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Procedure

Endoscopic Methods for Detecting Early Stomach Cancer

Phase 2
Waitlist Available
Led By Jeremy L Davis, M.D.
Research Sponsored by National Cancer Institute (NCI)
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Age greater than or equal to 18 years.
An individual who harbors a pathogenic, or likely pathogenic, CDH1 germline variant.
Must not have
Any clinical contraindication (e.g., known bleeding disorder, thrombocytopenia) to endoscopic biopsy.
Any clinical contraindication to general anesthesia.
Timeline
Screening 3 weeks
Treatment Varies
Follow Up 14 days
Awards & highlights
No Placebo-Only Group

Summary

This trial is comparing the Cambridge Method of endoscopy (where 30 pieces of tissue are taken from 6 areas of the stomach) to the Bethesda Protocol (where 88 pieces of tissue are taken from 22 areas of the stomach) to see which is more efficient in catching early signs of cancer.

Who is the study for?
This trial is for adults over 18 with a CDH1 gene mutation, which increases stomach cancer risk. They must be physically able to undergo an endoscopy and have had one previously through this study. People can't join if they have conditions that make anesthesia or biopsy risky, like bleeding disorders or recent heart problems.
What is being tested?
The trial compares two methods of detecting early-stage gastric cancer in those at high risk due to the CDH1 mutation. The 'Bethesda Protocol' involves taking more tissue samples than the current 'Cambridge Method', which also uses a contrast dye and confocal microscopy for cell imaging.
What are the potential side effects?
Potential side effects include risks associated with general anesthesia, discomfort from the endoscopic procedure, possible bleeding or infection from biopsies taken during the endoscopy, and reactions to any contrast dye used.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I am 18 years old or older.
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I have a genetic mutation in the CDH1 gene.
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I am physically fit for an upper endoscopy procedure.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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I do not have conditions like bleeding disorders that make biopsy unsafe for me.
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I cannot have general anesthesia due to health reasons.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~14 days
This trial's timeline: 3 weeks for screening, Varies for treatment, and 14 days for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
Determine if Bethesda protocol provides improved sensitivity for detection of early stage gastric cancer in CDH1 germline mutation carriers compared to the Cambridge method
Secondary study objectives
Define the false negative rate of SRCC detection using Bethesda protocol and Cambridge methods in patients who proceed to risk-reducing total gastrectomy
To estimate and compare the difference in crude cancer detection rates between endoscopy using the Bethesda protocol and the Cambridge method

Awards & Highlights

No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups
Experimental Treatment
Active Control
Group I: 1/ Arm 1Experimental Treatment2 Interventions
Bethesda protocol (investigational)with confocal endomicroscopy in assigned participants
Group II: 2/ Arm 2Active Control2 Interventions
Cambridge method (control) with confocal endomicroscopy in assigned participants

Find a Location

Who is running the clinical trial?

National Cancer Institute (NCI)Lead Sponsor
13,907 Previous Clinical Trials
41,012,105 Total Patients Enrolled
Jeremy L Davis, M.D.Principal InvestigatorNational Cancer Institute (NCI)
8 Previous Clinical Trials
2,747 Total Patients Enrolled

Media Library

Bethesda Protocol (Procedure) Clinical Trial Eligibility Overview. Trial Name: NCT04535414 — Phase 2
Stomach Cancer Research Study Groups: 2/ Arm 2, 1/ Arm 1
Stomach Cancer Clinical Trial 2023: Bethesda Protocol Highlights & Side Effects. Trial Name: NCT04535414 — Phase 2
Bethesda Protocol (Procedure) 2023 Treatment Timeline for Medical Study. Trial Name: NCT04535414 — Phase 2
~17 spots leftby Nov 2025