Colorectal Adenoma Clinical Trial
Official title:
PREPARE: PRevention Using EPA Against coloREctal Cancer
Within the gastroenterology practice of Massachusetts General Hospital (MGH), the investigators will conduct a prospective, single-arm clinical trial to measure the effects of daily 4-gram eicosapentaenoic acid (EPA), through treatment with AMR101 (VASCEPA, icosapent ethyl) on stool and tissue biomarkers associated with colorectal cancer.
This study will investigate the effects of standard-dose EPA treatment using the FDA-approved
drug AMR101. AMR101 (icosapent ethyl) is a prescription medicine for adults to lower blood
levels of triglycerides. It is supplied as a liquid-filled gel capsule for oral
administration. The standard dose is 4 g per day (administered as 4 one-gram capsules). Each
1-gram capsule of AMR101 contains 1 gram of icosapent ethyl, which is an ethyl ester of the
omega-3 fatty acid eicosapentaenoic acid (EPA).
EPA possesses triglyceride-lowering and anti-inflammatory activities, and has been suggested
to be beneficial for a variety of health outcomes in adults, including coronary heart
disease, stroke, type 2 diabetes,depression, and inflammatory bowel disease, although the
data are not univocal. Increasing evidence supports the anticancer effect of EPA.
Colorectal cancer is the third leading cause of cancer-related deaths in the US. Substantial
data support the benefit of EPA for colorectal cancer prevention and treatment, which may be
mainly due to the immunomodulatory and anti-inflammatory activity of EPA. Increasing data
support that gut microbes are pivotal in integrating dietary cues with host immunity, and
that disturbances in the gut microbiota may promote colorectal cancer by breakdown of
intestinal immune homeostasis. Dietary fat composition is a major driver of the gut microbial
community structure and EPA has been shown to enrich the gut bacteria that possess
immunoprotective activities. These data together the investigator's hypothesis that EPA
modulates the gut microbiota to preserve colorectalic immune homeostasis and suppress
colorectal cancer. In the current study, the investigators propose to experimentally test
this hypothesis by assessing the effect of EPA supplement on the gut microbiota - host immune
interaction.
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