Celecoxib in Preventing Polyps in Patients Who Have Undergone Surgery for Stage I Colon Cancer

NCT ID: NCT00087256

Last Updated: 2013-01-07

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: PHASE3
• Total Enrollment: 18 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2004-07-31
• Study Completion Date: 2006-04-30

Brief Summary

RATIONALE: Chemoprevention therapy is the use of certain drugs to try to prevent the development of cancer. It is not yet known whether celecoxib is effective in preventing polyps in patients with colon cancer.

PURPOSE: Randomized phase III trial to study the effectiveness of celecoxib in preventing the development of polyps in patients who have undergone surgery for stage I colon cancer.

Detailed Description

OBJECTIVES:

Primary

• Compare celecoxib vs placebo, in terms of decreasing the incidence of adenomatous polyps of the colon and rectum, in patients with resected stage I adenocarcinoma of the colon.

Secondary

• Compare disease-free survival of patients treated with these regimens.
• Compare the effect of these regimens on self-reported symptoms and health-related quality of life of these patients.
• Compare the quality of life of patients treated with these regimens.
• Compare the benefits of celecoxib in patients with primary tumors or polyps that express cyclo-oxygenase-2 (COX-2) with those that do not express COX-2.
• Compare the expression of signaling targets such as serine/threonine AKT, extracellular signal-regulated kinase 2 (ERK2), and endoplasmic reticulum Ca+2- ATPases in the index tumor and polyps.
• Determine the toxicity and safety of celecoxib in these patients.

OUTLINE: This is a randomized, double-blind, placebo-controlled, multicenter study. Patients are stratified according to gender, tumor stage (T1 vs T2), age (≤ 49 vs 50 to 59 vs ≥ 60 years), and current aspirin use (yes vs no). Patients are randomized to 1 of 2 treatment arms.

• Arm I: Patients receive oral celecoxib twice daily for 3 years.
• Arm II: Patients receive oral placebo twice daily for 3 years. In both arms, treatment continues in the absence of unacceptable toxicity or the diagnosis of invasive colon cancer, carcinoma in situ of the colon or rectum, or a non-colon primary cancer.

Quality of life is assessed at baseline and then at 6, 12, 24, 36, and 42 months.

Patients are followed at 6 months and at 2 years.

PROJECTED ACCRUAL: A total of 1,200 patients (600 per treatment arm) will be accrued for this study within 2.5 years.

Conditions

Colorectal Cancer

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: DOUBLE

Study Groups

Arm 1: placebo

one placebo capsule taken orally twice a day for 3 years

Group Type: PLACEBO_COMPARATOR

Celecoxib

Intervention Type: DRUG

Arm 2: celecoxib

one 400 mg capsule taken orally twice a day for 3 years

Group Type: EXPERIMENTAL

placebo

Intervention Type: OTHER

Interventions

Celecoxib

Intervention Type: DRUG

placebo

Intervention Type: OTHER

Other Intervention Names

Celebrex

Eligibility Criteria

Inclusion Criteria

• No prior familial adenomatous polyposis
• No prior invasive cancer or carcinoma in situ of the colon or rectum
• No clinical or radiologic evidence of metastatic disease

PATIENT CHARACTERISTICS:

Age

• 18 and over

Performance status

• Zubrod 0-1

Life expectancy

• At least 10 years

Hematopoietic

• Complete blood count normal
• Platelet count normal

Hepatic

• Aspartate aminotransferase (AST) normal
• Bilirubin normal
• Alkaline phosphatase normal

Renal

• Creatinine normal

Cardiovascular

• No active ischemic heart disease
• No New York Heart Association class III or IV heart disease
• No myocardial infarction within the past 6 months
• No symptomatic arrhythmia
• No symptomatic peripheral vascular disease or carotid disease that would preclude study participation

Pulmonary

• No aspirin-sensitive asthma

Gastrointestinal

• No history of inflammatory bowel disease
• No history of upper gastrointestinal bleeding
• No history of duodenal or gastric ulcer

Other

• No known hypersensitivity to any COX-2 inhibitor, NSAIDs, aspirin, or sulfonamides
• No non-colorectal malignancy within the past 5 years except carcinoma in situ of the cervix, melanoma in situ, or basal cell or squamous cell skin cancer
• No other disease that would preclude study participation
• No psychiatric disorders, including history of clinical depression or addictive disorders, that would preclude giving informed consent or long-term compliance
• No rheumatologic or skeletal disorders requiring chronic NSAIDs or steroid therapy
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Biologic therapy

• Not specified

Chemotherapy

• Not specified

Endocrine therapy

• Not specified

Radiotherapy

• Not specified

Surgery

• See Disease Characteristics

Other

• No other concurrent investigational agents for colon cancer
• No concurrent chronic use of other cyclo-oxygenase-2 (COX-2) inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), or salicylates (e.g., aspirin)

• Chronic use is defined as use for more than an average of 3 days per month

• Concurrent NSAIDs allowed for up to 10 consecutive days for temporary relief due to inflammatory syndromes, injury, or postoperative pain
• Cardioprotective doses of aspirin (≤ 81 mg/day or 325 mg every other day) allowed
• No concurrent fluconazole or lithium

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Cancer Institute (NCI)

NIH

Sponsor Role: collaborator

NSABP Foundation Inc

NETWORK

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Norman Wolmark, MD

Role: PRINCIPAL_INVESTIGATOR

NSABP Foundation Inc

Locations

Allegheny General Hospital

Pittsburgh, Pennsylvania, United States

Countries

United States

Other Identifiers

NSABP-P-3

Identifier Type: -

Identifier Source: secondary_id

NSABP P-3

Identifier Type: -

Identifier Source: org_study_id