Professor Rebecca Fitzgerald’s ‘Pill on a thread’ trial in final stage

Clinical trials of the capsule sponge – the ‘pill on a thread’- to detect oesophageal cancer are in the final phase.

The capsule sponge is a small, easy to swallow capsule on a thread, which contains a sponge. The patient swallows the capsule which dissolves in the stomach and the sponge expands to the size of a 50p coin.

This is a quick and simple test for Barrett’s Oesophagus, a condition that can be a precursor to cancer.

Early detection using the capsule sponge could halve the number of deaths from oesophageal cancer every year.

The first stage of the trial, BEST4 Surveillance, 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.

Heartburn is a common symptom of Barrett’s Oesophagus, a changing of cells in the food pipe.

Tim Cowper, a brewer from Cambridge, is the first to join BEST4 which began at Addenbrooke’s Hospital this week.

Mr Cowper has suffered from heartburn for over 30 years and is monitored following a diagnosis of Barrett’s Oesophagus.

The current monitoring procedure – an endoscopy and biopsy – is a sometimes uncomfortable and invasive hospital procedure.

Mr Cowper said:

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. Swallowing a capsule sponge is a much better experience and I now get the test before my regular endoscopy appointment.

The capsule sponge test takes around 10 minutes and can be conducted at a GP surgery.

The second stage of BEST4 opens in the summer and will recruit 120,000 people aged over 55 on long-term treatment for heartburn.

Professor 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% 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 BEST4 Surveillance Trial is led from Cambridge University Hospitals NHS Foundation Trust and the University of Cambridge, with trial design, coordination and analysis of results by the Cancer Research UK Cancer Prevention Trials Unit at Queen Mary University of London.

Read about earlier stages of the trial.

More on the BEST trial.