Spatiotemporal Study of a Risk-Stratification Epigenetic-Based Biomarker Assay in Patients With Barrett Esophagus

Area of Science:

• Gastroenterology
• Oncology
• Biomarker Development

Background:

• Barrett esophagus (BE) is the primary risk factor for esophageal adenocarcinoma (EAC), a highly lethal cancer.
• Esopredict is a validated methylation-based assay for quantifying neoplastic progression risk in BE.
• Challenges like tissue heterogeneity and sampling variability can impact predictive test accuracy.

Purpose of the Study:

• To evaluate the spatiotemporal performance of the Esopredict biomarker assay.
• To assess Esopredict's accuracy across multiple biopsy locations and time points in BE patients.

Main Methods:

• Analyzed 220 biopsies from 58 BE patients, including spatial and temporal sampling.
• Patients initially diagnosed with nondysplastic BE, indefinite for dysplasia, or low-grade dysplasia.
• Esopredict progression risk scores were computed to predict EAC development within 5 years.

Main Results:

• Esopredict showed 81% sensitivity in spatially profiled patients (highest-scoring biopsy).
• Sensitivity reached 100% when endpoint biopsies were within 5 years of the initial biopsy.
• Temporal profiling demonstrated 100% sensitivity based on the biopsy closest to the endpoint.

Conclusions:

• Esopredict exhibits high predictive performance across diverse spatiotemporal samples in BE.
• Supports Esopredict's utility in distinguishing high-risk BE patients needing intensified management.
• Enables identification of low-risk patients for less frequent surveillance or observation.