterogeneity and complexity of the tumor, to identify novel therapeutic targets and tumor phenotypes that correlate with response to treatment.

Patient-derived preclinical models, developed at unit UMR_S1110, will allow us to better understand the biology of chronic liver disease and liver tumors at the patient level, identify the most appropriate treatment for the patient, and evaluate new treatments and biomarkers to non-invasively diagnose the onset of liver disease, for the benefit of personalized medicine for the benefit of the patient.

Blood samples obtained from patients with chronic liver disease will also allow us to:

• Advance knowledge on viral hepatitis, in particular HCV, HBV and HDV;
• Implement new strategies for the development of a vaccine for HCV;
• Identify new biomarkers of hepatic carcinogenesis by comparing the metabolomic and inflammatory profiles of patients.

The partnership between Inserm, the University of Strasbourg and the University Hospitals of Strasbourg makes it possible to create unique synergies that will ultimately help identify new targets for therapeutic and preventive strategies against these diseases which represent a major public health problem.

Enrollment: 800 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Patients

   • diagnosed with chronic liver disease (viral or not)
   • diagnosed with at least one liver nodule for which a biopsy is planned as part of the care
   • for hepatobiliary surgery planned as part of care
   • for locoregional treatment for HCC is indicated

2. Patients able to receive and understand information relating to the study and give their written informed consent

3. Patients affiliated to the French social security system

Exclusion criteria

1. Minor patients
2. Patients under legal protection,
3. Patients subject to legal protection or unable to express their consent,
4. Patients in a situation of social fragility,
5. Pregnant or breastfeeding woman,
6. No signing of informed consent.

Trial design

800 participants in 3 patient groups

Hepato-bilio-pancreatic surgery

Description:

Patients whom hepato-bilio-pancreatic surgery is indicated as part of the care

Treatment:

Procedure: Blood sample during surgery

biopsy of the hepatic parenchyma

Description:

Patients whom a biopsy of the hepatic parenchyma, one or more hepatic nodules or a loco-regional treatment is indicated as part of the care

Treatment:

Procedure: Taking an additional biopsy

Viral chronic infection

Description:

Patients with a viral chronic liver disease

Treatment:

Diagnostic Test: Blood sample during diagnostic test