Surgical order of blood vessel division and circulating tumor DNA after lung cancer surgery
The Impact of Surgical Technique on Circulating Tumor DNA in Early-Stage Non-Small Cell Lung Cancer
This compares doing the pulmonary vein first versus the pulmonary artery first during lung cancer surgery to see if it lowers circulating tumor DNA in adults with stage I–III non-small cell lung cancer.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Thomas Jefferson University Academic / other |
| Drugs / interventions | chemotherapy, immunotherapy, radiation |
| Locations | 4 sites (Abington, Pennsylvania and 3 other locations) |
| Trial ID | NCT05502523 on ClinicalTrials.gov |
What this trial studies
Adults with resectable stage I–III non-small cell lung cancer are randomized to a pulmonary vein-first or pulmonary artery-first approach during anatomic lung resection. Blood is collected for circulating tumor DNA before surgery and at multiple postoperative time points including day 1, day 7, days 7–28, 4 months, and then every 6 months for up to 5 years. The primary outcome is postoperative ctDNA levels at specified time points, and secondary outcomes include disease-free survival and the relationship between ctDNA detection and recurrence. Patients with recent other cancers, preoperative systemic therapy, or perioperative transfusion are excluded and biospecimens are collected according to protocol.
Who should consider this trial
Good fit: Adults aged 18 or older with confirmed or suspected resectable stage I–III non-small cell lung cancer who are scheduled for lobectomy or segmentectomy are ideal candidates.
Not a fit: Patients who received preoperative chemotherapy, immunotherapy, or radiation, those with another recent cancer diagnosis within five years, or those unable to attend follow-up at the study sites are unlikely to benefit from this protocol.
Why it matters
Potential benefit: If successful, the vein-first approach could reduce tumor cell shedding during surgery and lower the risk of recurrence or enable earlier detection of relapse.
How similar studies have performed: Retrospective analyses and small prospective reports have suggested a vein-first technique may reduce intraoperative tumor cell release, but randomized prospective evidence remains limited.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Any patients 18 years of age or older with confirmed or suspected early-stage (stage I-III) NSCLC * Eligible and scheduled for surgical anatomic lung resection (e.g. lobectomy or segmentectomy) as routine clinical care for their disease Exclusion Criteria: * Previous cancer diagnosis within 5 years (except ductal carcinoma in situ \[DCIS\] of the breast, superficial bladder cancer, non-melanoma skin primary, other malignancy that does not require treatment). * Preoperative chemotherapy, immunotherapy, or radiation therapy * Receipt of perioperative blood transfusion
Where this trial is running
Abington, Pennsylvania and 3 other locations
- Abington Memorial Hospital — Abington, Pennsylvania, United States (Recruiting)
- Jefferson Health Northeast — Philadelphia, Pennsylvania, United States (Recruiting)
- Thomas Jefferson University Hospital — Philadelphia, Pennsylvania, United States (Recruiting)
- Asplundh Cancer Pavilion at Jefferson Health — Willow Grove, Pennsylvania, United States (Recruiting)
Study contacts
- Principal investigator: Tyler Grenda, MD — Tju
- Study coordinator: Tyler Grenda, MD
- Email: Tyler.grenda@jefferson.edu
- Phone: 215-955-5562
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.