Study of Oral Metronidazole on Postoperative Chemotherapy in Colorectal Cancer

NCT ID: NCT04264676

Last Updated: 2020-11-25

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

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

294 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-31

Study Completion Date

2025-03-31

Brief Summary

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Fusobacterium nucleatum (Fusobacterium nucleatum, Fn) has been identified as an independent risk factor for recurrence of colorectal cancer. In this study, oral metronidazole would be used to reduce the abundance of Fn in patients with high Fn, so as to explore whether oral metronidazole can improve the efficacy of postoperative chemotherapy in patients with colorectal cancer.

Detailed Description

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Gut microbiota are linked to chronic inflammation and carcinogenesis. Chemotherapy failure is the major cause of recurrence and poor prognosis in colorectal cancer patients. Previously in the investigators' research, the investigators find the contribution of gut microbiota to chemoresistance in patients with colorectal cancer. The investigators found that Fusobacterium nucleatum (Fn) was abundant in colorectal cancer tissues in patients with recurrence post chemotherapy, and was associated with patient clinicopathological characterisitcs. Furthermore, the investigators' bioinformatic and functional studies demonstrated that Fn promoted colorectal cancer resistance to chemotherapy. Metronidazole has been known to treat with anaerobe infection, including Fusobacterium. So oral metronidazole would be used to reduce the abundance of Fn in patients with high Fn, so as to explore whether oral metronidazole can improve the efficacy of postoperative chemotherapy in patients with colorectal cancer.

Conditions

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Colorectal Cancer Stage II Colorectal Cancer Stage III

Keywords

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Metronidazole Gut Microbiota Postoperative Chemotherapy Colorectal Cancer Fusobacterium nucleatum

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Metronidazole

supplement of metronidazole 0.4g three times per day for 7 days, which is one treatment every 4 weeks for mFOLFOX6(6 treatments totally),and every 6 weeks for CapeOX (4 treatments totally).

Group Type ACTIVE_COMPARATOR

Metronidazole Oral Tablet

Intervention Type DRUG

Supplement of metronidazole 0.4g three times per day for 7 days before each two cycles of chemotherapy (mFOLFOX6 once every 4 weeks, CapeOX once every 6 weeks), which is 6 treatments for mFOLFOX6 and 4 treatments for CapeOX totally.

Placebo

supplement of identical-appearing placebo 0.4g three times per day for 7 days, which is one treatment every 4 weeks for mFOLFOX6 (6 treatments totally),and every 6 weeks for CapeOX 4 treatments totally).

Group Type PLACEBO_COMPARATOR

Placebo oral tablet

Intervention Type DRUG

Supplement of placebo oral tablet 0.4g three times per day for 7 days before each two cycles of chemotherapy (mFOLFOX6 once every 4 weeks, CapeOX once every 6 weeks), which is 6 treatments for mFOLFOX6 and 4 treatments for CapeOX totally.

Interventions

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Metronidazole Oral Tablet

Supplement of metronidazole 0.4g three times per day for 7 days before each two cycles of chemotherapy (mFOLFOX6 once every 4 weeks, CapeOX once every 6 weeks), which is 6 treatments for mFOLFOX6 and 4 treatments for CapeOX totally.

Intervention Type DRUG

Placebo oral tablet

Supplement of placebo oral tablet 0.4g three times per day for 7 days before each two cycles of chemotherapy (mFOLFOX6 once every 4 weeks, CapeOX once every 6 weeks), which is 6 treatments for mFOLFOX6 and 4 treatments for CapeOX totally.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Individuals aged 18-75 years
* Individuals firstly confirmed by surgery pathology as colorectal cancer (AJCC cancer staging II - III), who need mFOLFOX6 or CapeOX postoperative chemotherapy
* Individuals with Fn - deltaCT value in colon tissue samples detected by qPCR ≥-12 before receiving chemotherapy
* Individuals who could tolerate chemotherapy drugs: ECOG (Eastern Cooperative Oncology Group) score ≤2 points, WBC(White Blood Cell) ≥4.0×10\^9/L, Hb (Hemoglobin) ≥80g/L, PLT (Platelet) ≥80×10\^9/L, ALT (Alanine Aminotransferase)\< 2ULN (Upper Limmit of Normal), Scr (Creatinine)\< 1.5ULN
* Individuals who participate this study and sign the informed consent form willingly.

Exclusion Criteria

* Individuals with colorectal adenoma or non-colorectal cancer, such as inflammatory bowel disease
* Individuals with a history of familial adenomatous polyposis (FAP)
* Individuals with severe heart, lung, brain, kidney, gastrointestinal or systemic diseases
* Individuals who used antibiotics for more than 5 days in 1 month prior to chemotherapy
* Individuals with stage I or IV colorectal cancer, or with stage II colorectal cancer who do not need postoperative chemotherapy
* Individuals with contraindications for metronidazole
* Individuals who unwilling to participate this study,or unwilling to sign the informed consent form
* Individuals with any conditions that the researchers considered inappropriate for inclusion
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Municipal Commission of Health and Family Planning

OTHER

Sponsor Role collaborator

Ruijin Hospital

OTHER

Sponsor Role collaborator

Fudan University

OTHER

Sponsor Role collaborator

Shanghai Zhongshan Hospital

OTHER

Sponsor Role collaborator

Shanghai Shenkang Hospital Development Center

UNKNOWN

Sponsor Role collaborator

Shanghai Jiao Tong University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Jing-yuan Fang, MD, Ph. D

Director of Department of Gastroenterology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jingyuan Fang, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Shanghai Jiao Tong University School of Medicine

Locations

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Division of Gastroenterology and Hepatology, Ren-Ji Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai Institute of Digestive Disease; Key Laboratory of Gastroenterology & Hepatology, Ministry of Health

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status NOT_YET_RECRUITING

Fudan University Shanghai Cancer Center

Shanghai, Shanghai Municipality, China

Site Status NOT_YET_RECRUITING

Zhongshan Hospital affiliated to Fudan University

Shanghai, Shanghai Municipality, China

Site Status NOT_YET_RECRUITING

Countries

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China

Central Contacts

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Jingyuan Fang, MD, PhD

Role: CONTACT

Phone: 86-021-58752345

Email: [email protected]

Danfeng Sun, PhD

Role: CONTACT

Phone: 86-021-58752345

Email: [email protected]

Facility Contacts

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Jing-Yuan Fang, MD. Ph D.

Role: primary

Yan Shi, MD. Ph D.

Role: primary

Sanjun Cai, MD. Ph D.

Role: primary

Jianyong Sun, MD. Ph D.

Role: primary

Other Identifiers

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KY2019-066

Identifier Type: -

Identifier Source: org_study_id