Project 458302

Intrahepatic cholangiocarcinoma (iCCA) is a type of bile duct cancer located inside the liver. iCCA is the second most common cause of liver cancers and only 10% of those who are diagnosed with this cancer survive past five years. The main challenge in treating iCCA is its high recurrence rate despite complete removal of the tumor. Harvesting circulating tumor DNA (ctDNA) or markers of inflammation from blood directly and studying them may be able to provide a solution to these issues. ctDNA are DNA fragments released in the blood stream from the tumor cells undergoing natural cell death. ctDNA is hypothesized to carry the same genetic altercations of the main tumor, however there are very few data available for this application. The same is true for blood derived systemic inflammatory biomarkers, like the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammatory index (SII). These ratios are easily obtainable from basic blood lab tests and could serve us in building tools to predict early cancer recurrence. Accurately predicting early cancer recurrence is important as it might save patients from undergoing major surgery, and instead receive additional treatments like chemotherapy to treat the whole body first from potential cancer spread. My research proposal seeks to study adult patients who undergo surgery for iCCA cure and (1) summarize all evidence on factors that predict early recurrence of iCCA; (2) define when is early and test whether systemic inflammatory biomarkers (NLR, PLR, SII) are a predictor for early recurrence; (3) assess whether ctDNA in the blood is a predictor for early recurrence and whether the mutations ctDNA in blood are representative of the resected primary tumor mutations. Findings from this study will be integral for guiding additional treatment strategies in patients with iCCA who are preparing to undergo surgery but are at high risk for early recurrence of the cancer.