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TerminatedNCT03366012REACTUpdated Nov 8, 2024Results posted

Rapid Assessment of Esophageal Adenocarcinoma Risk Test

An interventional study of Cytosponge in Barrett Esophagus and Esophageal Adenocarcinoma, sponsored by Columbia University. Terminated at 1 site in United States. Open to participants aged 50 Years to 75 Years. Per ClinicalTrials.gov, last updated 2024-11-08.

Sponsored by Columbia University · Not applicable, Interventional, and Screening

Why this study was terminated
Product recall
Phase
Not applicable
Study type
Interventional
Enrollment
51
Allocation
Not applicable
Ages
50 Years to 75 Years
Sex
All
01

Study summary

This study aims to evaluate the acceptability of a new non-invasive screening device to test for Barrett's esophagus. The investigators will prospectively enroll 100 patients to undergo Cytosponge testing. The time of involvement for an individual will range from 2 weeks to 2 months, depending on the results of the Cytosponge test and time to follow up endoscopy, if indicated.

Read the detailed description

The incidence of esophageal adenocarcinoma (EAC) has risen over the past half century and continues to have a dismal prognosis. Even though it has been established that Barrett's esophagus (BE) is the precursor lesion to EAC, more than 90% of EAC patients are never diagnosed with BE beforehand. Thus, the opportunity is missed to identify most patients at high risk for EAC who could benefit from surveillance and early endoscopic therapy, which in turn may lower EAC mortality. Upper endoscopy is the only means to diagnose BE, yet widespread endoscopic screening is impractical and expensive. There is an urgent need to develop minimally-invasive methods of BE screening that can be easily performed in the primary care setting to allow for efficient and cost-effective interventions to decrease EAC mortality.

02

Conditions studied

  • Barrett Esophagus
  • Esophageal Adenocarcinoma

Keywords

  • Cytosponge
  • GERD
03

Who can participate

Ages eligible
50 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

Males:

Ages 50-75 and at least one of the following:

  • Gastro-esophageal reflux disease (GERD)* or
  • Family history (first degree relative) with Barrett's esophagus or esophageal adenocarcinoma or
  • Both body mass index (BMI) ≥30 or
  • A history of cigarette smoking (at least 10 pack years)

Females:

Ages 50-75 and GERD* and at least one of the following:

  • Family history (first degree relative) with Barrett's esophagus or esophageal adenocarcinoma or
  • BMI ≥30 or
  • A history of cigarette smoking (at least 10 pack years)

Exclusion criteria

Exclusion Criteria:

  • History of gastric or esophageal cancer
  • History of esophageal surgery
  • Known untreated esophageal stricture or uninvestigated dysphagia
  • Previous upper endoscopy within 10 years
  • Cancer within 3 years except for non-melanoma skin cancer
  • Portal hypertension, with or without known varices
  • Uncontrolled coagulopathy
  • Uncontrolled major comorbid illness
  • Inability to tolerate or contraindication to upper endoscopy
  • Inability to give informed consent

GERD defined as either a history of frequent heartburn or fluid regurgitation symptoms (at least weekly for 6 months) or regular use of proton pump inhibitors or histamine-2 receptor antagonists.

04

Study design

Phase
Not applicable
Primary purpose
Screening
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
51 participants (actual)

Study arms

  • Other
    Cytosponge Test

    This arm will include individuals without formal diagnosis of Barrett's esophagus.

    Device: Cytosponge

Interventions

  • DeviceCytosponge

    The Cytosponge consists of a 3cm diameter, polyester, medical grade spherical sponge on a string, compressed within a gelatin capsule. The capsule is swallowed while the patient or the research specialist holds onto the string. After 3-5 minutes the gelatin capsule dissolves allowing the spherical sponge to expand. The sponge is then retrieved by gently pulling on the string, thus collecting cells along the passageway through the entire length of the esophagus. The sample is then put into a preservative to be processed for immunohistochemical testing for trefoil factor 3 (TFF3) to determine diagnosis of Barrett's esophagus.

05

What researchers measure

Primary outcomes

  1. Participation Rate

    Participation rate is defined as the percent of patients who agree to undergo Cytosponge testing among number of eligible patients offered Cytosponge testing.

    Time frame: 1 Day

  2. Patient Tolerability Determined by Score on Likert Scale

    After undergoing the Cytosponge test, subjects will be asked to take a "Cytosponge Post-Procedure Questionnaire" to assess tolerability using a Likert scale from 1 (no discomfort) to 10 (severe discomfort) and whether they would be willing to undergo Cytosponge testing again (yes/no). The scale for each question is rated 1 to 10. Lower scores are "better" (greater tolerability for that particular measure), higher scores are "worse" (less tolerable for that particular measure). Each question on the questionnaire will be assessed independently (i.e. one score per question). No total scores are calculated.

    Time frame: 1 Day

Secondary outcomes

  1. Positive Predictive Value (PPV)

    The PPV is the proportion of patients with endoscopic and histologic evidence of Barrett's esophagus on upper endoscopy from the total number of patients with TFF3-positive Cytosponge test who undergo a follow up endoscopy.

    Time frame: 1 Day

  2. Number of Adverse Events (AEs)

    Total number of all AEs related to Cytosponge testing

    Time frame: 1 Day

  3. Number of Serious Adverse Events (SAEs)

    Total number of all SAEs related to Cytosponge testing

    Time frame: 1 Day

06

Results

Posted Nov 8, 2024

Participant flow

Participant flow — Overall Study
MilestoneCytosponge Test
Started51
Completed51
Not completed0

Outcome measures

PrimaryParticipation Rate

Participation rate is defined as the percent of patients who agree to undergo Cytosponge testing among number of eligible patients offered Cytosponge testing.

Time frame:
1 Day
Reported as:
Number · percent of participants
Participation Rate
percent of participantsCytosponge Test
Participation Rate58.6
PrimaryPatient Tolerability Determined by Score on Likert Scale

After undergoing the Cytosponge test, subjects will be asked to take a "Cytosponge Post-Procedure Questionnaire" to assess tolerability using a Likert scale from 1 (no discomfort) to 10 (severe discomfort) and whether they would be willing to undergo Cytosponge testing again (yes/no). The scale for each question is rated 1 to 10. Lower scores are "better" (greater tolerability for that particular measure), higher scores are "worse" (less tolerable for that particular measure). Each question on the questionnaire will be assessed independently (i.e. one score per question). No total scores are calculated.

Time frame:
1 Day

No measurements were reported for this outcome.

SecondaryPositive Predictive Value (PPV)

The PPV is the proportion of patients with endoscopic and histologic evidence of Barrett's esophagus on upper endoscopy from the total number of patients with TFF3-positive Cytosponge test who undergo a follow up endoscopy.

Time frame:
1 Day

No measurements were reported for this outcome.

SecondaryNumber of Adverse Events (AEs)

Total number of all AEs related to Cytosponge testing

Time frame:
1 Day
Reported as:
Number · study-related adverse events
Number of Adverse Events (AEs)
study-related adverse eventsCytosponge Test
Number of Adverse Events (AEs)0
SecondaryNumber of Serious Adverse Events (SAEs)

Total number of all SAEs related to Cytosponge testing

Time frame:
1 Day
Reported as:
Number · serious study-related adverse events
Number of Serious Adverse Events (SAEs)
serious study-related adverse eventsCytosponge Test
Number of Serious Adverse Events (SAEs)0

Adverse events

Collected over 1 Day. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Cytosponge Test0/51 (0%)0/51 (0%)2/51 (3.9%)
Most frequent other events
Most frequent other events
EventCytosponge Test
FeverGeneral disorders1/51
Sore throatGeneral disorders1/51

Baseline characteristics

Age, Continuous
Age, Continuous(years)Cytosponge Test
Mean64 (50 to 74)
Sex: Female, Male
Sex: Female, Male(Participants)Cytosponge Test
Female14
Male37
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Cytosponge Test
07

Study locations

1 site
  • Columbia University Irving Medical Center
    New York, New York 10032, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Nov 30, 2022

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03366012
Lead sponsor
Columbia University
Responsible party
Julian A Abrams, MD (Associate Professor of Medicine and Epidemiology, Columbia University) — Principal investigator
First posted
Dec 8, 2017
Start date
Aug 1, 2018
Primary completion
May 19, 2023
Completion
May 19, 2023
Results posted
Nov 8, 2024
Last update
Nov 8, 2024

Study contacts

Julian Abrams, MD, MPH
principal investigator · Columbia University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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