Rectal Cancer Clinical Trial
Official title:
Randomized, Phase II Trial of Atorvastatin, RAFTILOSE Synergy 1, and Sulindac Among Patients at Increased Risk for Sporadic Colorectal Neoplasia
This randomized phase II trial is studying atorvastatin calcium to see how well it works compared to oligofructose-enriched inulin, sulindac, or a placebo in preventing cancer in patients at increased risk of developing colorectal neoplasia. Chemoprevention is the use of certain drugs or substances to keep cancer from forming, growing, or coming back. The use of atorvastatin calcium, oligofructose-enriched inulin, or sulindac may stop cancer from forming in patients at increased risk of colorectal neoplasia. It is not yet known whether atorvastatin calcium, oligofructose-enriched inulin, or sulindac are more effective than a placebo in preventing cancer in patients at increased risk of developing colorectal neoplasia.
PRIMARY OBJECTIVE:
I. Percent change in number of rectal aberrant cryptic foci (ACF) as measured by
magnification chromoendoscopy
SECONDARY OBJECTIVES:
I. Screening for possible phase III testing II. Effects on proliferation (Ki67 expression)
and apoptosis (caspase-3 expression) as measured by biopsy samples obtained from
normal-appearing rectal mucosa at baseline and after completion of study treatment III.
Correlation of endoscopic features with histologic characteristics of rectal ACF IV.
Observation of the natural history of rectal ACF in patients receiving placebo V. Adverse
events VI. Utilization of a biospecimen repository archive
OUTLINE: This is a multicenter, prospective, randomized, partially blinded,
placebo-controlled study. Patients are stratified according to history of prior surgical
resection of the colon (yes vs no) and number of rectal aberrant cryptic foci (ACF) (5-9 vs
>= 10). Patients are randomized to 1 of 4 treatment arms.
ARM I: Patients receive oral atorvastatin calcium once daily.
ARM II: Patients receive oral sulindac twice daily.
ARM III (blinded arm): Patients receive oral oligofructose-enriched inulin (Raftilose
Synergy 1) twice daily.
ARM IV (blinded arm): Patients receive an oral placebo twice daily.
In all arms, treatment continues for 6 months in the absence of unacceptable toxicity.
Tissue samples are collected at baseline and at the completion of study treatment. Tissue is
examined by immunohistochemistry for proliferation (Ki67) and apoptosis (cleaved caspase-3).
After completion of study treatment, patients are followed at approximately 30 days.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Prevention
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