Volatile Organic Compounds as Breath Biomarkers in Squamous Oesophageal Neoplasms

Last updated: April 29, 2025
Sponsor: Imperial College London
Overall Status: Active - Recruiting

Phase

N/A

Condition

Squamous Cell Carcinoma

Neoplasms

Digestive System Neoplasms

Treatment

Exhaled breath sampling

Clinical Study ID

NCT06169163
23SM8534
  • Ages 18-90
  • All Genders

Study Summary

Oesophageal Squamous Cell Carcinoma (OSCC) is a cancer of the food pipe that affects around 2000 patients in the UK every year. It is often detected at an advanced stage, resulting in poor survival (5-year survival less than 20%). Early detection can improve survival (5-year survival >70%). Therefore, early detection is vital to improving survival.

There are no national screening guidelines, and an endoscopy (A camera test to look at the food pipe) is the only available test to detect OSCC.

Early detection of OSCC is challenging for many reasons. Firstly, early disease symptoms are non-specific, which patients often overlook. Secondly, 'Alarm' symptoms such as weight loss, difficulty swallowing or vomiting blood are signs of advanced stage. Lastly, endoscopy is an invasive test with associated risks and significant discomfort.

The investigators propose to develop a breath test for patients with non-specific symptoms. Breath testing has the ideal characteristics for a triage test because it is non-invasive, simple to perform, cost-effective and highly acceptable to patients. The test is based on identifying volatile organic compounds (VOCs, small molecules) that are produced by the cancer and released in breath.

The breath test will be offered by General Practitioners (GPs) to patients with non-specific symptoms. Those who test positive will be referred for an urgent camera test, and those who test negative can be reassured.

Eligibility Criteria

Inclusion

Inclusion Criteria: Participants with all the following characteristics will be eligible for inclusion in the study:

  1. Cancer cohort (n=259): Patients with treatment naïve, histopathology confirmed OSCC.

  2. Control cohort (n=259): Patients who have undergone or are undergoing an endoscopy (OGD) as part of their investigation for upper GI symptoms and are found to haveeither:

  • A normal upper gastrointestinal tract

  • Benign upper gastrointestinal disease

Exclusion

Exclusion Criteria: Participants with the following characteristics will not be eligible for inclusion in the study:

  1. Received some form of treatment (chemotherapy, radiotherapy, immunotherapy,endoscopic resection, or surgery) for OSCC

  2. History of another cancer in the last five years

  3. Non-squamous cell oesophageal cancer

  4. Barrett's oesophagus (with or without dysplasia)

  5. Previous oesophageal or gastric resection

  6. Unable to provide written consent or lack capacity.

  7. Pregnant women

Study Design

Total Participants: 518
Treatment Group(s): 1
Primary Treatment: Exhaled breath sampling
Phase:
Study Start date:
December 01, 2023
Estimated Completion Date:
December 31, 2026

Study Description

In this prospective multicentre case-control study, the investigators will recruit a total of 518 patients. These will be divided into the following groups:

  1. Cancer group (n=259): Patients with treatment naive, histopathology confirmed OSCC.

  2. Control group (n=259): Patients who have undergone or are undergoing an upper gastrointestinal (GI) endoscopy as part of their investigation for upper GI symptoms and are found to have either - (i) A normal upper GI tract or (ii) Benign upper GI disease.

Eligible and willing participants will be asked to provide two breath samples by exhaling into single-use breath collection bags. Using a custom designed gas sampling pump, the breath VOCs will be transferred onto thermal desorption (TD) tubes at a controlled flow rate. When the participants' breath sampling is complete, room air (Blank) samples will be taken onto additional TD tubes using the same process.

Once collected, the TD tubes will be transported to Imperial College London (The Hanna lab), where they will be analysed.

Connect with a study center

  • Imperial College Healthcare NHS Trust

    London, Greater London W12 0NN
    United Kingdom

    Active - Recruiting

  • Hull University Teaching Hospitals NHS Trust

    Cottingham, Hull
    United Kingdom

    Active - Recruiting

  • Cardiff and Vale University Health Board

    Cardiff,
    United Kingdom

    Site Not Available

  • Velindre NHS Trust

    Cardiff,
    United Kingdom

    Site Not Available

  • University Hospitals Coventry and Warwickshire NHS Trust

    Coventry,
    United Kingdom

    Active - Recruiting

  • University Hospitals of Leicester NHS Foundation Trust

    Leicester,
    United Kingdom

    Active - Recruiting

  • Liverpool University Hospitals NHS Foundation Trust

    Liverpool,
    United Kingdom

    Site Not Available

  • The Clatterbridge Cancer Centre NHS Foundation Trust

    Liverpool,
    United Kingdom

    Active - Recruiting

  • Bedfordshire Hospitals NHS Foundation Trust

    Luton,
    United Kingdom

    Site Not Available

  • Newcastle Upon Tyne Hospitals NHS Trust

    Newcastle,
    United Kingdom

    Active - Recruiting

  • Norfolk and Norwich University Hospitals NHS Foundation Trust

    Norwich,
    United Kingdom

    Active - Recruiting

  • Oxford University Hospitals NHS Trust

    Oxford,
    United Kingdom

    Active - Recruiting

  • Portsmouth Hospitals University NHS Trust

    Portsmouth,
    United Kingdom

    Site Not Available

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