Contact information
Type
Public
Contact name
Ms Aisling Redmond
ORCID ID
Contact details
Cancer Research UK & King's College London Cancer Prevention Trials Unit
Cancer Prevention Trials Unit (CPTU)
Cancer Prevention Group
School of Cancer & Pharmaceutical Sciences
King’s College London
GH0603004 Research Oncology Seminar Room
Floor 3
Bermondsey Wing
Guy’s Hospital
Great Maze Pond
London
SE1 9RT
United Kingdom
+44 (0)207 882 2932
amr75@MRC-CU.cam.ac.uk
Additional identifiers
EudraCT/CTIS number
IRAS number
ClinicalTrials.gov number
Secondary identifying numbers
CPMS 32540
Study information
Scientific title
Barrett’s oESophagus Trial 3 (BEST3): randomised controlled trial comparing the Cytosponge™-TFF3 test with usual care to facilitate the diagnosis of oesophageal pre-cancer in primary care.
Acronym
BEST3
Study hypothesis
The aim of this study is to:
1. Demonstrate that the invitation to the Cytosponge-TFF3 test leads to an increase in the number of patients diagnosed with Barrett’s oesophagus (BE) compared to the usual clinical care pathway in primary care
2. Gain an in-depth understanding of the health economics of the Cytosponge -TFF3 test in patients on long-term treatment with acid suppressants as well as the economics for the projected reduction of cancer-related deaths
Ethics approval(s)
East of England – Cambridge East REC, 21/12/2016, ref: 16/EE/0546
Study design
Randomized; Interventional; Design type: Diagnosis, Device, Management of Care
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Study setting(s)
GP practice
Study type
Diagnostic
Patient information sheet
No participant information sheet available
Condition
Specialty: Primary Care, Primary sub-specialty: Cancer; UKCRC code/ Disease: Oral and Gastrointestinal/ Diseases of oesophagus, stomach and duodenum, Cancer/ Malignant neoplasms of lip, oral cavity and pharynx
Intervention
120 practices will be randomised on a 1:1 basis to either the intervention or control arm. Practices will be randomised via block randomisation and be stratified by number of eligible patients. A cluster randomisation will be used to simplify research procedures and minimise impact of differing clinical practice within the same practice.
Intervention arm: Participants on long-term acid suppressant medication will receive the Cytosponge™ -TFF3 test and a clinically-indicated endoscopy where required and followed up at 12 months.
Control arm: Participants will receive usual care and followed up at 12 months.
Intervention type
Other
Primary outcome measure
Effectiveness is assessed using GP and hospital records of histologically-confirmed Barrett’s oesophagus at 12 months post GP recruitment.
Secondary outcome measures
1. Cost-effectiveness is assessed using GP and hospital records to determine mean cost per patient receiving the Cytosponge™ -TFF3 test versus usual care and incremental cost per QALY gained of the Cytosponge™ TFF3 test versus usual care at 12 months post GP recruitment
2. Patient acceptability is measured using a bespoke questionnaire at 7-14 days post procedure
3. Accuracy is measured using Positive Predictive Value (PPV) and Negative Predictive Value (NPV) in relation to the length of BE at 12 months post GP recruitment
4. Safety is measured using number of adverse events reported by patients up to 7 days post procedure
Overall study start date
01/05/2016
Overall study end date
01/09/2019
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. Aged 50 years and over
2. Records of at least 6 months of prescription for acid-suppressant medication in the last year
Participant type(s)
Patient
Age group
Adult
Lower age limit
50 Years
Sex
Both
Target number of participants
Planned Sample Size: 9000; UK Sample Size: 9000
Total final enrolment
13514
Participant exclusion criteria
Current exclusion criteria as of 15/08/2017:
1. Recorded regular prescriptions of NSAIDs
2. Recorded upper GI endoscopy in the previous 5 years as identified from the practice database
3. Recorded diagnosis of a current or previous oro-pharynx, oesophageal or gastro-oesophageal tumour
4. Recorded diagnosis of Barrett’s oEsophagus (BE)
5. Unable to attend the GP surgery
6. Deemed not fit enough by their GP
Previous exclusion criteria:
1. Recorded regular prescriptions of NSAIDs
2. Recorded regular prescription of Clopidogrel
3. Recorded upper GI endoscopy in the previous 5 years as identified from the practice database
4. Recorded diagnosis of a current or previous oro-pharynx, oesophageal or gastro-oesophageal tumour
5. Recorded diagnosis of Barrett’s oEsophagus (BE)
6. Unable to attend the GP surgery
7. Deemed not fit enough by their GP
Recruitment start date
15/03/2017
Recruitment end date
01/05/2018
Locations
Countries of recruitment
England, United Kingdom
Study participating centre
Cancer Research UK & King's College London Cancer Prevention Trials Unit
Cancer Prevention Trials Unit (CPTU), Cancer Prevention Group
School of Cancer & Pharmaceutical Sciences
King’s College London
GH0603004 Research Oncology Seminar Room
Floor 3, Bermondsey Wing
Guy’s Hospital
Great Maze Pond
London
SE1 9RT
United Kingdom
Study participating centre
MRC Cancer Unit
University of Cambridge
Box 197
Addenbrookes Hospital
Cambridge Biomedical Campus
Cambridge
CB2 0XZ
United Kingdom
Sponsor information
Organisation
Cambridge University Hospitals NHS Foundation Trust and University of Cambridge
Sponsor details
Addenbrookes Hospital
Hills Road
Cambridge
CB2 0QQ
England
United Kingdom
+44 (0)1223 348490
Research@addenbrookes.nhs.uk
Sponsor type
Hospital/treatment centre
Website
ROR
Funders
Funder type
Charity
Funder name
Cancer Research UK
Alternative name(s)
CRUK
Funding Body Type
private sector organisation
Funding Body Subtype
Other non-profit organizations
Location
United Kingdom
Results and Publications
Publication and dissemination plan
Planned publication in a high-impact peer-reviewed journal.
Intention to publish date
31/03/2020
Individual participant data (IPD) Intention to share
Yes
IPD sharing plan
Detailed datasets generated during the study for publication purposes will be available in the form of data supplements to the main journal publication and will be accessible as summary tables and analyses immediately upon publication. This may also include de-identified line-level participant data of a limited number of data fields to protect privacy. The full trial dataset is not expected to be made available due to data protection responsibilities and proprietorial issues around data use.
IPD sharing plan summary
Published as a supplement to the results publication
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Protocol article | protocol | 03/08/2018 | Yes | No | |
| Results article | results | 01/08/2020 | 04/08/2020 | Yes | No |
| Results article | secondary results: patient experience | 10/01/2023 | 11/01/2023 | Yes | No |
| HRA research summary | 26/07/2023 | No | No | ||
| Other publications | Patient-reported experiences and views | 07/04/2022 | 14/02/2024 | Yes | No |
| Participant information sheet | 03/08/2018 | 14/02/2024 | No | Yes |