12 January 2016
Prof Rebecca Fitzgerald and her team have been successful in obtaining funding from Cancer Research UK for two new projects for 2016, which will support essential further research into efforts to improve the detection and diagnosis of oesophageal cancer and related conditions. These projects include the BEST3 trial and phase II of the OCCAMS (Oesophageal Cancer Clinical and Molecular Stratification) collaboration.
Early detection of oesophageal cancer has been shown to improve patient outcome. However, most patients with heartburn (the primary risk factor) are not investigated. Hence most cases of oesophageal cancer present at an advanced stage. The BEST3 trial will assess whether the newly-developed CytospongeTM test for patients with reflux symptoms will be effective in increasing the detection of Barrett’s oesophagus. In Barrett's oesophagus the cells that line the lower gullet (oesophagus) are abnormal. The main cause is long-standing reflux of acid from the stomach (heartburn). People with Barrett's oesophagus have an increased risk of developing oesophageal cancer.
The CytospongeTM device will be trialed in GP practices using a cutting-edge cluster randomisation approach. Eighty GP surgeries will be randomised to either treat patients with reflux symptoms in the usual way or to offer all patients the opportunity to have a CytospongeTM test. Four thousand patients will be recruited to the trial, which will take 3 years to complete.
It is hoped that this research will establish whether the CytospongeTM test offers earlier detection and an alternative approach to invasive endoscopy. This will build on the previous multi-site BEST1 and 2 trials, providing the final step before this test could be introduced into main-stream practice in the UK. The project will be implemented in partnership with the Cancer Prevention Trials Unit at the Queen Mary University of London, and the Cambridge Institute of Public Health at the University of Cambridge.
Five years of funding has been secured by Prof Fitzgerald and her team for the second phase of the OCCAMS (Oesophageal Cancer Clinical and Molecular Stratification) collaboration. OCCAMS is a research study bringing together a network of clinical specialist centres treating patients with oesophageal cancer in the UK. Large-scale collection of clinical data and tissue is being used to help to identify clinical, demographic and molecular factors in the progression of oesophageal adenocarcinoma. Insights from the study will inform future trials of novel diagnosis and treatment strategies.
OCCAMS forms part of international sequencing efforts to generate a comprehensive catalogue of genomic abnormalities of cancer tumour types as part of the International Cancer Genome Consortium (ICGC). In collaboration with Simon Tavare’s group at the CRUK Cambridge Institute at the University of Cambridge, the project works to maximise the efforts of academic organisations and NHS trusts across the UK working in oesophageal cancer research.