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| Name | Class |
|---|---|
| Centre for Statistics in Medicine | OTHER |
| Cancer Research UK | OTHER |
| University of Cambridge | OTHER |
| Cambridge University Hospitals NHS Foundation Trust |
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This is a feasibility study testing the use of the Cytosponge™ device in patients with known oesophageal cancer treated with pre-operative or definitive chemoradiation. All participants will receive one Cytosponge™ procedure at one time-point within 4-16 weeks after completion of chemoradiotherapy.
In this feasibility study, we are investigating a novel way to test for remaining or reoccurring oesophageal cancer following chemoradiotherapy. The technique used to test this is called a Cytosponge™. We will be testing the use of the Cytosponge™ to determine completion rate, safety and acceptability of the procedure.
Cytosponge™ is a capsule-sized device which contains an expandable, spherical mesh which is attached to a string. The capsule dissolves in the stomach after swallowing, releasing the sponge which is then retrieved by gently pulling the string after five minutes. As the sponge is pulled out it collects the cells from the lining of the gullet.
The Cytosponge™ will be processed for evidence of residual cancer through analysis of cellular atypia and molecular biomarkers. Where available, the results will be compared with histology.
Up to fifty patients will be recruited to the trial across 11 sites.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cytosponge™ | Experimental | All participants will receive the Cytosponge™ device. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cytosponge™ | Device | Cytosponge™ is a capsule-sized device which contains an expandable, spherical mesh which is attached to a string. The capsule dissolves in the stomach after swallowing, releasing the sponge which is then retrieved by gently pulling the string after five minutes. As the sponge is pulled out it collects the cells from the lining of the gullet. |
| Measure | Description | Time Frame |
|---|---|---|
| Completion Rate | The percentage of consented, evaluable patients successfully undergoing the Cytosponge™ procedure. | Day 1 following intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Safety; Number of SAEs Related to the Device Procedure | All serious adverse effects related to the procedure, including bleeding (requiring transfusion) and perforation. | Two week follow up |
| Number of Participants With Positive Cytosponge™ Results From Biomarker Analysis (i.e. Presence of Cytological Atypia and/or p53 Abnormality) |
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Inclusion Criteria:
Male or female, Age >/=16 years who
4-16 weeks post completion of CRT
Dysphagia score 0-2 (Mellow Scale)*
Able to swallow tablets
Physiologically fit for endoscopy
Written (signed and dated) informed consent
The patient is willing and able to comply with the protocol for the duration of the study, and scheduled follow-up visits and examinations.
Exclusion Criteria:
Known to have oesophageal varices or stricture requiring dilatation of the oesophagus.
Unable to temporarily discontinue anticoagulation therapy/medication prior to their procedure*
Oesophageal stent
Other psychological, social or medical condition, physical examination finding or a laboratory abnormality that the Investigator considers would make the patient a poor study candidate or could interfere with protocol compliance or the interpretation of study results.
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| Name | Affiliation | Role |
|---|---|---|
| Prof Somnath Mukherjee | University of Oxford | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Glan Clwyd hospital | Bodelwyddan | United Kingdom | ||||
| Cancer Institute Bristol |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36187722 | Derived | Jones CM, O'Connor H, O'Donovan M, Hayward D, Blasko A, Harman R, Malhotra S, Debiram-Beecham I, Alias B, Bailey A, Bateman A, Crosby TDL, Falk S, Gollins S, Hawkins MA, Kadri S, Levy S, Radhakrishna G, Roy R, Sripadam R, Fitzgerald RC, Mukherjee S. Use of a non-endoscopic immunocytological device (Cytosponge) for post chemoradiotherapy surveillance in patients with oesophageal cancer in the UK (CYTOFLOC): A multicentre feasibility study. EClinicalMedicine. 2022 Sep 23;53:101664. doi: 10.1016/j.eclinm.2022.101664. eCollection 2022 Nov. |
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| ID | Title | Description |
|---|---|---|
| FG000 | Cytosponge™ | All participants will receive the Cytosponge™ device. Cytosponge™ is a capsule-sized device which contains an expandable, spherical mesh which is attached to a string. The capsule dissolves in the stomach after swallowing, releasing the sponge which is then retrieved by gently pulling the string after five minutes. As the sponge is pulled out it collects the cells from the lining of the gullet. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Cytosponge™ | All participants will receive the Cytosponge™ device. Cytosponge™ is a capsule-sized device which contains an expandable, spherical mesh which is attached to a string. The capsule dissolves in the stomach after swallowing, releasing the sponge which is then retrieved by gently pulling the string after five minutes. As the sponge is pulled out it collects the cells from the lining of the gullet. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Completion Rate | The percentage of consented, evaluable patients successfully undergoing the Cytosponge™ procedure. | Individuals who attempted to carry out the Cytosponge procedure. | Posted | Count of Participants | Participants | Day 1 following intervention |
|
Adverse events were collected from Cytosponge administration to completion of the 2 week telephone follow up interview.
The Cytosponge is an Investigational Medical Device & therefore additional categorisation of Adverse Device Effect (ADE) and Serious Adverse Device Effect (SADE) was required. Of the 41 trial participants, 39 successfully swallowed the Cytosponge device and were therefore evaluable for Adverse Events.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Cytosponge™ | All participants will receive the Cytosponge™ device. Cytosponge™ is a capsule-sized device which contains an expandable, spherical mesh which is attached to a string. The capsule dissolves in the stomach after swallowing, releasing the sponge which is then retrieved by gently pulling the string after five minutes. As the sponge is pulled out it collects the cells from the lining of the gullet. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Acute cholecystitis | Hepatobiliary disorders | Systematic Assessment | Diagnosed 5 days after the Cytosponge procedure and persisting past the end of study. Defined as probably not related to the Cytosponge procedure. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Sore throat | Respiratory, thoracic and mediastinal disorders | Systematic Assessment | Starting on the day of Cytosponge procedure and persisting past the end of study. Classified as CTCAE grade 1 and probably not related to the procedure. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Somnath Mukherjee | Oxford University Hospitals NHS Trust | 01865 617018 | Somnath.Mukherjee@ouh.nhs.uk |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Feb 20, 2019 | Oct 19, 2021 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Apr 22, 2020 | Nov 4, 2021 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D004938 | Esophageal Neoplasms |
| D009369 | Neoplasms |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D006258 | Head and Neck Neoplasms |
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| OTHER |
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|
Quality of material obtained from Cytosponge™ test was centrally analysed at Cambridge (cellularity, yield and quality of extracted DNA as measure of quality). A positive Cytosponge™ result was defined as presence of positive cytological atypia, atypia of uncertain significance, and/or p53 aberrant. |
| From sample taken from Cytosponge™ on day of intervention |
| Acceptance Rate | Percentage of eligible patients approached who consented. | Day 1 after questionnaire completion |
| Number of Patients Who Would be Prepared to Repeat the Procedure | Number of patients who have successfully undergone the procedure & would be prepared to accept the procedure repeatedly if it was to be used for follow-up (data captured through questionnaire after procedure). | Day 1 after questionnaire completion |
| Bristol |
| United Kingdom |
| Addenbrooke's Hospital | Cambridge | United Kingdom |
| Velindre Cancer Centre | Cardiff | United Kingdom |
| Castle Hill hospital | Hull | United Kingdom |
| Leicester General hospital | Leicester | United Kingdom |
| The Christie | Manchester | United Kingdom |
| Clatterbridge hospital | Metropolitan Borough of Wirral | United Kingdom |
| Milton Keynes University Hospital | Milton Keynes | United Kingdom |
| Churchill hospital | Oxford | United Kingdom |
| University Hospital Southampton | Southampton | United Kingdom |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race and Ethnicity Not Collected | Race and Ethnicity were not collected from any participant. | Count of Participants | Participants |
|
| Dysphagia level | Count of Participants | Participants |
|
| Chemo-radiotherapy | Count of Participants | Participants |
|
| Tumour site | Count of Participants | Participants |
|
| Tumour type | Count of Participants | Participants |
|
| WHO performance status | Count of Participants | Participants |
|
| Units | Counts |
|---|
| Participants |
|
|
| Secondary | Safety; Number of SAEs Related to the Device Procedure | All serious adverse effects related to the procedure, including bleeding (requiring transfusion) and perforation. | The participants who successfully swallowed the Cytosponge device (i.e. 2 participants in the total population of 41 did not manage to do so). | Posted | Number | events | Two week follow up |
|
|
|
| Secondary | Number of Participants With Positive Cytosponge™ Results From Biomarker Analysis (i.e. Presence of Cytological Atypia and/or p53 Abnormality) | Quality of material obtained from Cytosponge™ test was centrally analysed at Cambridge (cellularity, yield and quality of extracted DNA as measure of quality). A positive Cytosponge™ result was defined as presence of positive cytological atypia, atypia of uncertain significance, and/or p53 aberrant. | Cytosponges suitable for biomarker analysis (i.e. 1 of the 39 swallowed devices was not analysed). | Posted | Count of Participants | Participants | From sample taken from Cytosponge™ on day of intervention |
|
|
|
| Secondary | Acceptance Rate | Percentage of eligible patients approached who consented. | Of the 101 individuals who were initially identified as being eligible for CYTOFLOC, 96 were approached for consent to participate. | Posted | Count of Participants | Participants | Day 1 after questionnaire completion |
|
|
|
| Secondary | Number of Patients Who Would be Prepared to Repeat the Procedure | Number of patients who have successfully undergone the procedure & would be prepared to accept the procedure repeatedly if it was to be used for follow-up (data captured through questionnaire after procedure). | Participants who successfully completed the Cytosponge procedure (out of a total of 41 who attempted it). | Posted | Count of Participants | Participants | Day 1 after questionnaire completion |
|
|
|
| 3 |
| 39 |
| 1 |
| 39 |
| 3 |
| 39 |
|
| Pneumonia | Infections and infestations | Systematic Assessment | Diagnosed 7 days after the Cytosponge procedure and persisting past the end of study. Defined as probably not related to the Cytosponge procedure. |
|
|
| Dysphagia | Gastrointestinal disorders | Systematic Assessment | Starting 7 days following the Cytosponge procedure and resolving within 7 days. Classified as CTCAE grade 1 and probably not related to the procedure. |
|
| Dyspepsia | Gastrointestinal disorders | Systematic Assessment | Starting on the day of the Cytosponge procedure and resolving within 3 days. Classified as CTCAE grade 1 and possibly related to the procedure. |
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NHS Organisations shall not publish or otherwise disseminate the conclusions of the Study, including all or any part of the Results of the Study without prior written consent of the Sponsor, such consent not to be unreasonably withheld. Any publication or other dissemination of the conclusions of the Study by NHS Organisations shall not occur until the Sponsor has published the conclusions of the Study & shall refer to publication by the Sponsor in such form as the Sponsor may reasonably direct.
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |