A In-Vivo Esophageal Protocol for Detection of Neoplasia in the Digestive Tract
Condition: Barrett's Esophagus
MeSH terms: Barrett Esophagus
Study type: Interventional
Phase: Phase 1

Summary: 
      You are invited to participate in a research study to develop new ways to look for abnormal
      areas/tissues of the esophagus. The current endoscopes used to look at the esophagus are very
      good, but if the area doesn't look different to the naked eye, then the endoscope can't
      improve on that. The investigators are looking at using special fluorescent stains in
      addition to special endoscopes designed to see abnormal areas that are not obvious to the
      naked eye. Currently specialized microscopes and fluorescent stains are used in clinical
      laboratories but it takes several days of processing to get results. It may be very helpful
      to look for areas to sample for abnormal tissue during the endoscopy procedure.

      You are being asked to let us use "fluorescent peptides" with a special endoscope that allow
      us to "see" your esophagus with both fluorescent and white light during your upper GI
      endoscopy procedure to help target your biopsies. Peptides are small chains of amino acids
      (the building blocks that make up proteins) linked together. Our peptide is a chain of 7
      amino acids attached to a fluorescent dye called FITC (like the one used by your eye doctor).

      The investigators have prepared special "fluorescent peptides", that will "glow" when a
      special light is used that should help us separate normal tissue from abnormal tissue. In
      this study, the investigators will apply the special fluorescent peptides by a spray catheter
      to your esophagus to help us target you biopsies. Both routine and targeted biopsies will be
      taken as your endoscopist feels is indicated.

      This is a phase 1b study. This means that although the investigators have applied the peptide
      to 25 people in our first research study, the investigators still need to learn more about
      "fluorescent peptide" in people. The Food and Drug Administration (FDA) has not approved this
      agent, but is allowing us to test it in this study. The main goal of this study is to see if
      the peptide "glows" well and if the investigators can take pictures of the areas that do
      glow.

      This is a research study of the peptide and our ability to see it "light up or fluoresce".
      Being in this study and applying this peptide won't change how your biopsies are taken nor
      how your endoscopy is done.
    


Intervention name(s): GI heptapeptide
Intervention type(s): Drug
Intervention description(s): Investigational Agent Name: GI heptapeptide, Linear, 7 amino acid peptide sequence ASYNYDA with a 5-FITC tag and NH2 terminus. Investigational Agent Administration (see SOP in Appendix C) ASYNYDA-GGGSK-(5-FITC)-NH2 0.8 mg lyophilized powder per single-use amber vial Lyophilized powder reconstituted with 5 ml of 0.9% NaCl Final 100 µM concentration for single, one-time topical application Entire 5 ml volume (100 uM concentration) will be sprayed topically onto esophagus by the nurse/physician during the procedure through a standard endoscopy spray catheter (Olympus Medical, Tokyo Japan, PW-5V-1)
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Diagnostic
Keywords: barrett's esophgus; High grade dysplasia; Esophageal adenocarcinoma