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Barrett's EsophagusNCT00081354

Early Detection of Barrett's Esophagus

An observational study of Barrett's Esophagus, run by National Cancer Institute (NCI) at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Background: The incidence rate for esophageal adenocarcinoma (EAC) has risen 10% per year over the past two decades and is the most rapidly increasing cancer in the U.S. Barrett's esophagus (BE), a metaplastic change from the normal squamous esophageal epithelium to a specialized intestinal-type columnar mucosa… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Barrett's Esophagus
How many people
737 participants
Where
1 siteUnited States
Study dates
6 Apr 2004to 21 May 2020
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: National Naval Medical Center (NNMC) in Bethesda

Who may be able to join

  • Greater than or equal to 18 years of age, and
  • presence of GERD or GERD-like symptoms, or
  • presence of BE, or
  • dysphagia, or
  • anemia, or
  • gastrointestinal bleeding, or
  • presence of other conditions (e.g., dyspepsia) that merit endoscopic evaluation.

Who cannot join

  • severe pulmonary or cardiac disease, or
  • pregnancy, or
  • refusal, or
  • inability or refusal to give consent, or
  • age less than 18 years or participation in NNMC Barrett's esophagus cryotherapy protocol, or
  • malignancy other than nonmelanoma skin cancer.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • National Naval Medical Center

    Bethesda, Maryland, 20889

Other trials in United States

About this study

Official title: Barrett's Esophagus Early Detection Study

Background:

The incidence rate for esophageal adenocarcinoma (EAC) has risen 10% per year over the past two decades and is the most rapidly increasing cancer in the U.S.

Read more

Barrett's esophagus (BE), a metaplastic change from the normal squamous esophageal epithelium to a specialized intestinal-type columnar mucosa, increases the risk of EAC by 30-125, and is considered a precursor lesion for EAC.

Individuals diagnosed with BE are currently entered into endoscopic surveillance programs to look for dysplasia or EAC. However, only 5% of subjects diagnosed with EAC have a previous diagnosis of BE or have been part of a surveillance program, so alternative screening methods are needed.

Objectives:

The primary goal of this project is to identify a practical blood-based biomarker(s) that can be used as a screening test to determine who has BE and who does not.

Secondary goals of the project are to characterize germ-line and tissue biomarkers associated with BE, and to compare biomarkers in non-BE patients with and without GERD.

Tertiary goals are to explore associations between biomarkers in blood or tissue and progression from BE to dysplasia or EAC, and to assess the stability of proteomic patterns over time.

Eligibility:

This study will be conducted among patients in the Barrett's Esophagus Registry (currently with 206 registrants) established at the National Naval Medical Center (NNMC) in Bethesda beginning in 1992, as well as a comparison group of approximately 600 matched non-BE patients endoscoped in the GI clinic at NNMC for other conditions.

Design:

Blood and tissue samples will be collected as well as questionnaire data on risk factors and medications as well as GERD.

Data analyses will be based primarily on laboratory testing of newly collected esophageal biopsies, brush samples, and blood samples, but secondarily will also include use of archival tissue biopsy samples.

Follow up of BE Registry patients will include standard periodic surveillance endoscopies, additional blood samples, and ascertainment of disease status (i.e., progression).

To distinguish BE versus non BE-patients in this case-control study, we will:

assess predictability of BE status from serum proteomic patterns;

characterize esophageal biopsies and brush samples for selected DNA alterations, RNA expression, and proteomic profiles;

genotype patients for selected polymorphisms potentially associated with BE;

compare blood and tissue biomarkers in non-BE patients with and without GERD;

explore the association of biomarkers with progression from BE to dysplasia or EAC;

assess proteomic pattern stability over time in BE patients.

Read the detailed description

Background:

The incidence rate for esophageal adenocarcinoma (EAC) has risen 10% per year over the past two decades and is the most rapidly increasing cancer in the U.S.

Barrett's esophagus (BE), a metaplastic change from the normal squamous esophageal epithelium to a specialized intestinal-type columnar mucosa, increases the risk of EAC by 30-125 fold (1), and is considered a precursor lesion for EAC.

Individuals diagnosed with BE are currently entered into endoscopic surveillance programs to look for dysplasia or EAC. However, only 5% of subjects diagnosed with EAC have a previous diagnosis of BE or have been part of a surveillance program, so alternative screening methods are needed.

Objectives:

The primary goal of this project is to identify a practical blood-based biomarker(s) that can be used as a screening test to determine who has BE and who does not.

Secondary goals of the project are to characterize germ line and tissue biomarkers associated with BE, and to compare biomarkers in non-BE patients with and without GERD.

Tertiary goals are to explore associations between biomarkers in blood or tissue and progression from BE to dysplasia or EAC, and to assess the stability of proteomic patterns over time.

Eligibility:

This study will be conducted among patients in the Barretts Esophagus Registry (currently with 206 registrants) established at the National Naval Medical Center (NNMC) in Bethesda beginning in 1992 as well as comparison group of approximately 600 matched non-BE patients endoscoped in the GI clinic at NNMC for other conditions.

Design:

Blood and tissue samples will be collected as well as questionnaire data on risk factors and medications as well as GERD.

Data analysis will be based primarily on laboratory testing of newly collected esophageal biopsies, brush samples, and blood samples, but secondarily will also include use of archival tissue biopsy samples.

Follow-up of BE Registry patients will include standard periodic surveillance endoscopies, additional blood samples, and ascertainment of disease status (i.e, progression).

To distinguish BE versus non-BE patients, we will: (1) assess predictability of BE status from serum proteomic patters; (2) characterize esophageal biopsies and brush samples for selected DNA alterations, RNA expression, and proteomic profiles; (3) genotype patients for selected polymorphisms potentially associated with BE; (4) compare blood and tissue biomarkers in non-BE patients with and without GERD; (5) explore the association of biomarkers with progression from BE to dysplasia or EAC; and (6) assess proteomic pattern stability over time in BE patients.

Keywords
Biopsy Tissue, Barrett Esophagus, Gastroesophageal Reflux Disease, GERD, Dysphagia, Swallowing Difficulty
Medical subject headings
Barrett Esophagus, Gastroesophageal Reflux, Deglutition Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT00081354
Study groupRoleWhat they receive
Barrett's esophagusBarrett's esophagus
Controls negative for Barrett's esophagusControls negative for Barrett's esophagus

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Case Control

    Measured: End of Study

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Apr 2004 (estimated)
  2. Study start6 Apr 2004
  3. Primary completion1 Jan 2013
  4. Study completion21 May 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Other
Enrolment
737 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00081354
Sponsor's protocol ID
040155
Other IDs
04-C-0155
Status last verified
May 2020
First submitted
9 Apr 2004
Last updated
22 May 2020
Results posted
No

Publications

  • Gerson LB, Shetler K, Triadafilopoulos G. Prevalence of Barrett's esophagus in asymptomatic individuals. Gastroenterology. 2002 Aug;123(2):461-7. doi: 10.1053/gast.2002.34748.

    PubMed 12145799
  • di Pietro M, Lao-Sirieix P, Boyle S, Cassidy A, Castillo D, Saadi A, Eskeland R, Fitzgerald RC. Evidence for a functional role of epigenetically regulated midcluster HOXB genes in the development of Barrett esophagus. Proc Natl Acad Sci U S A. 2012 Jun 5;109(23):9077-82. doi: 10.1073/pnas.1116933109. Epub 2012 May 17.

    PubMed 22603795
  • Yasui Y, Pepe M, Thompson ML, Adam BL, Wright GL Jr, Qu Y, Potter JD, Winget M, Thornquist M, Feng Z. A data-analytic strategy for protein biomarker discovery: profiling of high-dimensional proteomic data for cancer detection. Biostatistics. 2003 Jul;4(3):449-63. doi: 10.1093/biostatistics/4.3.449.

    PubMed 12925511

Questions about this trial

What is this clinical trial studying?

An observational study of Barrett's Esophagus, run by National Cancer Institute (NCI) at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 May 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Case Control (time frame: End of Study). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00081354, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 May 2020.

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