RECRUITING

Surveillance vs. Endoscopic Therapy for Barrett's Esophagus With Low-grade Dysplasia

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

The purpose of this study is to learn the best approach to treating patients with known or suspected Barrett's esophagus by comparing endoscopic surveillance to endoscopic eradication therapy. To diagnose and manage Barrett's esophagus and low-grade dysplasia, doctors commonly use procedures called endoscopic surveillance and endoscopic eradication therapy. Endoscopic surveillance is a type of procedure where a physician will run a tube with a light and a camera on the end of it down the patients throat and remove a small piece of tissue. The piece of tissue, called a biopsy, is about the size of the tip of a ball-point pen and is checked for abnormal cells and cancer cells. Endoscopic eradication therapy is a kind of surgery which is performed to destroy the precancerous cells at the bottom of the esophagus, so that healthy cells can grow in their place. It involves procedures to either remove precancerous tissue or burn it. These procedures can have side effects, so it is not certain whether risking those side effects is worth the benefit people get from the treatments. While both of these procedures are widely accepted approaches to managing the condition, there is not enough research to show if one is better than the other. Barrett's esophagus and low-grade dysplasia does not always worsen to high-grade dysplasia and/or cancer. In fact, it usually does not. So, if a patient's dysplasia is not worsening, doctors would rather not put patients at risk unnecessarily. On the other hand, endoscopic eradication therapy could possibly prevent the worsening of low-grade dysplasia into high-grade dysplasia or cancer (esophageal adenocarcinoma) in some patients. Researchers believe that the results of this study will help doctors choose the safest and most effective procedure for their patients with Barrett's esophagus and low-grade dysplasia. This is a multicenter study involving several academic, community and private hospitals around the United States. Up to 530 participants will be randomized. This study will also include a prospective observational cohort study of up to 150 Barrett's esophagus and low grade dysplasia patients who decline randomization in the randomized control trial but undergo endoscopic surveillance (Cohort 1) or endoscopic eradication therapy (Cohort 2), and are willing to provide longitudinal observational data.

Official Title

A Multicenter Randomized Controlled Trial of Surveillance vs. Endoscopic Therapy for Barrett's Esophagus With Low-grade Dysplasia (The SURVENT Trial)

Quick Facts

Study Start:2023-01-24
Study Completion:2028-02-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT05753748

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years to 89 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. Male or female, age ≥18 years,
  2. 2. Subject has endoscopic evidence of Barrett's esophagus characterized by the presence of salmon-colored mucosa in the tubular esophagus of at least 1 cm in length as well as endoscopic biopsies from the involved areas demonstrating columnar metaplasia with goblet cells. This inclusion criterion will exclude patients with intestinal metaplasia with dysplasia of the gastric cardia,
  3. 3. Biopsies within the previous 12 months demonstrating Barrett's esophagus and low grade dysplasia,
  4. 4. Confirmation of low grade dysplasia by expert central pathology panel from biopsies obtained within the previous 12 months (including those obtained from the referring physician),
  5. 5. Demonstrated ability to tolerate proton pump inhibitor (PPI) therapy based on patient self-report, and, Ability to discontinue antiplatelet and anticoagulant therapy based on standard guideline recommendations prior to and after endoscopic procedures.
  1. 1. Pregnancy;
  2. 2. Prior endoscopic eradication therapy for Barrett's esophagus;
  3. 3. History of high grade dysplasia or post-endoscopy esophageal adenocarcinoma;
  4. 4. History of esophageal resection/esophagectomy
  5. 5. Active erosive esophagitis (Los Angeles Grade B or higher) - patients are eligible upon resolution of erosive esophagitis;
  6. 6. Esophageal strictures precluding passage of the endoscope or treatment catheters - patients are eligible upon resolution of esophageal stricture due to endoscopic dilation or resolution with medical therapy;
  7. 7. Esophageal varices or known portal hypertension; and
  8. 8. Life expectancy of \<2 years as judged by the site investigator. \* Presence of a visible lesion (nodularity) at the index endoscopy is not an exclusion criterion. Subjects with visible lesions will undergo endoscopic mucosal resection (EMR) to determine pathology; those with high grade dysplasia or post-endoscopy esophageal adenocarcinoma pathology will exit the study after a 30-day safety follow up.

Contacts and Locations

Study Contact

Jillian Welker
CONTACT
303-724-8892
jillian.welker@cuanschutz.edu
Sandra Boimbo
CONTACT
303-724-8892
sandra.boimbo@cuanschutz.edu

Principal Investigator

Sachin Wani, MD
PRINCIPAL_INVESTIGATOR
University of Colorado, Denver
Nicholas J Shaheen, MD, MPH
PRINCIPAL_INVESTIGATOR
University of North Carolina
Valerie Durkalski, MPH, PhD
PRINCIPAL_INVESTIGATOR
Medical University of South Carolina
Rhonda Souza, MD
PRINCIPAL_INVESTIGATOR
Baylor University

Study Locations (Sites)

University of Colorado
Aurora, Colorado, 80045
United States

Collaborators and Investigators

Sponsor: University of Colorado, Denver

  • Sachin Wani, MD, PRINCIPAL_INVESTIGATOR, University of Colorado, Denver
  • Nicholas J Shaheen, MD, MPH, PRINCIPAL_INVESTIGATOR, University of North Carolina
  • Valerie Durkalski, MPH, PhD, PRINCIPAL_INVESTIGATOR, Medical University of South Carolina
  • Rhonda Souza, MD, PRINCIPAL_INVESTIGATOR, Baylor University

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2023-01-24
Study Completion Date2028-02-01

Study Record Updates

Study Start Date2023-01-24
Study Completion Date2028-02-01

Terms related to this study

Keywords Provided by Researchers

  • Barrett Esophagus
  • Esophageal Adenocarcinoma
  • Dysplasia

Additional Relevant MeSH Terms

  • Barretts Esophagus With Dysplasia
  • Barrett Esophagus
  • Esophageal Adenocarcinoma