Minimally Invasive Approaches for the Diagnosis of Barrett's Esophagus and Esophageal Cancer, SOS5C Trial

NCT ID: NCT07206589

Last Updated: 2026-01-23

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

1010 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-03-01

Study Completion Date

2027-10-31

Brief Summary

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This clinical trial studies how well minimally invasive approaches (an artificial intelligence \[AI\] powered risk tool, nurse navigation, and a sponge on a string \[SOS\] test) work in diagnosing patients with Barrett's esophagus (BE) and esophageal cancer. Esophageal cancer has a poor 5-year survival rate when diagnosed after onset of symptoms. While rising, incidence of esophageal cancer remains too low to screen the entire population. BE is a condition in which the cells lining the lower part of the esophagus have changed or been replaced with abnormal cells that could lead to esophageal cancer. Currently, patients are screened for BE based on certain risk factors (reflux, age \> 50 years, White race, family history of esophageal cancer, obesity, male sex, and smoking), followed by endoscopies and surgery for treatment. These standard procedures may result in under-recognition of BE risk due to inaccurate and difficult to use risk assessment tools, high cost, invasiveness, low access to endoscopy, and sub-optimal recognition of abnormal cells during routing endoscopy. An AI powered risk tool that integrates symptoms, health history, and laboratory values from electronic health record data may more accurately assess BE and esophageal cancer risk that manual assessment. The BE-SOS screening test combines a swallowable cell collection device with assessment of DNA, which may more accurately diagnose abnormal cells. Nurse navigation involves trained personnel assisting individuals through the screening process and completing the follow-up diagnostic test if the screening test is positive. Navigators address cultural, social, access, and logistical barriers to screening. Nurse navigation may increase completion rates of diagnostic procedures following a positive screening test. These minimally invasive approaches may enable higher rates of BE screening than currently being accomplished.

Detailed Description

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Conditions

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Barrett Esophagus Esophageal Adenocarcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Arm 1 (T1 SOC, T2-T4 Intervention)

Family Medicine Care Teams in Cluster A provide SOC procedures during T1 consisting of the following: 1) Care teams manually assess BE risk for patients, and patients meeting ACG criteria are recommended to undergo BE screening with BE-SOS test followed by endoscopy (only if BE-SOS positive). Family Medicine Care Teams in Cluster A then provide intervention procedures during T2, T3, and T4 consisting of the following: 1) Care teams utilize RN navigators that assist in using the AI powered BE Risk Tool to assess patients' BE risk; 2) Patients with AI powered BE Risk Tool high risk result undergo BE-SOS test with RN navigator assistance; 3) Patients with positive BE-SOS test results then undergo endoscopy with RN navigator facilitation.

Group Type EXPERIMENTAL

Cancer Screening

Intervention Type OTHER

Undergo BE-SOS test

Computer-Assisted Intervention

Intervention Type OTHER

Undergo BE risk assessment using AI powered BE Risk Tool

Endoscopic Procedure

Intervention Type PROCEDURE

Undergo endoscopy

Health Risk Assessment

Intervention Type BEHAVIORAL

Undergo manual BE risk assessment

Navigation

Intervention Type OTHER

Receive RN navigation

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm 2 (T1 SOC, T2-T4 Intervention)

Family Medicine Care Teams in Cluster B provide SOC procedures as in Arm 1 during T1, followed by intervention procedures as in Arm 1 during T2, T3, and T4.

Group Type EXPERIMENTAL

Cancer Screening

Intervention Type OTHER

Undergo BE-SOS test

Computer-Assisted Intervention

Intervention Type OTHER

Undergo BE risk assessment using AI powered BE Risk Tool

Endoscopic Procedure

Intervention Type PROCEDURE

Undergo endoscopy

Health Risk Assessment

Intervention Type BEHAVIORAL

Undergo manual BE risk assessment

Navigation

Intervention Type OTHER

Receive RN navigation

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm 3 (T1-T2 SOC, T3-T4 Intervention)

Family Medicine Care Teams in Cluster C provide SOC procedures as in Arm 1 during T1 and T2, followed by intervention procedures as in Arm 1 during T3 and T4.

Group Type EXPERIMENTAL

Cancer Screening

Intervention Type OTHER

Undergo BE-SOS test

Computer-Assisted Intervention

Intervention Type OTHER

Undergo BE risk assessment using AI powered BE Risk Tool

Endoscopic Procedure

Intervention Type PROCEDURE

Undergo endoscopy

Health Risk Assessment

Intervention Type BEHAVIORAL

Undergo manual BE risk assessment

Navigation

Intervention Type OTHER

Receive RN navigation

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm 4 (T1-T2 SOC, T3-T4 Intervention)

Family Medicine Care Teams in Cluster D provide SOC procedures as in Arm 1 during T1 and T2, followed by intervention procedures as in Arm 1 during T3 and T4.

Group Type EXPERIMENTAL

Cancer Screening

Intervention Type OTHER

Undergo BE-SOS test

Computer-Assisted Intervention

Intervention Type OTHER

Undergo BE risk assessment using AI powered BE Risk Tool

Endoscopic Procedure

Intervention Type PROCEDURE

Undergo endoscopy

Health Risk Assessment

Intervention Type BEHAVIORAL

Undergo manual BE risk assessment

Navigation

Intervention Type OTHER

Receive RN navigation

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm 5 (T1-T3 SOC, T4 Intervention)

Family Medicine Care Teams in Cluster E provide SOC procedures as in Arm 1 during T1, T2, and T3, followed by intervention procedures as in Arm 1 during T4.

Group Type EXPERIMENTAL

Cancer Screening

Intervention Type OTHER

Undergo BE-SOS test

Computer-Assisted Intervention

Intervention Type OTHER

Undergo BE risk assessment using AI powered BE Risk Tool

Endoscopic Procedure

Intervention Type PROCEDURE

Undergo endoscopy

Health Risk Assessment

Intervention Type BEHAVIORAL

Undergo manual BE risk assessment

Navigation

Intervention Type OTHER

Receive RN navigation

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Arm 6 (T1-T3 SOC, T4 Intervention)

Family Medicine Care Teams in Cluster F provide SOC procedures as in Arm 1 during T1, T2, and T3, followed by intervention procedures as in Arm 1 during T4.

Group Type EXPERIMENTAL

Cancer Screening

Intervention Type OTHER

Undergo BE-SOS test

Computer-Assisted Intervention

Intervention Type OTHER

Undergo BE risk assessment using AI powered BE Risk Tool

Endoscopic Procedure

Intervention Type PROCEDURE

Undergo endoscopy

Health Risk Assessment

Intervention Type BEHAVIORAL

Undergo manual BE risk assessment

Navigation

Intervention Type OTHER

Receive RN navigation

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Interventions

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Cancer Screening

Undergo BE-SOS test

Intervention Type OTHER

Computer-Assisted Intervention

Undergo BE risk assessment using AI powered BE Risk Tool

Intervention Type OTHER

Endoscopic Procedure

Undergo endoscopy

Intervention Type PROCEDURE

Health Risk Assessment

Undergo manual BE risk assessment

Intervention Type BEHAVIORAL

Navigation

Receive RN navigation

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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Cancer Screening for Patients Early Cancer Detection Screening Screening of Cancer Endoscopic Examination Endoscopy ES Risk Assessment

Eligibility Criteria

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Inclusion Criteria

* SPECIFIC AIM 1A: Adult patients 18-85 years old
* SPECIFIC AIM 1A INTERVENTION CLUSTERS: BE Risk Tool Score \> 0.087, indicating a higher risk for BE/esophageal adenocarcinoma (EAC). This will be run as a web-based application integrating data from several domains in the electronic health record (EPIC). Output score will range from 0-1.
* SPECIFIC AIM 1A CONTROL CLUSTERS: Meeting American College of Gastroenterology (ACG) screening criteria (gastroesophageal reflux disease \[GERD\]+ \> 2 BE risk factors: Age ≥ 50 years, Male sex, Caucasian race, obesity \[body mass index (BMI) \> 30\], ever smoker, family history of BE/EAC)
* SPECIFIC AIM 1B: A "low risk" BE risk tool score (\< 0.0897)

Exclusion Criteria

* SPECIFIC AIM 1A: History of Barrett's esophagus or esophageal adenocarcinoma
* SPECIFIC AIM 1A: Prior endoscopy in the last 10 years
* SPECIFIC AIM 1A: Patients who are unable to consent
* SPECIFIC AIM 1A: Patients with a current history of uninvestigated dysphagia
* SPECIFIC AIM 1A: History of eosinophilic esophagitis, achalasia
* SPECIFIC AIM 1A: Patients on oral anticoagulation including Coumadin, Warfarin unless discontinued for five days prior to the sponge procedure
* SPECIFIC AIM 1A: Patients on antiplatelet agents including Clopidogrel, unless discontinued for five days prior to the sponge procedure
* SPECIFIC AIM 1A: Patients on oral thrombin inhibitors including Dabigatran and oral factor Xa inhibitors such as rivaroxaban, apixaban, and edoxaban, unless discontinued for five days prior to the sponge procedure
* SPECIFIC AIM 1A: Patients with a history of known varices or cirrhosis
* SPECIFIC AIM 1A: Patients with a history of esophageal or gastric resection for esophageal or gastric carcinoma
* SPECIFIC AIM 1A: Patients with congenital or acquired bleeding diatheses
* SPECIFIC AIM 1A: Patients with a history of esophageal squamous dysplasia or esophageal squamous carcinoma
* SPECIFIC AIM 1A: Patients with limited life expectancy (\< 2 years): per provider judgement
* SPECIFIC AIM 1B: History of Barrett's esophagus or esophageal adenocarcinoma
* SPECIFIC AIM 1B: Prior endoscopy in the last 10 years
* SPECIFIC AIM 1B: Patients who are unable to consent
* SPECIFIC AIM 1B: Patients with a current history of uninvestigated dysphagia
* SPECIFIC AIM 1B: History of eosinophilic esophagitis, achalasia
* SPECIFIC AIM 1B: Patients on oral anticoagulation including Coumadin, Warfarin unless discontinued for five days prior to procedure
* SPECIFIC AIM 1B: Patients on antiplatelet agents including Clopidogrel, unless discontinued for five days prior to procedure
* SPECIFIC AIM 1B: Patients on oral thrombin inhibitors including Dabigatran and oral factor Xa inhibitors such as rivaroxaban, apixaban, and edoxaban, unless discontinued for five days prior to procedure
* SPECIFIC AIM 1B: Patients with a history of known varices or cirrhosis
* SPECIFIC AIM 1B: Patients with a history of esophageal or gastric resection for esophageal or gastric carcinoma
* SPECIFIC AIM 1B: Patients with congenital or acquired bleeding diatheses
* SPECIFIC AIM 1B: Patients with a history of esophageal squamous dysplasia or esophageal squamous carcinoma
* SPECIFIC AIM 1B: Patients with limited life expectancy (\< 2 years): per provider judgement
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Prasad G Iyer, MD, MS

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic in Arizona

Scottsdale, Arizona, United States

Site Status

Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status

Mayo Clinic Health System-Eau Claire Clinic

Eau Claire, Wisconsin, United States

Site Status

Countries

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United States

Central Contacts

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Clinical Trials Referral Office

Role: CONTACT

855-776-0015

Ramona Lansing

Role: CONTACT

Facility Contacts

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Clinical Trials Referral Office

Role: primary

855-776-0015

Ramona Lansing

Role: backup

507-538-4974

Clinical Trials Referral Office

Role: primary

855-776-0015

Ramona Lansing

Role: backup

507-538-4974

Clinical Trials Referral Office

Role: primary

855-776-0015

Ramona Lansing

Role: backup

507-538-4974

Related Links

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Other Identifiers

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NCI-2025-06682

Identifier Type: REGISTRY

Identifier Source: secondary_id

25-002435

Identifier Type: OTHER

Identifier Source: secondary_id

SOS5C

Identifier Type: OTHER

Identifier Source: secondary_id

R01CA241164

Identifier Type: NIH

Identifier Source: secondary_id

View Link

SOS5C

Identifier Type: -

Identifier Source: org_study_id

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