# Point-of-Care Diagnosis of Esophageal Cancer in LMICs

> **NIH NIH U01** · JOHNS HOPKINS UNIVERSITY · 2024 · $576,573

## Abstract

SUMMARY: Despite substantial progress in clinical approaches to squamous cancer of the esophagus (ESCC),
which causes most esophageal cancers (EC) in the world, this deadly tumor usually occurs at late disease
stages, with very poor survival. Restricted availability of endoscopy (EGD), along with rarity and delays in
histology, impairs detection of ESCC in LMICs, adversely impacting our ability to treat this disease effectively.
Thus, in LMICs, inexpensive, safe, locally performable strategies for detecting ESCC are necessary to identify
high-risk patients and refer them quickly to suitable diagnostic and therapeutic options.
Therefore, a diagnostic approach featuring a retrievable swallowed sponge-on-a-string to gather esophageal
specimens for molecular testing, combined with a point-of-care (POC) magnetofluidic chip for sample processing
and DNA methylation detection, is proposed. The string-sponge is less expensive, more noninvasive, more
convenient, and more rapid than EGD with biopsy. The magnetofluidic chip streamlines DNA purification, DNA
bisulphite treatment, and PCR detection of methylation markers into a single POC apparatus. This approach
does not necessitate EGD, can be performed in remote areas with portable energy supplies and does not require
extensive medical training, and is thereby amenable to implementation in LMICs.
Our Specific Aims are: 1: Using a sponge-capsule swallowed/tethered collection device, to construct a
methylation marker-based strategy to detect ESCC. In 100 ESCC and 100 benign control patients, we
propose (1) building a multivariate model containing biomarker candidates; (2) carrying out feedback-feasibility
meetings with health care and endoscopy personnel at Makerere University Hospitals to fine-tune eventual POC
usage; 2: In order to achieve a sample-to-answer assay, to implement DNA extraction, bisulfite treatment,
and methylation-specific PCR into a magnetofluidic chip with dried reagents. We’ll use magnetofluidic
techniques to streamline cell lysis, DNA extraction, bisulphite treatment, and methylation-specific PCR into a
compact chip built from cheap thermoplastic materials. In addition, we’ll lyophilize reagents and use heat-
deployed wax sealant plugs to permit storage at room temperature. In this fashion, we will fashion a sample-to-
answer assay that is easy to use, inexpensive, and free of cold-chain steps; 3: In order to achieve fully
automatic high-speed biomarker assaying, to design a small, light apparatus. We’ll engineer an instrument
containing programmable magnetic actuation, temperature control, and detection of fluorescence to execute the
test in a chip with very little user input. We’ll also design the apparatus to be small, light, easy to operate, portable
electricity-powered, and mobile phone-controlled to ease integration with LMIC-based clinical tasking; and 4:
Using our POC approach to carry out a diagnostic pilot study of ESCC in Uganda. While applying the
magnetofluidic chip and app...

## Key facts

- **NIH application ID:** 10843258
- **Project number:** 5U01CA279866-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Stephen J Meltzer
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $576,573
- **Award type:** 5
- **Project period:** 2023-07-01 → 2028-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10843258

## Citation

> US National Institutes of Health, RePORTER application 10843258, Point-of-Care Diagnosis of Esophageal Cancer in LMICs (5U01CA279866-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10843258. Licensed CC0.

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