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EMERALD in the making? A promising blood-based microRNA panel to detect oesophageal adenocarcinoma and Barrett’s oesophagus
  1. Prasad G Iyer
  1. Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA
  1. Correspondence to Dr Prasad G Iyer, Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA; iyer.prasad{at}mayo.edu

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Screening for oesophageal adenocarcinoma (OAC), a lethal cancer, when diagnosed after the onset of symptoms, and its sole known precursor, Barrett’s oesophagus (BO), though suggested by guidelines, remains underused.1 Support for screening is underpinned by level 1 evidence demonstrating the ability of endoscopic therapy of BO dysplasia to prevent progression to OAC and the excellent survival of patients with T1 OAC treated with endoscopic therapy.2

While multifactorial, a major obstacle to screening is thought to be the need for endoscopy (which is invasive and expensive with limited access) for BO detection. This has prompted efforts to develop non-endoscopic and non-physician-administered screening tools, which could lead to greater utilisation in practice. To this end, excellent performance characteristics and safety of swallowable cell collection devices+biomarkers in detecting BO (with and without OAC/dysplasia)3 have been reported, leading to the inclusion of this technology as an alternative to endoscopy, in guidelines. In a pragmatic clinical trial, 39% of approached patients expressed interest in this strategy.4 Another study reported that up to 60% of surveyed patients expressed interest in a capsule sponge+biomarker-based test, suggesting additional advantage with minimally invasive technologies.5

To this end, Miyoshi et al report promising results of a six-microRNA (miRNA) panel assayed in peripheral blood samples in detecting the presence …

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Footnotes

  • Contributors PGI is the sole author and guarantor.

  • Funding NCI R01 grant CA 241164 (to PGI).

  • Competing interests Research funding: Exact Sciences, Pentax Medical, CDx Medical. Consulting: Exact Sciences, Pentax Medical, CDx Medical, Castle Biosciences.

  • Provenance and peer review Not commissioned; internally peer reviewed.