Celebrex With Preoperative Chemoradiation - Rectal Cancer - Full Text View

Purpose

Colorectal carcinoma is the third most common cause of death from cancer. Approximately, 30% of colorectal carcinomas involve the rectum. Optimizing local control in the pelvis while reducing treatment toxicity remains one of the principal goals of therapy for patients with locally advanced rectal carcinoma. Treatment strategies that achieve this goal will have a significant impact on our society.C linical trials have shown that this type of cancer is less likely to come back if chemotherapy and radiotherapy are added to surgery. A combination of all three types of therapy is now standard.

Celecoxib (Celebrex®) is a drug that lessens the action of an enzyme called cyclooxygenase-2 (COX-2) also known as a "COX-2 inhibitor". It is an anti-inflammatory capsule (drug that reduces irritation) that is commonly used to treat arthritis. It is not a chemotherapy drug. Laboratory experiments have shown that such COX-2 inhibitors may increase the anti-cancer effect of radiotherapy, without increasing radiation side effects. This has not yet been confirmed in humans.The main purpose of this study is to confirm that celecoxib does not increase the side effects when given with radiotherapy and chemotherapy for rectal cancer. We shall also be looking at how effective the combination of radiotherapy, chemotherapy and celecoxib is in shrinking rectal cancer.

Condition	Intervention	Phase
Colorectal Neoplasms	Drug: Celecoxib	Phase I Phase II

MedlinePlus related topics:

Cancer Colorectal Cancer

ChemIDplus related topics:

Celecoxib 4-(5-(4-Methylphenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl)benzenesulfonamide

U.S. FDA Resources

Study Type:	Interventional
Study Design:	Treatment, Non-Randomized, Open Label, Uncontrolled, Single Group Assignment, Safety/Efficacy Study

Official Title:	A Phase I/II Trial of Celecoxib With Preoperative Chemoradiation for Resectable Rectal Cancer With In Vivo Analysis of Celecoxib Effector Pathways

Further study details as provided by University Health Network, Toronto:

Primary Outcome Measures:

- To assess the safety of celecoxib at a maximum dose of 400 mg orally twice daily in combination with preop RT and continuous infusional 5-FU. Incidence of dose-limiting toxicity (DLT) will be determined.
- To determine the efficacy of celecoxib in combination with preop RT and continuous infusional 5-FU. Pathologic complete response rate (pCR) will be used as the endpoint.

Secondary Outcome Measures:

Failure rate – locoregional and distant
Survival rate – disease-free and overall
Wound complication rate
Late toxicity incidence (RTOG criteria))
Sphincter preservation rate
Quality of life (FACT, EORTC)

Estimated Enrollment:	39
Study Start Date:	March 2004

Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

patients with resectable or potentially resectable adenocarcinoma of the rectum
clinical stage T2 N1-2 or T3-4 N0-2 (patients who require diverting loop colostomy are eligible)
age greater than 18 years, ECOG performance status < 2 (appendix, section 13.1)
biopsy proven adenocarcinoma, superior margin of the tumour within 15cm of the anal verge on rigid sigmoidoscopy

Exclusion Criteria:

Distant metastasis, Prior pelvic irradiation, Inflammatory bowel disease, Medical conditions which preclude radical therapy
History of malignancy within five years (except nonmelanoma skin cancer, CIN cervix)
Pregnancy
Hypersensitivity to celecoxib, NSAID, sulfonamides or 5-FU
Significant comorbid illness
History of peptic ulcer disease or NSAID-related gastrointestinal bleeding
Use of aspirin, other NSAID or coxib in the two weeks prior to study entry
Neutrophil count <1.5x109/L, platelet count <100x109/L, serum bilirubin >1.25xULN (upper limit of normal), AST/ALT >3xULN, serum creatinine >1.25xULN

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00188565

Contacts


Contact: John Kim, MD	416-946-2126	john.kim@rmp.uhn.on.ca

Locations


Canada, Ontario
	Princess Margaret Hospital	Recruiting
	Toronto, Ontario, Canada, M5G 2M9
	Contact: John Kim, MD 416-946-2126 john.kim@rmp.uhn.on.ca
	Principal Investigator: John Kim, MD

Sponsors and Collaborators

University Health Network, Toronto

Ontario Cancer Research Network

Princess Margaret Hospital, Canada

Investigators


Principal Investigator:	John Kim, MD	Princess Margaret Hospital, Canada

More Information

Study ID Numbers:	UHN REB 02-0130-C, Ontario Cancer ResearchNetwork
First Received:	September 12, 2005
Last Updated:	September 12, 2005
ClinicalTrials.gov Identifier:	NCT00188565
Health Authority:	Canada: Ethics Review Committee

Study placed in the following topic categories:

Digestive System Neoplasms

Celecoxib

Rectal Neoplasms

Gastrointestinal Diseases

Colonic Diseases

Intestinal Diseases

Rectal Diseases

Intestinal Neoplasms

Rectal neoplasm

Digestive System Diseases

Gastrointestinal Neoplasms

Rectal cancer

Colorectal Neoplasms

Additional relevant MeSH terms:

Anti-Inflammatory Agents

Molecular Mechanisms of Pharmacological Action

Cyclooxygenase Inhibitors

Physiological Effects of Drugs

Enzyme Inhibitors

Pharmacologic Actions

Neoplasms

Neoplasms by Site

Analgesics, Non-Narcotic

Sensory System Agents

Therapeutic Uses

Anti-Inflammatory Agents, Non-Steroidal

Analgesics

Peripheral Nervous System Agents

Antirheumatic Agents

Central Nervous System Agents

ClinicalTrials.gov processed this record on September 19, 2008

Sponsors and Collaborators:	University Health Network, Toronto Ontario Cancer Research Network Princess Margaret Hospital, Canada
Information provided by:	University Health Network, Toronto
ClinicalTrials.gov Identifier:	NCT00188565