Trial of Eflornithine Plus Sulindac in Patients With Familial Adenomatous Polyposis (FAP)

Completed · Phase 3 · Has a placebo group

Conditions studied: Familial Adenomatous Polyposis

In brief

The purpose of this randomized, double-blind, Phase III trial is to determine if the combination of eflornithine plus sulindac is superior to sulindac or eflornithine as single agents in delaying time to the first occurrence of any FAP-related event. This includes: 1) FAP related disease progression indicating the need for excisional intervention involving the colon, rectum, pouch, duodenum and/or 2) clinically important events which includes progression to more advanced duodenal polyposis, cancer or death.

Key facts

Study ID

NCT01483144

Run by

Cancer Prevention Pharmaceuticals, Inc.

People needed

171

Starts

2013-10-01

Expected to finish

2019-03-01

Last updated by the study team

2021-06-08

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Diagnosis of phenotypic classical FAP with disease involvement of the duodenum and/or colon/rectum/pouch.
• Genotype: Adenomatous polyposis coli (APC) mutation (with or without family history) required
• Classical FAP Phenotype: 100's to 1,000's of colorectal adenomatous polyps, usually appearing in teenage years
• Upper gastrointestinal (UGI) endoscopy/ lower gastrointestinal (LGI) endoscopy (proctoscopy/colonoscopy) performed within 30 days of randomization.
• Patients with an intact colon/rectum, except for clinical polyposis, and prophylactic surgery is being considered as a stratification site.
• Rectal/pouch polyposis as a stratification site as follows:
• At least three years since colectomy with ileorectal anastamosis (IRA)/proctocolectomy with pouch, and demonstrating polyposis as defined by Stage 1, 2, 3, of the proposed InSiGHT 2011 Staging System (Appendix B) and summarized as follows:
• Stage 1: 10-25 polyps, all < 5 mm Stage 2: 10-25 polyps, at least one > 1 cm Stage 3: >25 polyps amenable to complete removal, or any incompletely removed sessile polyp, or any evidence of high grade dysplasia, even if completely removed. [Note: For staging purposes only.]
• For all subjects, any rectal/pouch polyps > 5 mm must be excised at "baseline".
• Duodenal polyposis as a stratification site; one or more of the following:
• Current Spigelman Stage 3 or 4.
• Prior surgical endoscopic intervention within the past six months for Spigelman Stage 3 or 4 that may have been down staged to Spigelman Stage 1 or 2.
• Hematopoietic Status (within 30 days prior to randomization):
• No significant hematologic abnormalities
• White blood cell count (WBC) at least 3,000/mm3
• Platelet count at least 100,000/mm3
• Hemoglobin at least 10.0 g/dL
• No history of clinical coagulopathy
• Hepatic Status (within 30 days prior to randomization):
• Bilirubin no greater than 1.5 times ULN
• Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) no greater than 1.5 times ULN
• Alkaline phosphatase no greater than 1.5 times ULN
• Renal Status (within 30 days prior to randomization):
• a) Creatinine no greater than 1.5 times ULN
• Hearing:

You may not qualify if…

• Prior pelvic irradiation.
• Patients receiving oral corticosteroids within 30 days of enrollment.
• Treatment with other investigational agents in the prior 4 weeks.
• Use of other non-steroidal anti-inflammatory drugs (such as ibuprofen) exceeding 4 days per month, in the prior 6 weeks.
• Regular use of aspirin in excess of 700 mg per week.
• Treatment with other FAP directed drug therapy (including sulindac or celecoxib, fish oil) within 12 weeks of study enrollment.
• Hypersensitivity to cyclooxygenase-2 inhibitors, sulfonamides, NSAIDs, or salicylates; NSAID associated symptoms of gastritis.
• Patients must not have cardiovascular disease risk factors as defined below:
• Uncontrolled high blood pressure (systolic blood pressure > 150 mm Hg
• Unstable angina
• History of documented myocardial infarction or cerebrovascular accident
• New York Heart Association Class III or IV heart failure
• Known uncontrolled hyperlipidemia defined as LDL-C >= 190 mg/dL or triglycerides >= 500 mg/dL
• Patients with significant hearing loss are not eligible for study participation defined as hearing loss that affects everyday life and/or for which a hearing aid is required.
• Colon/rectum/pouch with high grade dysplasia or cancer on biopsy or a large polyp (>1 cm) not amenable to complete removal.
• Duodenal cancer on biopsy.
• Intra-abdominal desmoid disease, stage III or IV
• Inability to provide informed consent.

Where it is running

• University of California San Diego — La Jolla, California, United States
• Emory University — Atlanta, Georgia, United States
• Dana Farber Cancer Institute — Boston, Massachusetts, United States
• University of Michigan — Ann Arbor, Michigan, United States
• Mayo Clinic — Rochester, Minnesota, United States
• Washington University — St Louis, Missouri, United States
• Cleveland Clinic — Cleveland, Ohio, United States
• University of Pennsylvania — Philadelphia, Pennsylvania, United States
• MD Anderson Cancer Center — Houston, Texas, United States
• University of Utah- Huntsman Cancer Institute — Salt Lake City, Utah, United States
• UZ Leuven — Leuven, Belgium
• Zane Cohen Centre For Digestive Diseases — Toronto, Ontario, Canada
• University Hospital Bonn — Bonn, Germany
• Academic Medical Centre — Amsterdam, Netherlands
• Institut de Malalties Digestives — Barcelona, Catalonia, Spain
• Institute of Genetic Medicine — Newcastle upon Tyne, Tyne and Wear, United Kingdom
• Manchester Center for Genomic Medicine — Manchester, United Kingdom

Full record on ClinicalTrials.gov

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