Prognostic Assay Can Stratify Risk for Progression in Barrett Esophagus

THURSDAY, Aug. 22, 2024 (HealthDay News) -- Esoproedict can stratify Barrett esophagus (BE) patients as having a low or high risk for progression, according to a study published online Aug. 14 in the American Journal of Gastroenterology.

Sarah E. Laun, Ph.D., from Previse in Baltimore, and colleagues validated Esopredict, a prognostic assay based on DNA methylation levels that stratifies future progression risk in BE patients using biopsies by defining the risk for progression. Esopredict includes four biomarkers: p16, HPP1, RUNX3, and FBN1, as well as age. Biopsies from BE patients meeting inclusion criteria were received from six collaborating sites. The first 99 patients comprised the training set; an additional 110 patients were analyzed as the validation set.

Overall, 78 of the 209 patients progressed to high-grade dysplasia (HGD)/esophageal adenocarcinoma (EAC) within five years (progressors), and 131 had no progression (nonprogressors); 31 progressors who progressed at time intervals longer than five years were tested independently. The researchers found that the area under the receiver-operator characteristic curve for predicting progression to HGD or EAC was 0.76 and 0.73 in the training and validation sets, respectively. The odds of progression within five years were 6.4 times higher for patients in the higher-risk category (risk levels of high-moderate and high) for the Esopredict score versus those in the lower-risk category (risk levels of low and low-moderate). Comparing the low-risk level with other risk levels, similar trends were seen, with patients in the high-risk level 15.2 times more likely to progress than those in the low-risk level.

"Clinicians will be able to use Esopredicts' risk stratification system with an individualized probability of progression score to determine the most appropriate management for their patients with BE," the authors write.

Several authors disclosed ties to Previse, some of whom are inventors of the patented technologies described.

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