Trial Outcomes & Findings for Fiber and Fish Oil Supplements for the Prevention of Colorectal Cancer (NCT NCT04211766)

NCT ID: NCT04211766

Last Updated: 2024-09-27

Results Overview

This grant is an R21 with the intent to provide preliminary data to propose a trial with a larger sample size and adequate statistical power.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

38 participants

Primary outcome timeframe

Baseline to completion of the 2 study time periods

Results posted on

2024-09-27

Participant Flow

Recruitment occurred December 2020 thru March 2022 via ads, fliers and social media in the Seattle area. We received 243 screening questionnaires; 88 were incomplete. Of 155 completed, 95 were ineligible (61.3%). We contacted the 60 eligible; 43 attended orientation; 38 signed consent. Three were not randomized (2 ineligible based on abnormal clinical lab tests at baseline and 1 withdrew because of stool collection). Overall, we met planned recruitment goals.

Before randomization to determine the crossover order of supplements (active-washout-comparison, or comparison-washout-active), consented participants had a blood draw. Samples were sent to CLIA-certified Quest Labs for kidney/liver function tests as part of eligibility criteria. Two of the 38 were ineligible based on the lab test criteria. Additionally, 1 person decided they did not want to enter the trial and was not randomized.

Participant milestones

Participant milestones
Measure
Cross-over Randomization 1: Fiber Plus Fish Oil Followed by Comparator
Period 1: Fiber and Fish oil supplements (30 days) Washout: at least 60 days Period 2: Comparator supplements (30 days)
Cross-over Randomization 2: Comparator Followed by Fiber Plus Fish Oil
Period 1: Comparator supplements (30 days) Washout: at least 60 days Period 2: Fiber and Fish oil supplements (30 days)
Overall Study
STARTED
19
16
Overall Study
Completed Only Period 1
1
1
Overall Study
COMPLETED
14
15
Overall Study
NOT COMPLETED
5
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Cross-over Randomization 1: Fiber Plus Fish Oil Followed by Comparator
Period 1: Fiber and Fish oil supplements (30 days) Washout: at least 60 days Period 2: Comparator supplements (30 days)
Cross-over Randomization 2: Comparator Followed by Fiber Plus Fish Oil
Period 1: Comparator supplements (30 days) Washout: at least 60 days Period 2: Fiber and Fish oil supplements (30 days)
Overall Study
Withdrawal by Subject
5
1

Baseline Characteristics

Fiber and Fish Oil Supplements for the Prevention of Colorectal Cancer

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Cross-over Randomization 1: Fiber Plus Fish Oil Followed by Comparator
n=15 Participants
Participants received a fiber supplement and fish oil supplement PO daily for 30 days. After a washout period, of at least 60 days, they received the comparator supplements (also for 30 days)
Cross-over Randomization 2: Comparator Followed by Fiber Plus Fish Oil
n=16 Participants
Participants received the comparator supplements PO daily for 30 days. After a washout period, of at least 60 days, they received the fiber supplement and fish oil supplement (also for 30 days)
Total
n=31 Participants
Total of all reporting groups
Age, Continuous
60.7 years
STANDARD_DEVIATION 6.5 • n=5 Participants
64.9 years
STANDARD_DEVIATION 5.3 • n=7 Participants
62.6 years
STANDARD_DEVIATION 6.3 • n=5 Participants
Sex: Female, Male
Female
12 Participants
n=5 Participants
13 Participants
n=7 Participants
25 Participants
n=5 Participants
Sex: Female, Male
Male
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
15 Participants
n=5 Participants
15 Participants
n=7 Participants
30 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
3 Participants
n=5 Participants
0 Participants
n=7 Participants
3 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
White
12 Participants
n=5 Participants
14 Participants
n=7 Participants
26 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline to completion of the 2 study time periods

Population: All participants who consented and started the intervention.

This grant is an R21 with the intent to provide preliminary data to propose a trial with a larger sample size and adequate statistical power.

Outcome measures

Outcome measures
Measure
Cross-over Randomization 1: Fiber Plus Fish Oil Followed by Comparator
n=19 Participants
Period 1: participants receive fiber supplement and fish oil supplement PO daily on days 1-30. Washout: at least 60 days. Period 2: participants receive the comparators supplements also PO daily on days 90-120.
Cross-over Randomization 2: Comparator Followed by Fiber Plus Fish Oil
n=16 Participants
For Period 1: participants receive comparator supplements PO daily on days 1-30. Participants enter a washout period for at least 60 days. For Period 2: participants receive fiber supplement and fish oil supplement also PO daily on days 90-120.
Feasibility and Retention for a Trial With Daily Doses of 35 g of Fiber and 6.2 g of EPA +DHA (and Corresponding Comparators)
Participants who dropped out during Period 1
4 Participants
0 Participants
Feasibility and Retention for a Trial With Daily Doses of 35 g of Fiber and 6.2 g of EPA +DHA (and Corresponding Comparators)
Participants with complete measures (who completed Period 1 and Period 2)
14 Participants
15 Participants
Feasibility and Retention for a Trial With Daily Doses of 35 g of Fiber and 6.2 g of EPA +DHA (and Corresponding Comparators)
Participants with partial measures (who only completed Period 1)
1 Participants
1 Participants
Feasibility and Retention for a Trial With Daily Doses of 35 g of Fiber and 6.2 g of EPA +DHA (and Corresponding Comparators)
Participants who dropped out during Period 2
0 Participants
0 Participants

SECONDARY outcome

Timeframe: End of Fiber Plus Fish Oil Supplementation vs end of Comparator

Population: All participants who completed both the Fiber Plus Fish Oil Supplement and the Comparator intervention periods in this crossover study and had stools at the end of each intervention period were included in the analysis. RNA-Seq data from stool for 29 participants were analyzed for differential gene expression comparing the end of each intervention period.

Poly A+ RNA was isolated from exfoliated cells in stool, and libraries generated from stool RNA and sequenced on an Illumina HiSeq 2500 platform. Intestinal exfoliome gene sequencing data from the end of each intervention period were analyzed using differential expression (DE) analysis. Count data were aligned, and sample libraries were filtered and normalized; 25,118 detected features were filtered to keep any feature with \>20 cpm in 73% of samples in at least one of the groups; this resulted in 1000 genes. DE analysis between Fiber Plus Fish Oil Supplement vs the Comparator at the end time point was performed using edgeR with a paired design (Robinson et al, Bioinformatics 2010;26:139). Data are presented as number of DE genes significant at p \< 0.01 (without multiple test correction). Upregulated genes indicate higher gene expression with Fiber Plus Fish Oil vs the Comparator and downregulated genes indicate lower gene expression with Fiber Plus Fish Oil vs the Comparator.

Outcome measures

Outcome measures
Measure
Cross-over Randomization 1: Fiber Plus Fish Oil Followed by Comparator
n=1000 genes
Period 1: participants receive fiber supplement and fish oil supplement PO daily on days 1-30. Washout: at least 60 days. Period 2: participants receive the comparators supplements also PO daily on days 90-120.
Cross-over Randomization 2: Comparator Followed by Fiber Plus Fish Oil
For Period 1: participants receive comparator supplements PO daily on days 1-30. Participants enter a washout period for at least 60 days. For Period 2: participants receive fiber supplement and fish oil supplement also PO daily on days 90-120.
Number of Differentially Expressed Exfoliome Genes at p<0.01
Upregulated
10 number of genes at p<0.01
Number of Differentially Expressed Exfoliome Genes at p<0.01
Downregulated
2 number of genes at p<0.01
Number of Differentially Expressed Exfoliome Genes at p<0.01
Unchanged
988 number of genes at p<0.01

SECONDARY outcome

Timeframe: Average at the end of each intervention period

Serum Phospholipids - Eicosapentaenoic acid (EPA), concentration

Outcome measures

Outcome measures
Measure
Cross-over Randomization 1: Fiber Plus Fish Oil Followed by Comparator
n=31 Participants
Period 1: participants receive fiber supplement and fish oil supplement PO daily on days 1-30. Washout: at least 60 days. Period 2: participants receive the comparators supplements also PO daily on days 90-120.
Cross-over Randomization 2: Comparator Followed by Fiber Plus Fish Oil
n=31 Participants
For Period 1: participants receive comparator supplements PO daily on days 1-30. Participants enter a washout period for at least 60 days. For Period 2: participants receive fiber supplement and fish oil supplement also PO daily on days 90-120.
Compliance
43.9 mg/L
Standard Deviation 29.7
3.6 mg/L
Standard Deviation 3.0

Adverse Events

Cross-over Randomization 1: Fiber Plus Fish Oil Followed by Comparator

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Cross-over Randomization 2: Comparator Followed by Fiber Plus Fish Oil

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Johanna Lampe

Fred Hutchinson Cancer Center

Phone: (206) 667-6580

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place