Barrett's Esophagus & Gastroesophageal Reflux Disease
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Purpose
This is a study of Barrett's Esophagus (BE) and Gastroesophageal Reflux Disease (GERD). It aims to look at the long term efficacy of evidence-based cutting edge diagnostic and therapeutic algorithms and techniques such as radiofrequency ablation, endoscopic mucosal resection and surveillance endoscopy with biopsy. Additionally, biological analyses will be performed in hopes of identifying biomarkers associated with the progression of BE to esophageal cancer.
| Condition | Intervention | Phase |
|---|---|---|
|
Barrett's Esophagus GERD |
Procedure: Endoscopy Procedure: Radiofrequency ablation protocol Procedure: Endoscopic mucosal resection protocol |
Phase 2 Phase 3 |
| Study Type: | Observational |
| Study Design: | Time Perspective: Prospective |
| Official Title: | The Valley Hospital Center for Barrett's Esophagus and Gastroesophageal Reflux Disease (GERD) |
- To standardize physician recommendations and provide cutting edge technology to patients with BE and GERD, and establish a Valley Hospital Center for Barrett's Esophagus and GERD [ Time Frame: Until study complete ] [ Designated as safety issue: No ]
- To collect and store patient data regarding their Barrett's esophagus [ Time Frame: Througout Study ] [ Designated as safety issue: No ]
- To collect tissue specimens (biopsy and surgical specimens) for use in proteomic analysis to investigate the dysplasia/carcinoma sequence at the protein expression level. [ Time Frame: throughout Study ] [ Designated as safety issue: No ]
- To assess clinical outcomes of patients enrolled in The Valley Hospital Center for Barrett's Esophagus and GERD, and modify algorithms as appropriate. [ Time Frame: Annually ] [ Designated as safety issue: Yes ]
Biospecimen Retention: Samples With DNA
Tissue and blood for future analysis
| Estimated Enrollment: | 100 |
| Study Start Date: | July 2007 |
| Estimated Study Completion Date: | August 2017 |
| Estimated Primary Completion Date: | July 2016 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Algorithm #1
Patients without visable lesions
|
Procedure: Endoscopy
Initial Assessment for lesions can be based on information obtained from previous upper endoscopies and or pathology reports. Repeat Endoscopic assessments are based on initial and follow-up assessments.
|
|
Algorithm #2
Patients with a visable lesion that is less than 1cm
|
Procedure: Endoscopy
Initial Assessment for lesions can be based on information obtained from previous upper endoscopies and or pathology reports. Repeat Endoscopic assessments are based on initial and follow-up assessments.
Procedure: Radiofrequency ablation protocol
Ablation using the HALO 360 system according to protocol established by BARRX, Inc.
Procedure: Endoscopic mucosal resection protocol
Excision of lesion using DUETTE, marketed by Wilson-Cook
|
|
Algorithm #3
Patients with a visable lesion greater than 1cm
|
Procedure: Endoscopy
Initial Assessment for lesions can be based on information obtained from previous upper endoscopies and or pathology reports. Repeat Endoscopic assessments are based on initial and follow-up assessments.
Procedure: Radiofrequency ablation protocol
Ablation using the HALO 360 system according to protocol established by BARRX, Inc.
Procedure: Endoscopic mucosal resection protocol
Excision of lesion using DUETTE, marketed by Wilson-Cook
|
Detailed Description:
Barrett's esophagus (BE) is a known premalignant condition of the esophagus, predisposing to the development of esophageal adenocarcinoma. BE represents a change in the lining (mucosa) of the esophagus which is known to be produced as a result of chronic gastroesophageal reflux. The current standard of care for patients with BE includes serial performance of upper endoscopy with multiple biopsies, performed at designated time intervals. However, the emergence of new technologies for the management of this condition has made the care of these patients non-uniform, and subject to biases of individual treating physicians.
The protocol at The Valley Hospital and Blumenthal Cancer Center aims to standardize the management of patients with Barrett's esophagus, with and without dysplasia, using evidence-based, cutting edge diagnostic and therapeutic algorithms and techniques such as radiofrequency ablation, endoscopic mucosal resection, and surveillance endoscopy with biopsies. If biopsies suggest the development of carcinoma or high grade dysplasia surgical removal of the esophagus is recommended. This study aims to look at the long-term efficacy of these procedures. In addition, data regarding clinical outcomes will be collected as well as blood, tissue and surgical specimens for proteomic analysis in hopes of identifying biomarkers associated with the progression of dysplasia to adenocarcinoma. Although patients will ultimately make their own informed decisions regarding the management of their BE, this protocol serves to unify physician recommendations, and allows for the collection and interpretation of data.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Probability Sample |
Referred Patients with underlying disease of BE or GERD
Inclusion Criteria:
- Male or female, age 18 to 85.
- Patient must have Barrett's Esophagus. Patients may be enrolled based on previous endoscopy reports and/or pathology reports. It is not necessary that each patient have endoscopy for the sole purpose of enrollment.
- Must agree to allow their clinical information to be collected, stored, analyzed and reported.
- Must allow portions of their biopsy/surgical specimens to be collected, stored, analyzed and reported.
- Must agree to fill out patient questionnaires in conjunction with the research study assistant assigned to this protocol (either in person or via telephone contact) at designated timepoints.
Exclusion Criteria:
- Intestinal metaplasia of the cardia, without an esophageal columnar lining.
- Unable to provide informed consent.
- Unable or unwilling to undergo endoscopic procedures.
Contacts and Locations| Contact: Sobeida J. Santana-Joseph, MSN | 201-634-5567 | ssantan@valleyhealth.com |
| Contact: Jennifer Deraney, RN | 201-634-5792 | jderane@valleyhealth.com |
| United States, New Jersey | |
| Valley Health System - The Valley Hospital - Luckow Pavilion | Recruiting |
| Paramus, New Jersey, United States, 07652 | |
| Contact: Sobeida J. Santana-Joseph, MSN 201-634-5567 ssantan@valleyhealth.com | |
| Principal Investigator: Robert J. Korst, MD | |
| Principal Investigator: | Robert J. Korst, MD | Valley Health Systems/ The Valley Hospital |
More Information
No publications provided
| Responsible Party: | Valley Health System |
| ClinicalTrials.gov Identifier: | NCT00513331 History of Changes |
| Other Study ID Numbers: | VHS07.0017 |
| Study First Received: | August 6, 2007 |
| Last Updated: | April 11, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Valley Health System:
|
Barrett's Esophagus GERD Carcinoma |
Additional relevant MeSH terms:
|
Barrett Esophagus Gastroesophageal Reflux Digestive System Abnormalities Digestive System Diseases |
Esophageal Diseases Gastrointestinal Diseases Esophageal Motility Disorders Deglutition Disorders |
ClinicalTrials.gov processed this record on May 16, 2013