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Eflornithine and Sulindac in Preventing Colorectal Cancer in Patients With Colon Polyps

Basic Trial Information
Trial Description
     Summary
     Further Trial Information
     Eligibility Criteria
Trial Contact Information

Basic Trial Information

PhaseTypeStatusAgeSponsorProtocol IDs
Phase IIIPreventionClosed40 to 80NCI, OtherCDR0000429552
UCIRVINE-UCI-2002-2261, NCT00118365

Trial Description

Summary

RATIONALE: Chemoprevention is the use of certain drugs to keep cancer from forming, growing, or coming back. The use of eflornithine and sulindac may prevent colorectal cancer. It is not yet known whether eflornithine and sulindac are more effective than a placebo in preventing colorectal cancer.

PURPOSE: This randomized phase III trial is studying eflornithine and sulindac to see how well they work compared to a placebo in preventing colorectal cancer in patients with colon polyps.

Further Study Information

OBJECTIVES:

  • Compare the rate of new adenomatous polyp formation in patients with a history of adenomatous polyps of the colon treated with eflornithine and sulindac vs placebo.
  • Correlate the effects of eflornithine and sulindac on polyamine and prostaglandin content in the flat mucosa with the rate of new adenoma formation in these patients.
  • Compare the rate of side effects in patients treated with these regimens.

OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to participating center and aspirin use (yes vs no).

Patients receive oral double placebo once daily for 4 weeks. Patients who are more than 70% compliant by pill measurement or self reporting are randomized to 1 of 2 treatment arms.

  • Arm I: Patients receive oral double placebo once daily.
  • Arm II: Patients receive oral eflornithine (DFMO) and oral sulindac once daily. In both arms, treatment continues for 36 months in the absence of unacceptable toxicity or the development of an invasive malignancy.

PROJECTED ACCRUAL: A total of 150 additional patients (124 randomized) will be accrued for this study within 18 months.

Eligibility Criteria

DISEASE CHARACTERISTICS:

  • History of ≥ 1 surgically resected adenomatous polyp of the colon measuring ≥ 3 mm within the past 5 years
  • Screening colonoscopy performed within the past 6 months
  • All polyps must have been removed during colonoscopy, pathologically examined, and archived
  • No prior surgical resection removing > 40 cm of the colon
  • No personal or family history of familial polyposis or hereditary non-polyposis colon cancer

PATIENT CHARACTERISTICS:

Age

  • 40 to 80

Performance status

  • SWOG 0-1

Life expectancy

  • Not specified

Hematopoietic

  • Hematocrit ≥ 35%
  • WBC ≥ 4,000/mm³
  • Platelet count ≥ 100,000/mm³

Hepatic

  • Bilirubin ≤ 2.0 mg/dL
  • AST and ALT ≤ 2 times normal

Renal

  • Creatinine ≤ 1.5 mg/dL
  • Urine protein ≤ 1+*
  • Urine casts 0-3*
  • Urine WBC and RBC count 0-5 cells* NOTE: *By urinalysis

Gastrointestinal

  • No history of inflammatory bowel disease
  • No gastric or duodenal ulcers within the past 12 months
  • Gastric or duodenal ulcers that were adequately treated > 24 months ago are allowed
  • No symptomatic gastric or duodenal ulcers

Other

  • Not pregnant or nursing
  • Negative pregnancy test
  • Must have regional geographic stability over the next 36 months
  • Pure tone audiometry evaluation normal
  • Patients with ≥ 20 dB of uncorrectable hearing loss (for age) of any 2 contiguous frequencies are not allowed
  • No invasive malignancy within the past 5 years except adequately treated nonmelanoma skin cancer, level I (or Breslow < 0.76 mm) cutaneous melanoma, Duke's A colon cancer, stage I cervical cancer, or stage 0 chronic lymphocytic leukemia
  • No severe metabolic disorder
  • No other significant acute or chronic disease that would preclude study participation
  • No history of abnormal wound healing or repair
  • No conditions that would confer risk of abnormal wound healing or repair
  • No history of allergy to NSAIDs or eflornithine

PRIOR CONCURRENT THERAPY:

Biologic therapy

  • Not specified

Chemotherapy

  • No concurrent chemotherapy

Endocrine therapy

  • No concurrent corticosteroids on a regular or predictable intermittent basis

Radiotherapy

  • No concurrent radiotherapy

Surgery

  • See Disease Characteristics

Other

  • Concurrent calcium supplements (≤ 1,000 mg/day) allowed
  • Concurrent aspirin for cardiovascular prophylaxis (i.e., 81 mg/day) allowed
  • Concurrent lipid-lowering drugs (i.e., high-dose statins) allowed
  • No other concurrent nonsteroidal anti-inflammatory drugs (NSAIDs) on a regular or predictable intermittent basis
  • No concurrent anticoagulants on a regular or predictable intermittent basis
  • No concurrent treatment for gastric or duodenal ulcers

Trial Contact Information

Trial Lead Organizations/Sponsors

Chao Family Comprehensive Cancer Center at University of California Irvine Medical Center

National Cancer Institute

Frank L. MeyskensPrincipal Investigator

Eugene GernerPrincipal Investigator

Link to the current ClinicalTrials.gov record.
NLM Identifer NCT00118365
Information obtained from ClinicalTrials.gov on September 16, 2009

Note: Information about this trial is from the ClinicalTrials.gov database. The versions designated for health professionals and patients contain the same text. Minor changes may be made to the ClinicalTrials.gov record to standardize the names of study sponsors, sites, and contacts. Cancer.gov only lists sites that are recruiting patients for active trials, whereas ClinicalTrials.gov lists all sites for all trials. Questions and comments regarding the presented information should be directed to ClinicalTrials.gov.

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