Celecoxib in Treating Patients With Early-Stage Rectal Cancer

NCT ID: NCT00608595

Last Updated: 2013-03-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

NA

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-07-31

Study Completion Date

2008-04-30

Brief Summary

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RATIONALE: Studying samples of tissue, blood, and urine from patients with cancer in the laboratory may help doctors learn more about changes that may occur in DNA and identify biomarkers related to cancer. It may also help doctors predict how rectal cancer will respond to treatment with celecoxib.

PURPOSE: This clinical trial is studying how well celecoxib works in treating patients with early-stage rectal cancer.

Detailed Description

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OBJECTIVES:

* Determine cyclooxygenase-2 (COX-2) over-expression in tumor specimens from patients with early-stage rectal cancer.
* Determine whether administration of a COX-2 inhibitor, celecoxib, results in changes in tumor (COX-2 overexpressing) levels of eicosanoids but not in levels in the surrounding normal tissue that is expected not to express COX-2.
* Determine whether surrogate markers of eicosanoid metabolism (i.e., serum VEGF levels, tumor prostaglandin E\_2 \[PGE\_2\], and the major urinary metabolite of PGE\_2 \[PGE-M\]) in biological specimens from these patients correlate with changes noted in tumor tissue.
* Determine if there is a greater change in protein and gene expression from pretreatment biopsy levels in patient tumor specimens (COX-2 overexpressing) vs specimens of surrounding normal tissue (expected not to be COX-2 overexpressing).

OUTLINE: Patients receive oral celecoxib twice daily on days 1-5. Patients then undergo planned local excision or definitive radical resection on day 6.

Tumor tissue and normal tissue (at least 5 cm away from the tumor) samples are collected pretreatment. Post-treatment tissue samples are collected along with the surgery. Serum and urine samples are obtained at baseline and after administration of celecoxib. Tumor and normal tissue specimens are analyzed by assays measuring markers of cyclooxygenase-2 (COX-2) activity (i.e., COX-2 mRNA and protein, tumor prostaglandin E\_2 \[PGE\_2\], and VEGF). Tissue samples are also assessed by cDNA microarray and imaging mass spectrometry to determine overall changes in gene and protein expression from pretreatment levels. Surrogate markers of COX-2 activity in serum (i.e., VEGF) and urine (i.e., urinary metabolite of PGE\_2 \[PGE-M\]) are also assessed and compared with changes noted in tumor tissue. COX-2 protein levels are determined by immunohistochemistry in patients with limited pretreatment tumor tissue specimens.

Conditions

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Colorectal Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Therapeutic Intervention/Celecoxib

Celecoxib

Group Type EXPERIMENTAL

celecoxib

Intervention Type DRUG

Will be administered orally 400 mg po BID starting 5 days prior to planned surgical resection.

gene expression analysis

Intervention Type GENETIC

not noted

protein expression analysis

Intervention Type GENETIC

Not noted

immunohistochemistry staining method

Intervention Type OTHER

not noted

laboratory biomarker analysis

Intervention Type OTHER

not noted

mass spectrometry

Intervention Type OTHER

biopsy

Intervention Type PROCEDURE

At the time of preoperative evaluation by surgeon as well as one week after administration of Celecoxib.

neoadjuvant therapy

Intervention Type PROCEDURE

not noted

therapeutic conventional surgery

Intervention Type PROCEDURE

not noted

Interventions

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celecoxib

Will be administered orally 400 mg po BID starting 5 days prior to planned surgical resection.

Intervention Type DRUG

gene expression analysis

not noted

Intervention Type GENETIC

protein expression analysis

Not noted

Intervention Type GENETIC

immunohistochemistry staining method

not noted

Intervention Type OTHER

laboratory biomarker analysis

not noted

Intervention Type OTHER

mass spectrometry

Intervention Type OTHER

biopsy

At the time of preoperative evaluation by surgeon as well as one week after administration of Celecoxib.

Intervention Type PROCEDURE

neoadjuvant therapy

not noted

Intervention Type PROCEDURE

therapeutic conventional surgery

not noted

Intervention Type PROCEDURE

Other Intervention Names

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Celebrex

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of primary adenocarcinoma of the rectum (to be histologically confirmed upon study entry)

* Tumor must be at or below the peritoneal reflection
* The distal border of the tumor is within 12 cm of the anal verge on proctoscopic examination
* Clinically resectable disease

PATIENT CHARACTERISTICS:

* Karnofsky performance status 60-100%
* WBC ≥ 4,000/mm³
* Platelet count ≥ 150,000/mm³
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No other serious medical illness (other than rectal cancer) that would preclude study therapy
* No psychiatric condition that would preclude informed consent
* No history of allergy to celecoxib or any other NSAIDs, including acetylsalicylic acid (i.e., aspirin), ibuprofen, or indomethacin
* No history of allergy to sulfonamides

Exclusion Criteria

Not noted

PRIOR CONCURRENT THERAPY:

* At least 7 days since prior and no concurrent NSAIDs or other cyclooxygenase-2 inhibitors
* No concurrent warfarin, except low-dose warfarin (i.e., 1 mg/day) administered for prophylaxis
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Vanderbilt-Ingram Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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A Bapsi Chakravarthy, MD

Professor of Medicine, Medical Oncologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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A. Bapsi Chakravarthy, MD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt-Ingram Cancer Center

Locations

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Veterans Administration

Nashville, Tennessee, United States

Site Status

Vanderbilt-Ingram Cancer Center

Nashville, Tennessee, United States

Site Status

Countries

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United States

Other Identifiers

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VU-VICC-GI-0174

Identifier Type: -

Identifier Source: secondary_id

VICC GI 0174

Identifier Type: -

Identifier Source: org_study_id

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