Colorectal Cancer Clinical Trial
Official title:
Phase I Pilot Toxicity/Methods Validation Study of Celecoxib in Genotype-Positive Children With Familial Adenomatous Polyposis
RATIONALE: Chemoprevention is the use of certain drugs to keep cancer from forming. The use
of celecoxib may keep polyps and colorectal cancer from forming in patients with familial
adenomatous polyposis.
PURPOSE: This randomized phase I trial is studying the side effects and best dose of
celecoxib in treating young patients with a genetic predisposition for familial adenomatous
polyposis.
OBJECTIVES:
Primary
- Determine the safety and toxicity of celecoxib in pediatric patients with
genotype-positive familial adenomatous polyposis.
Secondary
- Determine the aberrant crypt foci (ACF) and adenoma burden in the entire colorectum of
these patients.
- Eliminate the learning curve in a phase II/III trial (reproducibility of endoscopic
techniques, tolerability of procedure).
- Compare sedation strategies based on local standards (monitored anesthesia care vs
conscious sedation).
- Validate the ACF scoring technique.
- Establish the short-term (3 month) impact of celecoxib on ACF count in order to
determine appropriateness of ACF as a pathologic endpoint in a phase II/III trial.
OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients receive oral celecoxib twice daily for 3 months in the absence of
disease progression or unacceptable toxicity.
- Arm II: Patients receive oral placebo twice daily for 3 months in the absence of disease
progression or unacceptable toxicity.
Patients undergo colonoscopy at baseline and at 3 months. Patients also complete psychosocial
questionnaires at baseline.
Blood samples are collected at baseline to assess the influence of polymorphisms (CYP2C9,
uridine diphosphate (UDP)-glucuronosyl transferase, A6, glutathione S-transferase [GST] M1,
and Glutathione S-transferase (GST) theta 1 (GSTT1)) on age of onset of phenotype or number
of colorectal polyps. Plasma drug trough levels are assessed at baseline, 1 month, and 3
months.
After completion of study treatment, patients are followed periodically for up to 2 months.
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