Upper gastrointestinal cancers 

Around 20,000 people are diagnosed with upper gastrointestinal cancers each year in the UK, but survival rates are poor. The main reason that these cancers have such a high death rate is that they tend to advance to a very late, or incurable, stage before causing any obvious symptoms. Early stage diagnosis is associated with a far higher survival rate. 

In people with cancer, biomarker tests can detect and quantify cells and proteins which have been shed from their tumour into the bloodstream, saliva or urine. Analysis of biomarkers gives scientists the ability to see beyond the tumour itself, to the individual traits of the particular cancer. It is hoped that the development of biomarker tests will revolutionise our ability to diagnose and treat cancers much earlier.

If you would like further information on our upper gastrointestinal work please contact Jennifer McGivney on jennifer.mcgivney@nhs.net

  • SPIT - biomarker study for oesophageal cancer

    Just 12 per cent of patients with oesophageal cancer live more than 10 years following diagnosis. Currently, there is no effective screening test for oesophageal cancer and most patients with suspicious symptoms undergo an endoscopy where a thin flexible lighted instrument with a camera at the end is passed through the mouth into the oesophagus. This test is a costly procedure as well as being uncomfortable and invasive for patients.

    The SPIT study (saliva to predict risk of disease using transcriptomics and epigenetics) is led by Prof Laurence Lovat, professor of gastroenterology and biophotonics and consultant gastroenterologist, at UCL/UCLH. The study aims to develop a cost effective saliva test for oesophageal cancer. It is hoped this test can be used to predict a patient’s risks of developing oesophageal cancer, so that only high-risk patients will need to undergo invasive investigations in future. A simple way to assess patients would be particularly beneficial for those who have Barrett’s oesophagus – a pre-cancerous condition. These patients currently undergo repeated endoscopies to check for cancerous changes.

    The trial involves 240 patients who are being investigated for oesophageal cancer at UCLH and will aim to evaluate whether the characteristics of patients’ saliva, in combination with symptoms and other risk factors, can accurately predict the presence of the disease.­­

  • TRANSBIL - biomarker study for pancreatic cancer

    Pancreatic cancer is difficult to diagnose as many people have vague symptoms or no symptoms at all. It is mostly diagnosed at a late stage when it has already spread and can therefore lead to poor outcomes for patients. Just one per cent of those diagnosed will live for ten years or more after diagnosis.

    Currently the best non-invasive tests for pancreatic cancer are MRI and CT scans, but they cannot accurately detect early cancer or reliably tell the difference between cancer and pre-cancerous growths. By developing a urine and blood test, it is hoped that pancreatic cancer can be detected at an earlier stage to allow successful treatment.

    The Transbil study (TRANSlational research in BILiary tract and pancreatic diseases), led by Prof Steve Pereira, professor of hepatology & gastroenterology and consultant gastroenterologist at UCL/UCLH (supported by the University College Hospitals NIHR Biomedical Research Centre) is an early biomarker study which aims to detect pancreatic cancer in patients at a much earlier stage.

    Previous studies have identified biomarker molecules in blood and urine that could be used as a new diagnostic test to detect pancreatic cancer earlier or at a pre-cancerous stage. The Transbil study aims to validate these biomarkers through blood and urine tests with 600 pancreatic cancer patients at UCLH, the Royal Free and other hospitals. In addition, the study aims to assess whether combining this diagnostic tool with a symptom-based risk assessment questionnaire will help to detect pancreatic cancer earlier in high risk patients.