Non-invasive Testing for Early oEesophageal Cancer and Dysplasia

NCT ID: NCT04001478

Last Updated: 2023-07-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-10-01

Study Completion Date

2024-10-31

Brief Summary

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This study aims to determine whether a breath test could be used for early detection of oesophageal cancer and Barrett's high grade dysplasia.

Patients who are attending for a planned gastroscopy or who are scheduled to undergo elective resection of histologically confirmed early stage oesophageal adenocarcinoma or dysplasia will be approached to provide a breath sample.

Multi platform mass spectrometry analysis will be performed to establish volatile biomarkers that can discriminate between early stage (T1) oesophageal cancer/ Hight grade dysplasia from non cancer healthy controls/non dysplastic Barrett's cancer.

Detailed Description

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The incidence of oesophageal adenocarcinoma has been rising over the last decade. Despite improvements in oncological and surgical therapies the associated survival remains poor, mainly due to delays in diagnosis and advanced stage at presentation. Identifying patients at earlier stages as well as those at risk of cancer may lead to survival benefit. Barrett's oesophagus is an established risk factor for the development of oesophageal adenocarcinoma. It has an established histopathologic progression from low-grade, through high-grade dysplasia (HGD) to oesophageal adenocarcinoma (OAC). Barrett's oesophagus patients currently undergo regular endoscopic surveillance to allow earlier detection of oesophageal cancer.

The primary objective is to evaluate the diagnostic accuracy and clinical utility of the volatile organic compounds (VOC) in exhaled breath to detect early stage oesophageal adenocarcinoma and high-grade dysplastic Barrett's oesophagus.

All patients will be fasted for a minimum of 6 hours prior to the breath sample as part of their routine clinical care. Breath collection will be conducted using a previously validated method. Samples of breath (500ml) collected using "breath collecting device utilising bags". Breath samples collected within thermal desorption tubes (Markes International, Llantrisant, UK) will be transferred to a central laboratory for analysis by gas chromatography mass spectrometry (GC-MS) and proton transfer reaction time of flight mass spectrometry (PTR-ToF-MS). Raw data files will be extracted and analysed in accordance with established protocols.

Conditions

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Oesophageal Cancer Barrett Esophagus Barretts Esophagus With Dysplasia

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Control group

Patients who are attending hospital for a gastroscopy as part of their routine clinical care as a 2 week wait rule referral and those on Barrett's surveillance , will be asked to give a sample of their breath prior to the procedure.

Breath test

Intervention Type DIAGNOSTIC_TEST

Patients will provide a breath test prior to gastroscopy or resection of Barrett's HGD lesion or oesophageal cancer.

Early oesophageal cancer (T1)/ Barrett's high grade dysplasia

Patients who have known pre-diagnosed T1 oesophageal adenocarcinoma or HGD attending hospital as part of their clinical care will be asked to give a breath sample prior to their endoscopy resection/ cancer operation. Patients will be sampled upon return for follow up endoscopy to assess breath profile changes and correlation with endoscopy findings.

Breath test

Intervention Type DIAGNOSTIC_TEST

Patients will provide a breath test prior to gastroscopy or resection of Barrett's HGD lesion or oesophageal cancer.

Advanced Oesophageal cancer (T2/3/4)

Patients who have been diagnosed with oesophageal adenocarcinoma attending hospital as part of their clinical care will be asked to give a breath sample prior to their endoscopy resection/ cancer operation.

Breath test

Intervention Type DIAGNOSTIC_TEST

Patients will provide a breath test prior to gastroscopy or resection of Barrett's HGD lesion or oesophageal cancer.

Interventions

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Breath test

Patients will provide a breath test prior to gastroscopy or resection of Barrett's HGD lesion or oesophageal cancer.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* ≥18 years and ≤90 years of age
* Undergoing gastroscopy or elective resection of histologically confirmed oesophageal adenocarcinoma/ high grade dysplasia
* Fasted \>6 hours
* Able to provide informed written consent

Exclusion Criteria

* Any patient \<18 years or \>90 years of age.
* Lacks capacity or is unable to provide informed written consent.
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Guts UK

OTHER

Sponsor Role collaborator

University College London Hospitals

OTHER

Sponsor Role collaborator

Guy's and St Thomas' NHS Foundation Trust

OTHER

Sponsor Role collaborator

Oxford University Hospitals NHS Trust

OTHER

Sponsor Role collaborator

Nottingham University Hospitals NHS Trust

OTHER

Sponsor Role collaborator

University Hospital Birmingham NHS Foundation Trust

OTHER

Sponsor Role collaborator

Northern Care Alliance NHS Foundation Trust

OTHER

Sponsor Role collaborator

London North West Healthcare NHS Trust

OTHER

Sponsor Role collaborator

Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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George B Hanna, FRCS PhD

Role: PRINCIPAL_INVESTIGATOR

Imperial College London

Locations

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University Hospitals Birmingham Nhs Foundation Trust

Birmingham, , United Kingdom

Site Status RECRUITING

University Hospital Dorset NHS Foundation Trust

Bournemouth, , United Kingdom

Site Status RECRUITING

University Hospital Coventry and Warwickshire

Coventry, , United Kingdom

Site Status RECRUITING

Royal Liverpool University Hospital

Liverpool, , United Kingdom

Site Status RECRUITING

University College London Hospitals Nhs Foundation Trust

London, , United Kingdom

Site Status RECRUITING

Guy'S and St Thomas' Nhs Foundation Trust

London, , United Kingdom

Site Status RECRUITING

Imperial College Healthcare Trust

London, , United Kingdom

Site Status RECRUITING

Newcastle Hospital NHS Foundation Trust

Newcastle upon Tyne, , United Kingdom

Site Status RECRUITING

Nottingham University Hospitals Nhs Trust

Nottingham, , United Kingdom

Site Status RECRUITING

Portsmouth Hospitals Nhs Trust

Portsmouth, , United Kingdom

Site Status RECRUITING

University Hospital Southampton NHS Foundation Trust

Southampton, , United Kingdom

Site Status RECRUITING

Betsi Cadwaladr University Health Board

Wrexham, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Sara H Jamel, MBBS MRCS

Role: CONTACT

02033126328

George B Hanna, FRCS PhD

Role: CONTACT

02033126328

Facility Contacts

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Sara Jamel, MBBS MRCS

Role: primary

Katja Christodoulou, MBBS MRCP

Role: primary

Katja Christodoulou, MBBS MRCP

Role: primary

Katja Christodoulou, MBBS MRCP

Role: primary

Sara Jamel, MBBS MRCS

Role: primary

Sara Jamel, MBBS MRCS

Role: primary

Sara H Jamel, MBBS MRCS

Role: primary

George B Hanna, FRCS PhD

Role: backup

Katja Christodoulou, MBBS MRCP

Role: primary

Sara Jamel, MBBS MRCS

Role: primary

Sara Jamel, MBBS MRCS

Role: primary

Katja Christodoulou, MBBS MRCP

Role: primary

Katja Christodoulou, MBBS MRCP

Role: primary

Other Identifiers

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19/LO/0780

Identifier Type: -

Identifier Source: org_study_id

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