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RecruitingNCT05028725Updated Jul 23, 2026

Novel Strategy for Early Detection of Esophageal Squamous Cell Carcinoma

An interventional study of EsophaCap Sponge and Chromoendoscopy in Esophageal Squamous Cell Carcinoma and Esophageal Squamous Dysplasia, sponsored by University of California, San Francisco. Recruiting at 2 sites in Tanzania. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-23.

Sponsored by University of California, San Francisco · Not applicable, Interventional, and Diagnostic

From the registry’s dates

  • Started May 2022; still recruiting 4 years 5 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
289
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

In the current protocol, we propose a study to evaluate a novel, combined esophageal sponge-methylation biomarker strategy for the early detection of esophageal squamous cell carcinoma (ESCC) as well as its precursor, esophageal squamous dysplasia (ESD). This strategy leverages the 'EsophaCap', a swallowable, retrievable sponge, with subsequent evaluation of the sample using a novel molecular biomarker assay. This biomarker assay evaluates methylation levels in select genes, which have been shown to differ significantly between ESCC cases and controls in pilot studies. Detection of methylation markers highly associated with ESCC could help identify patients with concurrent ESCC or at high risk of imminently developing this condition. If successful, this strategy could result in a paradigm shift for esophageal cancer control strategies in Tanzania and other high-incidence ESCC regions.

Read the detailed description

PRIMARY OBJECTIVE:

I. To evaluate the sensitivity and specificity of a diagnostic strategy combining esophageal sponge sampling with the 'EsophaCap' sponge device with use of the EsoCAN assay, a novel molecular biomarker assay, among patients with histologically-confirmed ESCC cases and controls.

SECONDARY OBJECTIVES:

I. To evaluate the sensitivity and specificity of a diagnostic strategy combining esophageal sponge sampling with the 'EsophaCap' sponge device with use of the the EsoCAN assay, among patients with histologically-confirmed ESD and controls.

II. To evaluate the safety and feasibility of 'EsophaCap' a swallowable and retrievable sponge, as a non-invasive strategy for screening and early detection of ESCC and its precursor, ESD, in Tanzania.

EXPLORATORY OBJECTIVES:

I. Sensitivity and specificity of esophageal sponge sampling with standard cytological examination among histologically-confirmed ESCC cases and controls.

II. Sensitivity and specificity of esophageal sponge sampling with standard cytological examination among histologically-confirmed ESD cases and controls.

III. To examine methylation levels in new and previously identified genes among patients recruited as suspected ESCC cases who are found to have an alternative diagnosis, with the goal of optimizing the EsoCAN Assay.

OUTLINE:

Each participant will undergo esophageal sponge sampling suing the 'EsophaCap' sponge device. Participants will be on study for up to 38 days.

02

Conditions studied

  • Esophageal Squamous Cell Carcinoma
  • Esophageal Squamous Dysplasia

Keywords

  • EsophaCap
  • Biomarker Detection
  • Cancer Detection
  • Chromoendoscopic screening
03

In context

Esophageal Squamous Cell Carcinoma

675 studies on the registry are indexed under Esophageal Squamous Cell Carcinoma; 267 are open to participants now.

This study's planned enrollment of 289 is above the median of 64 across 563 interventional studies indexed under Esophageal Squamous Cell Carcinoma.

Browse Esophageal Squamous Cell Carcinoma studies →

Lead sponsor

University of California, San Francisco is the lead sponsor of 2,169 studies on the registry; 372 are open to participants now.

Of its 267 completed or terminated interventional studies of FDA-regulated products, 202 (76%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

ESCC Cases (Group 1):

  • Male or female >= 18 years of age at screening visit.
  • Patients are currently seen for clinical care at Muhimbili National Hospital (MNH)-Upanga or at MNH-Mloganzila.
  • Patient meets one of the following two criteria-
  • Patients with a confirmed diagnosis of ESCC as evidenced by histological confirmation OR
  • Patient planned to undergo EGD with for suspected ESCC based upon any one of the following clinical criteria: (1) findings on computed tomography (CT) scan; (2) findings on barium swallow; (3) findings on endoscopy without biopsy confirmation, (4) symptoms of dysphagia and/or odynophagia without an alternative explanation for these symptoms.
  • Patient must be able to swallow liquid (Ogilvie's score \< 3).
  • Patients must be well enough to participate in a 20-minute interview or have a close relative who is able to do so on their behalf.
  • Patients must be willing to be contacted either in person or via phone 7-10 days following administration of the 'EsophaCap' sponge device.
  • Native of Tanzania.
  • Written (and assent when applicable) obtained from subject or subject's legal representative and ability for subject to comply with the requirements of the study.

Non-ESCC study participants (Group 2):

  • Male or female ≥ 18 years of age at screening visit.
  • Patients are currently seen for clinical care at MNH-Upanga or at MNH-Mloganzila.
  • Patient is scheduled to undergo EGD for a suspected non-malignant condition with no symptoms concerning for esophageal cancer (i.e. dysphagia or odynophagia).
  • Patient must be able to swallow liquid (Ogilvie's score \< 3).
  • Patients must be well enough to participate in a 20-minute interview or have a close relative who is able to do so on their behalf.
  • Patients must be willing to be contacted either in person or via phone 7-10 days following administration of the 'EsophaCap' sponge device.
  • Native of Tanzania.
  • Written informed consent (and assent when applicable) obtained from participant or participant's legal representative and ability for subject to comply with the requirements of the study.

Exclusion criteria

Exclusion Criteria:

ESCC Cases (Group 1):

  • Known pregnancy during participation in the study.
  • Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
  • Clinical instability (i.e. hypotension or a recent cardiovascular event).
  • Any history of upper gastrointestinal bleeding within the past 3 months (including reported history of hematemesis and/or melena).
  • Diagnosis of peptic ulcer disease within the last 3 months.
  • Known history of esophageal varices.
  • Patients taking anticoagulation or antiplatelet therapy/medication (warfarin, clopidogrel, aspirin, heparin or enoxaparin) for high-risk conditions.
  • Patients with an active extra-esophageal (not currently in remission).
  • Patient with a known history of a non-malignant esophageal stricture.
  • Patients with esophageal stents currently in place.
  • Patients with a history of radiation therapy to the head, neck, any part of the gastrointestinal tract (including esophagus) or thorax.
  • Patients who have previously received chemotherapy in the last 12 months
  • Patients with any history of major surgery for esophageal cancer (e.g. esophageal bypass, esophagectomy, etc.).
  • Patients who have a known history of or clinical symptoms concerning for tracheoesophageal fistula (aspiration history, severe cough)
  • Patients with a known history of small bowel obstruction
  • Patients with a history of bleeding complications during esophageal .
  • Patients with any history of a head and neck malignancy.
  • Patients with a known bleeding disorder
  • Patients with known thrombocytopenia (less than 50,000 per microliter)
  • Individuals who are not permanent residents or natives of Tanzania.
  • Inability to follow instructions.
  • Unable to provide .

Non-ESCC study participants (Group 2):

  • Known pregnancy during participation in the study.
  • Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
  • Clinical instability (i.e. hypotension or a recent cardiovascular event).
  • Any history of upper gastrointestinal bleeding within the past 3 months (including reported history of hematemesis and/or melena).
  • Diagnosis of peptic ulcer disease within the last 3 months.
  • Known history of esophageal varices.
  • Patients taking anticoagulation or antiplatelet therapy/medication (warfarin, clopidogrel, aspirin, heparin or enoxaparin) for high-risk conditions.
  • Patients with an active extra-esophageal malignancy (not currently in remission) or any history of a non-cutaneous malignancy diagnosed within the previous five years.
  • Patient with a known history of esophageal strictures disabling passage of the capsule.
  • Patient with esophageal stents currently in place.
  • Patients with a history of radiation therapy to the head, neck, any part of the gastrointestinal tract (including esophagus) or thorax.
  • Patients with a known history of small bowel obstruction
  • Patients with a known bleeding disorder
  • Patients with known thrombocytopenia (less than 50,000 platelets per microliter)
  • Individuals who are not permanent residents or natives of Tanzania.
  • Allergy to iodine
  • Presence of goiter.
  • Inability to follow instructions.
  • Unable to provide informed consent
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

05

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
289 participants (estimated)

Study arms

  • Experimental
    Esophageal Squamous Cell Carcinoma (ESCC) Cases

    Each study participant will undergo esophageal sponge sampling using the 'EsophaCap' sponge device. Group 1 will include a safety-phase, which will consist of a lead-in cohort of 8 patients with ESCC. Subsequent recruitment of ESCC Cases (Group 1) will not commence until the Data Safety Monitoring Board (DSMB) has deemed the safety lead-in data appropriate for continuation. Following collection of esophageal cells, samples will be assessed using the EsoCAN assay. Study participant evaluations will be taken at baseline, immediately after undergoing esophageal sponge sampling, and 7 days following administration of the 'EsophaCap' device.

    Device: EsophaCap Sponge · Device: EsoCAN assay

  • Experimental
    Non-ESCC, Esophageal squamous dysplasia (ESD) Cases

    Each study participant will undergo (1) Esophagogastroduodenoscopy (EGD) with chromoendoscopic screening and possible biopsy, and (2) esophageal sponge sampling using the 'EsophaCap' sponge device. Pathology from chromoendoscopic screening will be used to categorize non-ESCC study participants as esophageal squamous dysplasia (ESD) cases and controls. Following collection of esophageal cells, samples will be assessed using the EsoCAN assay. Study participant evaluations will be taken at baseline, immediately after undergoing esophageal sponge sampling, and 7 days following administration of the 'EsophaCap' device.

    Device: EsophaCap Sponge · Procedure: Chromoendoscopy · Device: EsoCAN assay

  • Experimental
    Non-ESCC, Control Group

    Each study participant will undergo (1) Esophagogastroduodenoscopy (EGD) with chromoendoscopic screening and possible biopsy, and (2) esophageal sponge sampling using the 'EsophaCap' sponge device. Pathology from chromoendoscopic screening will be used to categorize non-ESCC study participants as esophageal squamous dysplasia (ESD) cases and controls. Following collection of esophageal cells, samples will be assessed using the EsoCAN assay. Study participant evaluations will be taken at baseline, immediately after undergoing esophageal sponge sampling, and 7 days following administration of the 'EsophaCap' device.

    Device: EsophaCap Sponge · Procedure: Chromoendoscopy · Device: EsoCAN assay

Interventions

  • DeviceEsophaCap Sponge

    Non-invasive strategy to sample esophageal tissue

    Also known as: EsophaCap Sponge Device, EsophaCap Swallowable Sponge device

  • ProcedureChromoendoscopy

    Lugol's iodine chromoendoscopy is a technique that is used to identify mucosal abnormalities of the esophagus

    Also known as: Lugol's iodine chromoendoscopy, Chromoendoscopic screening

  • DeviceEsoCAN assay

    Biomarker Test

06

What researchers measure

Primary outcomes

  1. Proportion of True-Positives (sensitivity) detected with the EsoCAN assay after specimen collection using 'EsophaCap' sponge sampling (ESCC cases & controls only)

    The proportion of participants with a positive EsoCAN assay result, among patients with histologically-confirmed Esophageal Squamous Cell Carcinoma (ESCC). The following equation will be used as a cut point for ESCC using the EsoCAN assay \[0.139\*log2(gene A)\] + \[0.176\* log2(gene B)\] + \[0.185\* log2(gene C)\], whereas a cutoff value (for the numerical index produced by this formula) of greater than -2.327 is classified as positive.

    Time frame: Up to 38 days

  2. Proportion of True-Negatives (specificity) detected with the EsoCAN assay after specimen collection using 'EsophaCap' sponge sampling (ESCC cases & controls only)

    The proportion of participants with a negative EsoCAN assay result for will be reported, among study participants who are classified as controls. The following equation will be used as a cut point for ESCC using the EsoCAN assay \[0.139\*log2(gene A)\] + \[0.176\* log2(gene B)\] + \[0.185\* log2(gene C)\], whereas a cutoff value (for the numerical index produced by this formula) of less than -2.327 is classified as negative.

    Time frame: Up to 38 days

Secondary outcomes

  1. Proportion of True-Positives (sensitivity) detected with the EsoCAN assay after specimen collection using 'EsophaCap' sponge sampling (ESD cases & controls only)

    The proportion of participants with both a positive EsoCAN assay result, among patients with histologically-confirmed Esophageal Squamous Dysplasia (ESD). The following equation will be used as a cut point for ESD: \[0.139\*log2(gene A)\] + \[0.176\* log2(gene B)\] + \[0.185\* log2(gene C)\], whereas a cutoff value (for the numerical index produced by this formula) of greater than -2.327 is classified as positive.

    Time frame: Up to 38 days

  2. Proportion of True-Negatives (specificity) detected with the EsoCAN assay after specimen collection using 'EsophaCap' sponge sampling (ESD cases & controls only)

    The proportion of participants with a negative EsoCAN assay result will be reported. The following equation will be used as a cut point for ESD: \[0.139\*log2(gene A)\] + \[0.176\* log2(gene B)\] + \[0.185\* log2(gene C)\], whereas a cutoff value (for the numerical index produced by this formula) of less than -2.327 is classified as negative.

    Time frame: Up to 38 days

  3. Proportion of study participants who successfully swallow the esophageal sponge device

    The success of swallowing the esophageal sponge device will be determined by the clinical team overseeing the EsophaCap' administration and categorized as a dichotomous response of Yes (successful) or No (not successful).

    Time frame: Up to 38 days

  4. Proportion of study participants who experienced an esophageal sponge device-related adverse event in the lead in cohort of ESCC Cases

    Adverse events for the lead in cohort with histologically confirmed or suspected ESCC based upon pre-specified clinical criteria will be reported and graded and classified according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0

    Time frame: Up to 38 days

  5. Median Acceptability Scores

    Participants will be asked to rate their satisfaction with their experience with the EsophaCap sponge procedure after the procedure is complete by selecting a score on a scale with corresponding facial images with scores ranging between 0='Best Experience' (large smile on facial expression) to 10='Worst experience' (crying and frowning facial expression).

    Time frame: Up to 38 days

07

Study locations

2 of 2 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 23, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05028725
Collaborators
National Cancer Institute (NCI), Johns Hopkins University, Muhimbili University of Health and Allied Sciences, CapNostics, LLC
Responsible party
Sponsor
First posted
Aug 31, 2021
Start date
May 16, 2022
Primary completion
Dec 31, 2027 (estimated)
Completion
Dec 31, 2027 (estimated)
Last update
Jul 23, 2026

Study contacts

Geoffrey Buckle, MD, MPH
Contact
geoffrey.buckle@ucsf.edu
508-380-9129
Geoffrey Buckle, MD, MPH
principal investigator · University of California, San Francisco

Oversight

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

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