Colorectal Cancer Clinical Trial
Official title:
Phase III Study of the Effects of Selenium on Adenomatous Polyp Recurrence
RATIONALE: Chemoprevention therapy is the use of certain drugs to try to prevent the
development or recurrence of cancer. Selenium may be effective in preventing the recurrence
of adenomatous colorectal polyps.
PURPOSE: This randomized phase III trial is studying selenium to see how well it works in
preventing the recurrence of polyps in patients with adenomatous colorectal polyps.
OBJECTIVES:
Primary
- Compare the effects of selenium vs placebo on the recurrence of adenomatous colorectal
polyps, in terms of histologic type, degree of dysplasia, number, size, and location, in
patients with adenomatous colorectal polyps.
- Compare the type, incidence, and outcome of side effects in patients treated with these
regimens.
- Determine patient adherence to long-term treatment with these regimens.
Secondary
- Determine the effects of regimen modification by baseline blood selenium level, low-dose
aspirin, selenoprotein genetic marker polymorphisms (e.g., GPx-1, GPx-2, and SEP15)
- Determine the effects of low-dose aspirin (81 mg/day) modification by ornithine
decarboxylase promoter genotype, and toxicity by slow-metabolizer genotypes of the
cytochrome p450 2C9 and UT1A6 loci in these patients.
OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients
are stratified according to use of low-dose (≤ 81 mg/day) aspirin (yes vs no). Patients are
randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral selenium once daily.
- Arm II: Patients receive oral placebo once daily. In both arms, treatment continues for
up to 5 years* in the absence of disease progression or unacceptable toxicity.
Patients undergo follow-up colonoscopy approximately 5 years* after baseline colonoscopy.
NOTE: Some patients will continue participation for up to 7 and a half years
PROJECTED ACCRUAL: A total of 1,600 patients with an adenoma will be randomized to this
study, followed by a second group of randomization of 200 patients with at least one advanced
adenoma (at baseline) for a substudy. Total planned randomizations = 1,800 participants.
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