Biomarker holds promise for esophageal cancer

A new biomarker for esophageal cancer shows promise in improving screening for this deadly disease and its precursor, Barrett esophagus. These findings were presented at Digestive Disease Week, in Chicago, Illinois.

Amitabh Chak, MD, of University Hospitals Case Medical Center's Seidman Cancer Center and Case Western Reserve University School of Medicine in Cleveland, Ohio, and a research team found that a change in the DNA, methylation of the vimentin gene, can be an effective new less-invasive test for detecting Barrett esophagus. In 117 patients, they examined if a new, nonendoscopic brushing of the esophagus is as effective as the more invasive, traditional biopsy.

Affecting up to 6.8% of the population, Barrett esophagus is a leading predictor of esophageal cancer. Compared with the general population, patients with Barrett esophagus have an 11-fold higher risk of developing adenocarcinoma of the esophagus.

"Despite the fact that the rates of common cancers have declined in recent years, esophageal cancer has a poor 5-year survival rate of less than 15%," said Chak. "Early detection through screening can prevent the development of esophageal cancer. This promising new test has important clinical implications through its potential to improve screening and decrease mortality from this deadly disease."

The research builds upon previous work by the team that found aberrant methylation of vimentin is a highly common epigenetic alteration in neoplasia of the upper gastrointestinal tract. In this study, they analyzed esophageal specimens in patients with Barrett's esophagus, patients with esophageal cancer, and control subjects. The data determined that methylated vimentin is a highly sensitive biomarker for Barrett's esophagus and that the less invasive brushing technique can effectively detect these changes in the DNA.

"Our team's hope is that the use of molecular markers for nonendoscopic screening will drive down the cost and increase the ease of screening for these early esophageal lesions that can give rise to cancer," said Sanford Markowitz, MD, an oncologist at University Hospitals Case Medical Center Seidman Cancer Center and Ingalls Professor of Cancer Genetics at Case Western Reserve School of Medicine. "Longer term we hope to find additional markers that will allow the same approach to be used in the monitoring of Barrett patients to detect early progression to more advanced disease."

"This is true translational research, bringing a discovery from the laboratory to the patient care setting," said Chak. "This new technique to sensitively detect changes in the DNA may have significant implication for the clinical practice of screening and primary prevention of esophageal cancer."

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