Lishan Aklog, the CEO of US-based cancer prevention company Lucid Diagnostics, called attention to Lucid's EsoCheck cell collection device during testimony last week before the US House of Representatives' Committee on Small Business’. 

The company unveiled its EsoGuard oesophageal DNA test last November to identify patients with gastroesophageal reflux disease (GERD), also known as chronic heartburn, who are at risk of developing oesophageal precancer and cancer. 

EsoGuard 2.0 is a molecular diagnostic test designed to detect the earliest epigenetic changes associated with precancerous conditions in the oesophagus. Samples of cells are collected and subtle methylation changes on the DNA can indicate the earliest stages of precancer.

The test works along with EsoCheck, a cell-collection device that consists of a small capsule with an attached balloon – patients swallow the device, allowing targeted cell collection without the need for invasive procedures. 

Aklog highlights the importance of testing cells at the pre-cancerous stage: “If you think of breast cancer - you get a mammogram and pick it up early and the cancer can be cured at stage one.

"You can also get a colonoscopy for colon cancer, many cancers have early detection programmes that are successful but that's not an option for oesophageal cancer, because the mortality rate for the earliest stage one oesophageal cancer is still 50%. So, it doesn't help to pick it up at the cancer stage. You must pick it up at the pre-cancer stage.” 

According to a report on GlobalData’s Pharma Intelligence Center, there will be 482,655 oesophageal cancer cases across 16 pharmaceutical markets (UK, US, China, Canada, Australia, Brazil, France, Germany, Spain, South Korea, South Africa, Russia, Italy, Mexico, Japan, and India) by 2027. 

Where can these tests be applied? 

The test is offered to patients who suffer from GERD, which, if left untreated, can lead to a precancerous condition called Barrett’s oesophagus that increases the risk of cancer.  

As well as offering the test to patients who suffer from chronic heartburn, Aklog said Lucid holds health fair screening events, testing firefighters as they’re at a higher risk for oesophageal cancer.  

The company is also in the process of working with employers to offer screening services:. Aklog said: “We're just getting started on some self-insured employers who really care about their patient's health. They like the idea of having this as a covered benefit.”  

Targeted or broad cancer tests? 

Earlier this week, at-home diagnostic services provider Getlabs announced the addition of Grail‘s Galleri multi-cancer early detection test into its suite of offerings. The test works by analysing cell-free DNA (cfDNA) fragments in the blood to screen for various cancers, including those without current screening recommendations such as pancreatic, oesophageal, ovarian, and liver cancers. 

This raises the question of whether to develop customised tests for individual cancers or broad tests capable of developing multiple cancers.

Aklog explained that the current focus for Lucid remains on specialised tests tailored for specific cancers: “For now, we know we are focused on the individual cancer because there is such a huge unmet need here.”  

Efforts to utilise genomic technology for a single blood test to detect various cancers face obstacles such as sensitivity limitations and uncertainty regarding the target population. 

The focus for Lucid remains on increasing access to its test: “We're trying to stamp out cancer and do so with these two really remarkable technologies,” says Aklog.