Heartburn sufferer is first to take part in trial of new cancer test on a string in Cambridge

A trial for a new test for Barrett’s oesophagus began at the Cambridge Cancer Research Centre site in Cambridge this week, with the first of 120,000 assessments being carried out on Milton Brewery director Tim Cowper.

Tim, 49, has suffered from acid reflux, or heartburn, every night since he was 16.

Heartburn is a common symptom of Barrett’s oesophagus, a changing of cells in the food pipe. Until now, the test has involved an endoscopy, which involves a long, thin tube with a small camera inside, called an endoscope, being passed into your body, usually through your mouth. But the new test used in the BEST4 surveillance trial is far gentler, says Tim.

“Since my diagnosis, I’ve been going for an endoscopy at least once every three years to monitor my oesophagus,” says Tim. “It is not pleasant at all. Each time I have a thick tube pushed down through my mouth and I can feel every single one of the biopsies taken by the camera.”

The new test is far better, he said, following the procedure on Tuesday (January 9).

“You just swallow a capsule on a string and there’s a sponge compressed inside it. You sit there for seven minutes and then it’s taken out and sent off to the labs. They ask how you feel – whether you experience any discomfort – and assess the relative ease compared to the endoscopy.

“The new test is immeasurably more pleasant and so much easier.”

The test takes just 10 minutes and can be done in a GP surgery.

The BEST4 trial launched at the Cambridge Clinical Research Centre on the Addenbrooke’s site this week (January 8) is the final step to see if the capsule sponge can prevent oesophageal cancer when used to screen or monitor those most at risk of the disease. If so, it could become a national screening programme across the NHS, in the same way mammograms are used to screen for breast cancer.

The first stage of the trial is for people already diagnosed with Barrett’s oesophagus. It will look at whether the capsule sponge test could replace endoscopies to monitor their condition. Participants will receive both treatments during the trial, with results used to assess their risk of developing oesophageal cancer.

The trial builds on decades of research led by Professor Rebecca Fitzgerald, a doctor and researcher at Addenbrooke’s and the University of Cambridge, working with a team of scientists, clinicians and nurses at the Early Cancer Institute, University of Cambridge and Cancer Research UK Cambridge Centre.

Prof Fitzgerald said: “The capsule sponge, a quick and simple test for Barrett’s oesophagus, could halve the number of deaths from oesophageal cancer every year. Cases of oesophageal cancer have increased six-fold since the 1990s.

“On average only 12 per cent of patients live more than five years after diagnosis. Most don’t realise there’s a problem until they have trouble swallowing. By then it is too late.

“The first phase of the trial looks at whether the capsule sponge can be used as a cancer early warning system for patients diagnosed with Barrett’s. Using the capsule sponge and a new set of lab tests, we will be monitoring patients to see if we can prevent more cases of cancer.”

The capsule sponge for the BEST4 surveillance trial is manufactured by Cambridge-based Cyted, though similar technology has been manufactured under different brand names.

Marcel Gehrung, CEO and co-founder of Cyted – which had assistance from Prof Fitzgerald at formation in 2018 - said: “This is another major step forward for our technology. The trial will evaluate the potential for a national screening programme and explore if our Heartburn Health Check using the minimally invasive test, EndoSign, can be used to prevent oesophageal cancer when offered as a screening test to people on long-term medication for heartburn.

“Our test is already deployed in over 70 hospitals and GP surgeries all across the UK and demonstrates how innovation can have a real and lasting impact on our health system, reducing waiting lists and ultimately saving lives.”

The second stage of the trial, BEST4 Screening, opens in the summer and will recruit 120,000 people aged over 55 on long-term treatment for heartburn. Cyted will also be responsible for analysing both the samples from the BEST4 surveillance trial and samples from the second stage of the programme.

The £6.4million trial is jointly funded by Cancer Research UK and the National Institute for Health and Care Research.