Efficacy of Difluoromethylornithine and Aspirin for Treatment of Adenomas and Aberrant Crypt Foci in Patients with Prior Advanced Colorectal Neoplasms
| Autor: | Stephen N. Sinicrope, Thomas R. Viggiano, Joni S. Noaeill, John B. Kisiel, Louis M. Wong Kee Song, Kenneth W. Schroeder, Jeffrey P. Meyers, Asad Umar, Ellen Richmond, Pruthvi R. Velamala, Robert E. Kraichely, Nathan R. Foster, David H. Bruining, Christopher J. Gostout, Seth Sweetser, Elizabeth Rajan, Mark V. Larson, Gary Della'Zanna, Robert R. Sedlack, Navtej S. Buttar, Frank A. Sinicrope |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Adenoma Male Cancer Research medicine.medical_specialty Eflornithine Colonoscopy Antineoplastic Agents Placebo digestive system Gastroenterology 03 medical and health sciences 0302 clinical medicine Aberrant Crypt Foci Double-Blind Method Internal medicine Clinical endpoint Medicine Humans Adverse effect Aged Aged 80 and over Aspirin medicine.diagnostic_test business.industry Anti-Inflammatory Agents Non-Steroidal Cancer Middle Aged medicine.disease Prognosis digestive system diseases 030104 developmental biology Oncology 030220 oncology & carcinogenesis Drug Therapy Combination Female Neoplasm Recurrence Local business Colorectal Neoplasms medicine.drug Aberrant crypt foci Follow-Up Studies |
| Zdroj: | Cancer prevention research (Philadelphia, Pa.). 12(11) |
| ISSN: | 1940-6215 |
| Popis: | Difluoromethylornithine (DFMO), an inhibitor of polyamine synthesis, was shown to act synergistically with a NSAID for chemoprevention of colorectal neoplasia. We determined the efficacy and safety of DFMO plus aspirin for prevention of colorectal adenomas and regression of rectal aberrant crypt foci (ACF) in patients with prior advanced adenomas or cancer. A double-blinded, placebo-controlled trial was performed in 104 subjects (age 46–83) randomized (1:1) to receive daily DFMO (500 mg orally) plus aspirin (325 mg) or matched placebos for one year. All polyps were removed at baseline. Adenoma number (primary endpoint) and rectal ACF (index cluster and total) were evaluated at a one year colonoscopy. ACF were identified by chromoendoscopy. Toxicity was monitored, including audiometry. Eighty-seven subjects were evaluable for adenomas or ACF modulation (n = 62). At one year of treatment, adenomas were detected in 16 (38.1%) subjects in the DFMO plus aspirin arm (n = 42) versus 18 (40.9%) in the placebo arm (n = 44; P = 0.790); advanced adenomas were similar (n = 3/arm). DFMO plus aspirin was associated with a statistically significant reduction in the median number of rectal ACF compared with placebo (P = 0.036). Total rectal ACF burden was also reduced in the treatment versus the placebo arm relative to baseline (74% vs. 45%, P = 0.020). No increase in adverse events, including ototoxicity, was observed in the treatment versus placebo arms. While adenoma recurrence was not significantly reduced by one year of DFMO plus aspirin, the drug combination significantly reduced rectal ACF number consistent with a chemopreventive effect. |
| Databáze: | OpenAIRE |
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