Colon Carcinoma Clinical Trial
Official title:
Myo-Inositol Chemoprevention in Colitis-Associated Dysplasia
This pilot, randomized phase I/II trial studies how well inositol works in preventing colorectal cancer in patients with abnormal cells (dysplasia) associated with inflammation of the colon (colitis). Patients with colitis-associated dysplasia may have an increased risk of developing colorectal cancer. Inositol is a vitamin-like substance that may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth.
Status | Terminated |
Enrollment | 20 |
Est. completion date | |
Est. primary completion date | May 2013 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Participants must have ulcerative colitis or Crohn's disease with low grade dysplasia or polyploid dysplasia or have a history of dysplasia and increased positive beta-catenin levels confirmed by a consensus of the study pathologists (2 of 2, or 2 of 3) - Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1 - Absolute neutrophil count (ANC) > 1,500/uL - Platelets > 100,000/uL - Total bilirubin within normal institutional limits - Aspartate aminotransferase (AST)(serum glutamic oxaloacetic transaminase [SGOT]/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT] =< 1.5 times upper limit of normal - Creatinine within normal institutional limits - International normalized ratio (INR) < 1.5 - Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) from the time of baseline pregnancy test, throughout the duration of the study, and for 1 month following cessation of study drug; females must begin adequate contraception immediately following screening pregnancy test; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately; if she is pregnant, she will be immediately withdrawn from the study and followed until the birth of the child - Ability to understand and the willingness to sign a written informed consent document Exclusion Criteria: - Subjects with life-threatening medical conditions that would preclude study treatment intervention and colonoscopy - Participants may not be receiving any other investigational agents - History of allergic reactions to rice or compounds of similar chemical or biologic composition to myo-inositol (i.e., urticaria, dermatologic reaction) - Use of medications known to elevate serum blood glucose; participants on steroids are still eligible, as they will be monitored weekly for fasting blood glucose - Participants with dysplasia-associated lesion or mass (DALM), high-grade dysplasia or invasive colonic carcinoma are excluded - Uncontrolled intercurrent illness including, but not limited to - Ongoing or active infection - Symptomatic congestive heart failure - Unstable angina pectoris - Cardiac arrhythmia - Chronic renal failure - Chronic renal insufficiency - Psychiatric illness or social situations that would limit compliance with study requirements - Prior treatment with myo-inositol - History of systemic chemotherapy within 18 months of screening - Subjects taking valproic acid and/or lithium - Diabetes mellitus - History of total proctocolectomy - Concomitant primary sclerosing cholangitis (PSC) - Pregnant or lactating subjects are excluded |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
Country | Name | City | State |
---|---|---|---|
United States | Northwestern University | Chicago | Illinois |
United States | University of Chicago Comprehensive Cancer Center | Chicago | Illinois |
United States | Mount Sinai Medical Center | New York | New York |
Lead Sponsor | Collaborator |
---|---|
National Cancer Institute (NCI) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in P-ß-catenin staining within areas of dysplasia as measured by immunohistochemistry from samples obtained before and after study treatment | P-beta-catenin staining will be measured as percent of positive cells = counted # positively stained cells/total # cells present in the sample under consideration. | Baseline to 90 days | No |
Secondary | Incidence of dysplasia in previously marked areas | The effects on disappearance of dysplasia in colonic biopsies will be determined as a pathological diagnosis rendered by two out of three study pathologists. | Day 90 | No |
Secondary | Change in p53 staining within dysplasia or in segments with prior dysplasia | Descriptive analysis will be provided. | Baseline to day 90 | No |
Secondary | Change in Ki67 staining within dysplasia or in segments with prior dysplasia | Descriptive analysis will be provided. | Baseline to day 90 | No |
Secondary | Change in mucosal apoptosis (cleaved caspase-3) within dysplasia or in segments with prior dysplasia | Descriptive analysis will be provided. | Baseline to day 90 | No |
Secondary | Change in mucosal mRNA levels of MCP-1 as determined by real time polymerase chain reaction (PCR) | Descriptive analysis will be provided. | Baseline up to 90 days | No |
Secondary | Change in mucosal mRNA levels of iNOS as determined by real time PCR | Descriptive analysis will be provided. | Baseline up to 90 days | No |
Secondary | Change in mucosal mRNA levels of Cox-2 as determined by real time PCR | Descriptive analysis will be provided. | Baseline up to 90 days | No |
Secondary | Adverse events in study treatment | Identify the adverse event using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. | Up to 2 weeks post-treatment | Yes |
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