Genetic Predictors for Oesophageal Cancer Identified in High-Risk Patients

OESOPHAGEAL cancer could be diagnosed up to 8 years before the first symptoms appear, enabling earlier treatment of the condition, according to research presented during the National Cancer Research Institute’s (NCRI) Cancer Conference, Liverpool, UK, on 5th–8th November 2017. This follows the identification of predictive markers in some individuals with Barrett’s oesophagus, a common precursor to oesophageal cancer, by Dr Sarah Killcoyne and Dr Eleanor Gregson, University of Cambridge, Cambridge, UK.

Barrett’s oesophagus progresses to oesophageal cancer in around 5% of cases; however, until now, it has proved difficult to identify biomarkers to predict those patients who will go on to develop the malignancy. Currently, nearly all patients with Barrett’s oesophagus are given endoscopies every few years to detect the presence of cancerous lesions as early as possible.

To identify cancer determinants, the researchers analysed samples taken from routine endoscopies of patients with the pre-cancerous condition over a 15-year period, comparing genetic markers between 45 patients who developed early symptoms of oesophageal cancer and 45 individuals who did not. By pinpointing predictive markers in 94% of the patients who were diagnosed with oesophageal cancer, which could be detected many years before the first signs appeared, the researchers created a diagnostic test to identify the presence of the high-risk genetic patterns.

Using this test, not only could such high-risk patients be closely monitored for early symptoms of oesophageal cancer, but those deemed at a low risk, without the presence of the genetic markers, would require far fewer endoscopies. Early detection and treatment of cancer are strongly associated with successful outcomes for patients, meaning such a test could be hugely significant to the oncology field.

Commenting on the findings, Prof Matt Seymour, National Cancer Research Institute, London, UK, stated: “Survival for cancer of the gullet remains stubbornly low, and we face big challenges in diagnosing the disease earlier when it is more likely to be treated successfully. Studies like this not only mean we may be able to identify the disease earlier, but may also reveal more about the disease itself. It could be that, as well as helping predict who will develop the disease, these genetic markers could point the way to new treatments.” To prove that the test can help diagnose oesophageal cancer at an earlier stage when treatment is likely to be more successful, the researchers suggested that the next step is for the method to be utilised in clinical trials.

James Coker, Senior Editorial Assistant

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