Prospective Study on the Use of Biomarkers to Guide Management of Patients Treated With Radiofrequency Ablation for Early Oesophageal Neoplasia
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Barrett's Oesophagus
- Sponsor
- University of Cambridge
- Enrollment
- 147
- Locations
- 1
- Primary Endpoint
- Diagnostic accuracy of methylation panel for diffuse IM at the GOJ
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
This prospective cohort study aims to assess the utility of a panel of molecular biomarkers for predicting the risk of relapse of Barrett's Oesophagus after endoscopic treatment of early oesophageal neoplasia with RadioFrequency Ablation (RFA). Patients who received endoscopic treatment of early oesophageal neoplasia with RFA and achieved endoscopic remission will be recruited. During the surveillance visits patients will receive a Cytosponge test followed by an endoscopy with Narrow Band Imaging (NBI) magnification and biopsies. Patients will receive an endoscopy every 6 months and Cytosponge every 12 months for at least 2 years. Molecular biomarkers including a methylation panel on DNA and immunohistochemical markers on formalin fixed paraffin embedded samples. After 2 years of intensive endoscopic follow up, patients will be prospectively tracked for up to 3 years.
The investigators will also evaluate:
- The risk of progression to dysplasia or oesophageal intestinal metaplasia (IM) in patients with IM at the GOJ post RFA in the absence of retreatment
- the diagnostic accuracy of NBI for IM/dysplasia at the GOJ .
Detailed Description
The panel of predetermined molecular biomarkers includes: 1. IM-SCORE - a score quantifying the extent of intestinal metaplasia at GOJ, which uses a 4-tier system based on the number of glands and the number of biopsies with features of IM. The score has been developed in a pilot study (manuscript under submission) and will be validated in this study 2. Methylation markers- assessed by a PCR-based method (Methylight) on Cytosponge samples. 3. P53 status. 4. TFF3 protein expression.
Investigators
Massimiliano di Pietro, MD
Dr Massimiliano di Pietro, Senior Clinical Investigator Scientist, MRC Cancer Unit, Hutchison-MRC Research Hon. Consultant Gastroenterologist, Addenbrooke's Hospital, Cambridge.
University of Cambridge
Eligibility Criteria
Inclusion Criteria
- Not provided
Exclusion Criteria
- Not provided
Outcomes
Primary Outcomes
Diagnostic accuracy of methylation panel for diffuse IM at the GOJ
Time Frame: 5 years
Diagnostic accuracy of a panel of methylation markers (ZNF345, ZNF569 and TFPI2 loci) for diffuse IM at the GOJ assessed by Methylight on DNA extracted from GOJ biopsies (separately random and targeted biopsies) and Cytosponge samples.
Secondary Outcomes
- Proportion of patients developing true BE recurrence(5 years)
- Biomarker score for BE recurrence(5 years)
- Safety of Cytosponge(5 years)
- Accuracy of Light Blue Crest sign(5 years)