ASGE Releases Update Guideline on Screening and Surveillance of Barrett’s Esophagus

September 6, 2019

The American Society for Gastrointestinal Endoscopy (ASGE) has released its updated “ASGE guideline on screening and surveillance of Barrett’s esophagus,” published in the September issue of GIE: Gastrointestinal Endoscopy.

The guideline aims to help clinicians understand the published literature and quality of available data on screening and surveillance in patients with Barrett’s esophagus; a precancerous condition for esophageal cancer (adenocarcinoma.)  This document addresses several key clinical issues in this field, including the role and impact of screening and surveillance of Barrett’s esophagus. As with other types of cancer, identifying this precancerous condition and early changes of cancer provides the best chance of successful treatment and, ultimately, improves patient outcomes.

Several endoscopic procedures and related technologies are used to screen and monitor patients with known or suspected Barrett’s esophagus. If changes are found in the cells lining the esophagus, various endoscopic treatment approaches are available.

This guideline addresses the utility of advanced imaging and sampling modalities used during screening and surveillance endoscopic procedures and includes chromoendoscopy, confocal laser endomicroscopy, endoscopic ultrasound, wide-area transepithelial sampling (WATS) and others. Table 4 contains a summary of the recommendations.

The document complies with the standards of guideline development set forth by the Institute of Medicine for the creation of trustworthy guidelines and provides recommendations based on the GRADE framework.

“We are hopeful that this current information will help guide clinicians in using the growing array of tools and technologies available to us to diagnose and manage Barrett’s esophagus, which, in turn, has the potential to significantly impact patient outcomes,” said Sachin Wani, MD, FASGE, Chair of the ASGE Standards of Practice Committee.

The full guideline is available here.

Barrett’s esophagus is one possible risk factor associated with esophageal cancer, which is one of the fastest growing and deadliest cancers in the United States.  There are no routine screenings to detect esophageal cancer in earlier stages and symptoms (such as difficulty swallowing, choking sensation, etc…) often occur once the cancer spreads and becomes more difficult (if not impossible) to treat.

Learn the facts about esophageal cancer

-Esophageal cancer has increased over 700% and is considered one of the fastest growing cancer in the US.*

-Risk factors include:

  • Gastroesophageal Reflux Disease (GERD, acid reflux, chronic heartburn),
  • obesity,
  • poor nutrition,
  • tobacco use,
  • excessive alcohol use,
  • Barrett’s esophagus.

-As one of the deadliest cancers, esophageal cancer has an overall 5 year survival rate of only 19.2%.

-There are no routine or standard screenings to improve early detection of esophageal cancer.

-Symptoms often arise late, once the cancer is considered advanced or “distant” (spread to lymph nodes and other organs.)

-Stage IV esophageal cancer has a survival rate of only 4.8%.

-Despite these facts, esophageal cancer research is extremely underfunded.

To make a tax-deductible donation to The Salgi Esophageal Cancer Research Foundation, please visit: salgi.org/donate

Materials Provided By:
Journal reference:

Qumseya, B. et al. (2019) ASGE guideline on screening and surveillance of Barrett’s esophagus. Gastrointestinal Endoscopydoi.org/10.1016/j.gie.2019.05.012.

Editor Note:

Content may be edited.

Disclaimer

This post contains information from an article regarding recently published research and reflects the content of that research.  It does not necessarily reflect the views or opinions of The Salgi Esophageal Cancer Research Foundation who cannot be held responsible for the accuracy of the data.

 

To read more esophageal cancer news, please visit: SALGI.org/news

Follow The Salgi Esophageal Cancer Research Foundation on Facebook: Facebook.com/SalgiFoundation

 

 

 

 

 

 


FDA Approves Keytruda to Treat Esophageal Cancer, Squamous Cell Carcinoma

July 31, 2019

The FDA approved pembrolizumab as monotherapy for certain patients with recurrent locally advanced or metastatic squamous cell carcinoma of the esophagus.

The approval applies to use of pembrolizumab (Keytruda, Merck) for patients whose tumors express PD-L1 — with a combined positive score of 10 or higher — as determined by an FDA-approved test, and who experienced disease progression after one or more previous lines of systemic therapy.

“Historically, patients with advanced esophageal cancer have had limited treatment options, particularly after their disease has progressed,” Jonathan Cheng, MD vice president for oncology clinical research at Merck Research Laboratories, said in a press release. “With this approval, Keytruda is now the first anti-PD-1 therapy approved for the treatment [for this patient population], providing an important new monotherapy option for physicians and patients in the United States.”

Squamous cell carcinoma is cancer that begins in squamous cells of the esophagus. Squamous cells are thin, flat cells that look like fish scales, and are found in the tissue that forms the surface of the skin, the lining of the hollow organs of the body, and the lining of the respiratory and digestive tracts.  Esophageal squamous cell carcinoma is most often found in the upper and middle part of the esophagus, but can occur anywhere along the esophagus.

Esophageal squamous cell carcinoma

The FDA based the approval on results from the randomized controlled KEYNOTE-181 trial, which included 628 patients with recurrent locally advanced or metastatic esophageal cancer who progressed on or after one prior line of systemic treatment for advanced disease.

Researchers randomly assigned patients 1:1 to pembrolizumab 200 mg every 3 weeks or investigator’s choice of IV chemotherapy with paclitaxel, docetaxel or irinotecan. Treatment continued for up to 24 months, or until disease progression or unacceptable toxicity.

OS among three groups — patients with esophageal squamous cell carcinoma, those whose tumors express PD-L1 with a combined positive score of 10 or higher, and all randomly assigned patients — served as the key efficacy outcome.

Secondary outcomes included PFS, objective response rate and duration of response.

Researchers reported HRs for OS of 0.77 (95% CI, 0.63-0.96) among patients with esophageal squamous cell carcinoma; 0.7 (95% CI, 0.52-0.94) among patients whose tumors met the defined PD-L1 expression threshold; and 0.89 (95% CI, 0.75-1.05) among all randomly assigned patients.

Among patients with esophageal squamous cell carcinoma who met the defined PD-L1 expression threshold, those assigned pembrolizumab achieved longer median OS (10.3 months vs. 6.7 months; HR = 0.64; 95% CI, 0.46-0.9) and median PFS (3.2 months vs. 2.3 months; HR = 0.66; 95% CI, 0.48-0.92).

A higher percentage of pembrolizumab-treated patients achieved response (22% vs. 7%), complete response (5% vs. 1%) and partial response (18% vs. 6%). Median duration of response was 9.3 months in the pembrolizumab group and 7.7 months in the chemotherapy group.

Adverse reactions that occurred among pembrolizumab-treated patients with esophageal cancer appeared similar to those that have been observed among patients with melanoma or non-small cell lung cancer who received pembrolizumab monotherapy.

The FDA also considered data from the KEYNOTE-180 trial, a nonrandomized, open-label study that included 121 patients with locally advanced or metastatic esophageal cancer who progressed on or after at least two prior systemic treatments for advanced disease.

Thirty-five patients with esophageal squamous cell carcinoma expressed PD-L1 with a combined positive score of 10 or higher. Seven patients achieved response, equating to an ORR of 20%. The duration of response ranged from 4.2 months to more than 25.1 months. Five patients achieved responses that lasted 6 months or longer, and three patients achieved responses that lasted 12 months or longer.

In patients with esophageal cancer, the recommended dose of KEYTRUDA is 200 mg administered as an intravenous infusion over 30 minutes every 3 weeks until disease progression, unacceptable toxicity, or up to 24 months in patients without disease progression.

Editor Note: Content may be edited.


Researchers identify cancer-killing capability of lesser known immune cells

July 11, 2019
This article was posted on  to view the original article, please click here.

Researchers at Trinity College Dublin have identified, for the first time in esophageal cancer, the cancer killing capability of a lesser-known type of immune cell, presenting a new potential therapeutic target. Their research has been published today in the international journal Frontiers in Immunology here.

Esophageal cancer is a very aggressive type of cancer with poor prognosis, and the 5-year survival rate is typically less than 15%. Linked with obesity, esophageal cancer is one of the fastest growing cancers in the Western world and incidence is due to double in Ireland within the next few decades. Current treatment strategies work well but only for a minority (approx. 25%) of patients so new treatment options are urgently needed.

New treatment strategies targeting the immune system have had revolutionary effects in other cancer types, but the latest clinical trials show that, disappointingly, immunotherapy offers no real benefit for the majority of patients with esophageal cancer.

To read the full article, please click here.

Esophageal cancer is one of the fastest growing and deadliest cancers in the United States.  There are no routine screenings to detect esophageal cancer in earlier stages and symptoms (such as difficulty swallowing, choking sensation, etc…) often occur once the cancer spreads and becomes more difficult (if not impossible) to treat.

Learn the facts about esophageal cancer

-Esophageal cancer has increased over 700% and is considered one of the fastest growing cancer in the US.*

-Risk factors include:

  • Gastroesophageal Reflux Disease (GERD, acid reflux, chronic heartburn),
  • obesity,
  • poor nutrition,
  • tobacco use,
  • excessive alcohol use,
  • Barrett’s esophagus.

-As one of the deadliest cancers, esophageal cancer has an overall 5 year survival rate of only 19.2%.

-There are no routine or standard screenings to improve early detection of esophageal cancer.

-Symptoms often arise late, once the cancer is considered advanced or “distant” (spread to lymph nodes and other organs.)

-Stage IV esophageal cancer has a survival rate of only 4.8%.

-Despite these facts, esophageal cancer research is extremely underfunded.

To make a tax-deductible donation to The Salgi Esophageal Cancer Research Foundation, please visit: salgi.org/donate


“Building a Cancer Breathalyzer” Esophageal Cancer Research Funded by The Salgi Esophageal Cancer Research Foundation

April 15, 2019

From Virginia Mason Foundation:

What if a “cancer breathalyzer” could detect esophageal cancer so early that many patients could be cured without surgery, chemotherapy or radiation? Virginia Mason surgeon Donald Low, MD, FACS, intends to find out, by developing a breath test that could transform diagnosis for the deadly disease. 

“Esophageal cancers don’t typically show symptoms until they’re very advanced, which is why only 20 to 30 percent of patients live for five years after diagnosis,” Dr. Low says. “If a breath test could detect esophageal cancer before it spreads, we could cure many patients with an endoscopic procedure.”

The Salgi Foundation

The research is fueled by the Salgi Esophageal Cancer Research Foundation, which pools donations from individuals to fight esophageal cancer.

To read more, click here or visit: http://www.virginiamasonfoundation.org

 

 

 

From our blog:

The Salgi Esophageal Cancer Research Foundation Issues Esophageal Cancer Research Funding For the Second Time: SALGI.org/blog

 

 

 

 

 

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The Salgi Foundation’s Letter to our Supporters During April, Esophageal Cancer Awareness Month:

March 28, 2019

As we near the end of April, recognized as Esophageal Cancer Awareness Month, I felt it important to reach out to all of our wonderful donors and supporters.  Our support has come from people who have been adversely affected by this horrific disease: the family members and friends of those diagnosed with esophageal cancer, the men and women who continue to battle this cancer day in and day out, our survivors and those who we will hold close in our memories and in our hearts forever.    We’ve shared our sorrows and joys with so many people throughout the years because we, too, have personal experience with esophageal cancer.

Since this charity was founded a mere nine years ago, we have already funded research twice!  This is an accomplishment that would not have been brought to fruition without our supporters.  We do not receive any corporate or government grants monies to fund the charity or the core mission; we simply rely on the generosity of our donors.

We, too, are people who have been directly affected by esophageal cancer and we have felt the pain, just as so many of our supporters have.  We recognize the extreme need for raising awareness of the risk factors and symptoms associated with this cancer, as so many people are still not aware of them or esophageal cancer at all.  We advocate for the early detection of this disease, due to the fact that by the time symptoms are noticed, the cancer has already progressed.  We actively pursue funding for research so that we can change esophageal cancer’s destructive course.  We do all this, always, in hopes of a cure™.

So, during April, the month dedicated to Esophageal Cancer Awareness, I wish to thank everyone who has supported and will continue to support The Salgi Esophageal Cancer Research Foundation’s efforts because it is together that we will make a difference.  Together, we will end esophageal cancer.

~The Salgi Esophageal Cancer Research Foundation

 

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Survivor Story: Borden “Yes, you can beat this!”

March 8, 2019

Below is a story from a wife of a man who was diagnosed with esophageal cancer.  We are very thankful to this couple for sharing their personal experiences with us in order to bring awareness to this devastating cancer.  As his wife said, “I want to bring hope to people facing this horrible disease. [My husband} is a testament to fighting and winning!”

Survivor Story: Borden. Story by wife, Mary A.

My husband was diagnosed on March 3, 2009 with stage 3 Esophageal cancer. He fought it with chemo and radiation first then after 2 months if intensive treatments had the 9.5 hr surgery to remove the cancer. He had to learn how to swallow again and ate through a feeding tube for 7 months. It was such a scary time for us.

Jump ahead to ten years later, he’s doing great!!! He survived with lots of care and prayer. My prayers were answered and I hope his story will help others know, yes you can beat this awful disease!

 

Awareness, Early Detection and Research

Too often, esophageal cancer is ignored and disregarded. There is a tremendous need to bring not only awareness but tools and resources to encourage early detection and advocacy and actual funding for esophageal cancer research.

The personal stories we share on our website do just that.  They are each equally important and deserve to be published.  Please do not reproduce any of these stories without our permission.  You may contact us with any questions or comments.

Do you have an experience with esophageal cancer that you would like to share either publicly or privately?  To learn more, please visit: Share Your Story.

 

For more ways to help, please visit:  SALGI.org/ways-to-give 

 

 

 

 

 

 

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The Salgi Esophageal Cancer Research Foundation Issues Esophageal Cancer Research Funding For the Second Time

December 14, 2018

The Salgi Esophageal Cancer Research Foundation has issued funding for esophageal cancer research in November, 2018; the second time in just seven years since the charity was founded.

The Foundation awarded principal investigator, Dr. Donald Low and Virginia Mason Medical Center, grant funding.  Dr. George Hanna of St Mary’s Hospital (Imperial College London) is co-investigator.  The research is currently underway.

In 2011, The Salgi Esophageal Cancer Research Foundation was established to raise awareness, encourage early detection and to fund research of esophageal cancer.  Since 2011, the foundation has both raised awareness and encouraged the importance of earliest possible detection throughout New England, across the United States and internationally.  The Salgi Esophageal Cancer Research Foundation first funded esophageal cancer research in July, 2015.

“The Salgi Esophageal Cancer Research Foundation is excited to be a part of Dr. Low’s, Professor Hanna’s and Virginia Mason’s research efforts in honor of all the brave men and women who have been affected by esophageal cancer and to hopefully reduce incidence and improve outcomes for individuals in the future,” President of the foundation, stated.

The research intends to establish a non-invasive test for the detection of esophageal cancer that is based upon the unique signature of volatile organic compounds (VOCs) within exhaled breath and to analyze exhaled VOCs in response to therapeutic intervention in patients.

Learn the Facts About Esophageal Cancer

One of the primary risk factors associated with esophageal cancer is Gastroesophageal Reflux Disease, also known as GERD or acid reflux disease, of which the most common symptom is chronic heartburn.  Other risk factors include obesity, heavy drinking, poor nutrition and smoking and/or use of tobacco products.

With over a 733% increase in the past four decades, esophageal cancer is among the fastest growing and deadliest cancers in the United States and the western world.1

There are no current standard or routine screenings to detect esophageal cancer in its earlier stages. Current guidelines recommend referral for endoscopy “only in the setting of ‘red flag’ symptoms that are frequently associated with inoperable disease,” Dr. Low stated.

These ‘red flag’ symptoms, such as difficulty swallowing, typically appear once the cancer has become advanced.  This, in addition with other factors mentioned, leads to the current overall five-year survival rate of only 19.2%.2  Despite its rapid increase and poor prognosis, esophageal cancer receives very little awareness and research funding.

The Salgi Esophageal Cancer Research Foundation

The Salgi Foundation: Past Esophageal Cancer Research Funding

In July, 2015, the Salgi Esophageal Cancer Research Foundation issued esophageal cancer research funding to Program Director Dr. Carlos Minacapelli and Rutgers Robert Wood Johnston Medical School.  That research was presented as a poster presentation during Digestive Disease Week in May, 2017.

Thank you!

The Salgi Esophageal Cancer Research Foundation would like to thank all our supporters and donors who believe in this mission and who make these accomplishments possible.  However, this is just the beginning.  The Salgi Esophageal Cancer Research Foundation continuously receives many requests for esophageal cancer research.  We need to continue our efforts to fundraise so that we may continue to fulfill this mission to raise awareness, encourage early detection and fund research.

To make a tax-deductible donation to The Salgi Esophageal Cancer Research Foundation, please visit: SALGI.org/donate.

 

 

 

 

Sources:

1 “Esophageal Cancer Sees Dramatic Spike.” Gastroenterology and Endoscopy News. 18 October 2018. https://www.gastroendonews.com/In-the-News/Article/10-18/Esophageal-Cancer-Sees-Dramatic-Spike-/53083

2 “Cancer Stat Facts: Esophageal Cancer.” National Cancer Institute, Surveillance, Epidemiology, and End Results Program.  11 December 2018. https://seer.cancer.gov/statfacts/html/esoph.html


Support Esophageal Cancer Awareness, Research This #GivingTuesday!

November 26, 2018

Giving Tuesday The Salgi Esophageal Cancer Research Foundation

Today is Giving Tuesday!

Make a charitable gift to The Salgi Esophageal Cancer Research Foundation to support esophageal cancer awareness, early detection and research.  Donate Now!  All donations are 100% tax deductible.

PLUS! 

On November, 27th, 2018, Facebook will match a total of up to $7 million in donations made on Facebook to eligible US-based 501(c)(3) nonprofits like The Salgi Esophageal Cancer Research Foundation!

Donate here!

Giving Tuesday opens the giving season and with your help, we will raise funds to raise awareness, encourage early detection and fund research of esophageal cancer…in hopes of a cure.™

Giving Tuesday helps to unite us in the spirit of giving and to bring a spotlight to esophageal cancer, a cause that needs desperate attention.  Let’s make this Giving Tuesday a great success!  Please donate today Thank you in advance for helping to make a difference today and every day.

The Salgi Esophageal Cancer Research Foundation @SalgiFoundation

The Salgi Esophageal Cancer Research Foundation is a registered nonprofit as recognized by the IRS. EIN: 453633809

DONATE TODAY! The Salgi Esophageal Cancer Research Foundation. Thank you!


Fundraising Spotlight: 3rd Annual Brian Blood Memorial Golf Tournament

October 22, 2018
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Brian Blood The Salgi Esophageal Cancer Research Foundation The 3rd Annual Brian Blood Memorial Golf Tournament was held on Monday, September 24th at Butter Brook Golf Club in Westford, MA.  The annual event is in honor of Brian Blood, who passed away after a short but courageous battle with esophageal cancer.
Prior to his passing, his family promised him they would hold an annual golf tournament in his honor, with the goal of raising money for esophageal cancer awareness and research.  This year, the tournament raised $12,500!  We are pleased to share that in three years, they have raised a total of $37,500 for esophageal research!
A special thank you to Gold Sponsors: Neuro Corporation, Devereaux LLC and Hillside Constructions and Silver Sponsors: University Orthopedics and Feeney Brother, Inc.
Thank you to the many other families and organizations who donated to the event and helped to make the day a success.
The Salgi Esophageal Cancer Research Foundation is honored to fulfill this mission in honor of Mr. Brian Blood and we are so thankful to his family and friends for their hard work, dedication, generosity and support!
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Esophageal Cancer Sees Dramatic Spike- Gastroenterology & Endoscopy News

October 18, 2018

October 18, 2018 | Gastroenterology & Endoscopy News

This article was posted on gastroendonews.com to view the original article, please click here.

“The incidence of esophageal adenocarcinoma (EAC) has spiked more than sevenfold over the past four decades, far outpacing other tumor types. But the disease is detected early enough to be resected in at least 20% of patients with minimally invasive procedures.

Those findings come from a new epidemiological study of esophageal cancer in the United States. Researchers found that the incidence of EAC rose 733% between 1973 and 2014, according to government data, climbing an average of 5.4% per year during the 41-year period (Figure). The next-fastest form of cancer—breast cancer—rose by 0.9% per year, on average, during that time.”

To read the full article, please visit: gastroendonews.com

Esophageal cancer is one of the fastest growing and deadliest cancers in the United States.  There are no routine screenings to detect esophageal cancer in earlier stages and symptoms (such as difficulty swallowing, choking sensation, etc…) often occur once the cancer spreads and becomes more difficult (if not impossible) to treat.

Learn the facts about esophageal cancer

-Esophageal cancer has increased over 700% and is considered one of the fastest growing cancer in the US.

-Risk factors include:

  • Gastroesophageal Reflux Disease (GERD, acid reflux, chronic heartburn),
  • obesity,
  • poor nutrition,
  • tobacco use,
  • excessive alcohol use,
  • Barrett’s esophagus.

-As one of the deadliest cancers, esophageal cancer has an overall 5 year survival rate of only 18.8%.

-There are no routine or standard screenings to improve early detection of esophageal cancer.

-Symptoms often arise late, once the cancer is considered advanced or “distant” (spread to lymph nodes and other organs.)

-Stage IV esophageal cancer has a survival rate of only 4.6%.

-Despite these facts, esophageal cancer research is extremely underfunded.

To make a tax-deductible donation to our charity, please visit: salgi.org/donate