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Aspirin for Dukes C and High Risk Dukes B Colorectal Cancers (ASCOLT)

Primary Purpose

Colorectal Cancer

Status
Active
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
placebo
Acetylsalicylic acid
Sponsored by
National Cancer Centre, Singapore
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring stage II colon cancer, stage III colon cancer, stage II rectal cancer, stage III rectal cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  • Male or female outpatient of ≥ 18 years of age or ≥ country's legal age for adult consent
  • Dukes C colon cancer, high risk Dukes B colon cancer, Dukes B rectal cancer or Dukes C rectal cancer (see Appendix 1 for definition of High Risk Dukes B)
  • Undergone complete resection of primary tumour
  • Completed standard therapy ( at least 3 months of chemotherapy ± radiotherapy )
  • Within 120 days of completion of standard therapy (surgery, chemotherapy ± radiotherapy)
  • ECOG performance status 0 to 2
  • Satisfactory haematological or biochemical functions (tests should be carried out within 8 weeks prior to randomisation): Results of clinical investigations carried out within 8 weeks prior to randomisation can be used in place of the required screening investigations. Patients with mild laboratory abnormalities can be included at the discretion by the site principal investigator, and after approval by ASCOLT Trial Management Group
  • ANC ≥ 1.0 x 109/L
  • Platelets ≥ 100 x 109/L
  • Creatinine clearance ≥ 30 mL/min
  • Total bilirubin ≤ 2.0 x the upper limit normal
  • AST & ALT ≤ 5 x the upper limit normal
  • Completed the following investigations
  • Colonoscopy(or CT colonogram(within 16 months prior to randomization)
  • Imaging of abdomen (CT or CT colonogram or MRI or PET or Ultrasound) within 16 months prior to randomization
  • Written informed consent

Exclusion Criteria

  • Pre-existing Familial adenomatous polyposis, inflammatory bowel disease or ulcerative colitis
  • Active gastritis or active peptic ulcer
  • History of continuous daily use of PPI more than 1 year prior to consent
  • Gastrointestinal bleeding within the past one year
  • Haemorrhagic diathesis (i.e. haemophilia)
  • Uncontrolled hypertension (untreated systolic blood pressure > 160 mmHg, or diastolic blood pressure > 95 mmHg)
  • History of recent cancers (except for colorectal cancers, non-melanoma skin cancers, basal cell carcinomas, squamous cell carcinomas) in the past 5 years
  • History of stroke, coronary arterial disease, angina, or vascular disease
  • Patients who are on current long term treatment (≥ 4 consecutive weeks) with Aspirin, NSAID or Cox-2 inhibitors
  • History of erosive GERD or active erosive GERD on gastroscopy.
  • Patient on active current treatment of antiplatelet agents (i.e. off-study Aspirin, clopidogrel, ticlopidine)
  • Patient receiving active treatment of anticoagulants (i.e. warfarin, low molecular weight heparins)
  • Pregnant, lactating, or not using adequate contraception
  • Patient having known allergy to NSAID or Aspirin
  • Unexplained rise of CEA (i.e. smoker with elevated CEA will not be excluded)
  • Patient on other investigational drug
  • Patients with HNPCC (Lynch Syndrome)

Sites / Locations

  • Bankstown-Lidcombe Hospital Bankstown Cancer Centre
  • Macarthur Cancer Therapy Centre
  • Chris O'Brien Lifehouse, Clinical Research Centre
  • Coffs Harbour Health Campus North Coast Cancer Institute
  • Central Coast Cancer Centre Gosford Hospital
  • Newcastle private Hospital
  • Orange Health Service
  • Port Macquarie Base Hospital North Coast Cancer Institute
  • Northern Cancer Institute, St Leonards
  • St Vincent's Hospital
  • Northwest Cancer Centre Tamworth Hospital
  • The Tweed Hospital
  • Calvary Mater Newcastle Hospital
  • Royal Darwin Hospital
  • Townsville Hospital
  • Royal Brisbane and Women's Hospital
  • Toowoomba Hospital
  • Lyell McEwin Hospital
  • Royal Hobart Hospital
  • Border Medical Oncology Research Unit
  • Ballarat Regional Integrated Cancer Centre
  • Barwon Health Andrew Love Cancer Centre
  • Austin Health Cancer Clinical Trials
  • Launceston General Hospital
  • Monash Health Medical Oncology
  • Mildura Base Hospital
  • Goulburn Valley Health
  • St John of God Healthcare Southwest Oncology
  • Sir Charles Gairdner Hospital
  • St John of God Hospital Subiaco
  • Beijing University Cancer Hospital
  • The First People's Hospital of Foshan City
  • Sixth Affiliated Hospital
  • Guangdong General Hospital
  • Sun Yat Sen University Cancer Center
  • Zhongshan City People's Hospital
  • Jinan Central Hospital
  • Yantai Yuhuangding Hospital
  • The Second Affiliated Hospital of Zhejiang University
  • Queen Mary Hospital - Hong Kong
  • Affiliated Hospital of Nantong University
  • Kidwai Memorial Institute of Oncology
  • G. Kuppuswamy Naidu Memorial Hospital
  • Nizam's Institute of Medical Sciences
  • Tata Memorial Hospital
  • All India Institute of Medical Sciences
  • Regional Cancer Center
  • Christian Medical College and Hospital
  • Dharmais Cancer Hospital
  • Cipto Mangunkusumo General Hospital
  • Rumah Sakit RSUP Dr. Sardjito
  • Hallym University Sacred Heart Hospital
  • Severance Hospital
  • Ajou University Hospital
  • Sarawak General Hospital
  • Hospital Kuala Lumpur
  • University of Malaysia Medical Center
  • University Kebangsaan Malaysia Medical Center
  • Christchurch Public Hospital
  • Dunedin Hospital
  • King Fahad Medical City
  • National Cancer Centre - Singapore
  • Johns Hopkins Singapore International Medical Center
  • National Cancer Institute
  • Shuang Ho Hospital
  • Koo Foundation Sun Yat Sen Cancer Centre
  • Taipei Medical University Hospital
  • Wan Fang Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

acetylsalicylic acid

Placebo

Arm Description

200mg OD for 3 years

200mg OD for 3 years

Outcomes

Primary Outcome Measures

Disease-free survival

Secondary Outcome Measures

Overall survival

Full Information

First Posted
November 29, 2007
Last Updated
September 9, 2021
Sponsor
National Cancer Centre, Singapore
Collaborators
University of Oxford, Australasian Gastro-Intestinal Trials Group, INDOX Cancer Research Network
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1. Study Identification

Unique Protocol Identification Number
NCT00565708
Brief Title
Aspirin for Dukes C and High Risk Dukes B Colorectal Cancers
Acronym
ASCOLT
Official Title
Aspirin for Dukes C and High Risk Dukes B Colorectal Cancers - An International, Multi-Center, Double Blind, Randomized Placebo Controlled Phase III Trial
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Active, not recruiting
Study Start Date
December 2008 (undefined)
Primary Completion Date
December 2025 (Anticipated)
Study Completion Date
June 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
National Cancer Centre, Singapore
Collaborators
University of Oxford, Australasian Gastro-Intestinal Trials Group, INDOX Cancer Research Network

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
We hypothesize through this randomized, placebo-controlled adjuvant study, that Aspirin in patients with dukes C or high risk dukes B colorectal cancer (ASCOLT) can improve survival in this patient population over placebo control. If indeed found to be beneficial, because aspirin is cheap and easy to administer, it will positively impact the lives of many individuals in Asia and globally. STUDY OBJECTIVE To assess the effectiveness of Aspirin against placebo control in patients with dukes C or high risk dukes B colorectal cancer in terms of Disease Free Survival (DFS) and Overall Survival (OS) Primary endpoints DFS among all eligible subjects (high risk Dukes B colon cancer, Dukes C colon cancer and rectal cancer patient sub-groups); DFS among patients with colon cancer (high-risk Dukes B and Dukes C colon cancer). Secondary endpoints Overall survival (OS) over 5 years DFS and OS in Chinese, Malay, Indian and other ethnic groups Resected high risk Dukes B colon cancer, Dukes C colon cancer and rectal cancer sub-groups, individually Compliant versus non-compliant subjects PIK3CA mutated tumors (where samples are available)
Detailed Description
Aspirin in patients with dukes C or high risk dukes B colorectal cancer can improve survival in this patient population over placebo control. Eligible patients will be randomized to treatment arms, using the following stratification factors: Study Centre Tumour Type Type of adjuvant chemotherapy received(exposed/not exposed to oxaliplatin Patients will be randomized over a 5 years' time period. After randomization, patient will have 3 monthly assessments with treatment for 3 years followed by 6 monthly assessments for additional 2 years follow-up

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer
Keywords
stage II colon cancer, stage III colon cancer, stage II rectal cancer, stage III rectal cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
1587 (Actual)

8. Arms, Groups, and Interventions

Arm Title
acetylsalicylic acid
Arm Type
Experimental
Arm Description
200mg OD for 3 years
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
200mg OD for 3 years
Intervention Type
Other
Intervention Name(s)
placebo
Intervention Description
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Acetylsalicylic acid
Other Intervention Name(s)
Aspirin
Intervention Description
Adjuvant Therapy
Primary Outcome Measure Information:
Title
Disease-free survival
Time Frame
5 years
Secondary Outcome Measure Information:
Title
Overall survival
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Male or female outpatient of ≥ 18 years of age or ≥ country's legal age for adult consent Dukes C colon cancer, high risk Dukes B colon cancer, Dukes B rectal cancer or Dukes C rectal cancer (see Appendix 1 for definition of High Risk Dukes B) Undergone complete resection of primary tumour Completed standard therapy ( at least 3 months of chemotherapy ± radiotherapy ) Within 120 days of completion of standard therapy (surgery, chemotherapy ± radiotherapy) ECOG performance status 0 to 2 Satisfactory haematological or biochemical functions (tests should be carried out within 8 weeks prior to randomisation): Results of clinical investigations carried out within 8 weeks prior to randomisation can be used in place of the required screening investigations. Patients with mild laboratory abnormalities can be included at the discretion by the site principal investigator, and after approval by ASCOLT Trial Management Group ANC ≥ 1.0 x 109/L Platelets ≥ 100 x 109/L Creatinine clearance ≥ 30 mL/min Total bilirubin ≤ 2.0 x the upper limit normal AST & ALT ≤ 5 x the upper limit normal Completed the following investigations Colonoscopy(or CT colonogram(within 16 months prior to randomization) Imaging of abdomen (CT or CT colonogram or MRI or PET or Ultrasound) within 16 months prior to randomization Written informed consent Exclusion Criteria Pre-existing Familial adenomatous polyposis, inflammatory bowel disease or ulcerative colitis Active gastritis or active peptic ulcer History of continuous daily use of PPI more than 1 year prior to consent Gastrointestinal bleeding within the past one year Haemorrhagic diathesis (i.e. haemophilia) Uncontrolled hypertension (untreated systolic blood pressure > 160 mmHg, or diastolic blood pressure > 95 mmHg) History of recent cancers (except for colorectal cancers, non-melanoma skin cancers, basal cell carcinomas, squamous cell carcinomas) in the past 5 years History of stroke, coronary arterial disease, angina, or vascular disease Patients who are on current long term treatment (≥ 4 consecutive weeks) with Aspirin, NSAID or Cox-2 inhibitors History of erosive GERD or active erosive GERD on gastroscopy. Patient on active current treatment of antiplatelet agents (i.e. off-study Aspirin, clopidogrel, ticlopidine) Patient receiving active treatment of anticoagulants (i.e. warfarin, low molecular weight heparins) Pregnant, lactating, or not using adequate contraception Patient having known allergy to NSAID or Aspirin Unexplained rise of CEA (i.e. smoker with elevated CEA will not be excluded) Patient on other investigational drug Patients with HNPCC (Lynch Syndrome)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John Chia, MBBS, MRCP
Organizational Affiliation
National Cancer Centre, Singapore
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Raghib Ali, MBBS, MRCP
Organizational Affiliation
University of Oxford
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Han Chong Toh, MD, MBBS, MRCP
Organizational Affiliation
National Cancer Centre, Singapore
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Eva Segelov, MBBS,FRACP,PhD
Organizational Affiliation
St Vincent's Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Bankstown-Lidcombe Hospital Bankstown Cancer Centre
City
Bankstown
State/Province
New South Wales
Country
Australia
Facility Name
Macarthur Cancer Therapy Centre
City
Campbelltown
State/Province
New South Wales
Country
Australia
Facility Name
Chris O'Brien Lifehouse, Clinical Research Centre
City
Camperdown
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
Facility Name
Coffs Harbour Health Campus North Coast Cancer Institute
City
Coffs Harbour
State/Province
New South Wales
ZIP/Postal Code
2450
Country
Australia
Facility Name
Central Coast Cancer Centre Gosford Hospital
City
Gosford
State/Province
New South Wales
ZIP/Postal Code
2050
Country
Australia
Facility Name
Newcastle private Hospital
City
New Lambton Heights
State/Province
New South Wales
Country
Australia
Facility Name
Orange Health Service
City
Orange
State/Province
New South Wales
Country
Australia
Facility Name
Port Macquarie Base Hospital North Coast Cancer Institute
City
Port Macquarie
State/Province
New South Wales
ZIP/Postal Code
2444
Country
Australia
Facility Name
Northern Cancer Institute, St Leonards
City
St Leonards
State/Province
New South Wales
ZIP/Postal Code
2065
Country
Australia
Facility Name
St Vincent's Hospital
City
Sydney
State/Province
New South Wales
Country
Australia
Facility Name
Northwest Cancer Centre Tamworth Hospital
City
Tamworth
State/Province
New South Wales
ZIP/Postal Code
2340
Country
Australia
Facility Name
The Tweed Hospital
City
Tweed Heads
State/Province
New South Wales
Country
Australia
Facility Name
Calvary Mater Newcastle Hospital
City
Waratah
State/Province
New South Wales
Country
Australia
Facility Name
Royal Darwin Hospital
City
Tiwi
State/Province
Northern Territory
Country
Australia
Facility Name
Townsville Hospital
City
Douglas
State/Province
Queensland
ZIP/Postal Code
4814
Country
Australia
Facility Name
Royal Brisbane and Women's Hospital
City
Herston
State/Province
Queensland
Country
Australia
Facility Name
Toowoomba Hospital
City
Toowoomba
State/Province
Queensland
Country
Australia
Facility Name
Lyell McEwin Hospital
City
Elizabeth Vale
State/Province
South Australia
ZIP/Postal Code
5112
Country
Australia
Facility Name
Royal Hobart Hospital
City
Hobart
State/Province
Tasmania
ZIP/Postal Code
7000
Country
Australia
Facility Name
Border Medical Oncology Research Unit
City
Albury
State/Province
Victoria
Country
Australia
Facility Name
Ballarat Regional Integrated Cancer Centre
City
Ballarat
State/Province
Victoria
ZIP/Postal Code
3350
Country
Australia
Facility Name
Barwon Health Andrew Love Cancer Centre
City
Geelong
State/Province
Victoria
Country
Australia
Facility Name
Austin Health Cancer Clinical Trials
City
Heidelberg
State/Province
Victoria
Country
Australia
Facility Name
Launceston General Hospital
City
Launceston
State/Province
Victoria
Country
Australia
Facility Name
Monash Health Medical Oncology
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3165
Country
Australia
Facility Name
Mildura Base Hospital
City
Mildura
State/Province
Victoria
Country
Australia
Facility Name
Goulburn Valley Health
City
Shepparton
State/Province
Victoria
ZIP/Postal Code
3630
Country
Australia
Facility Name
St John of God Healthcare Southwest Oncology
City
Warrnambool
State/Province
Victoria
ZIP/Postal Code
3280
Country
Australia
Facility Name
Sir Charles Gairdner Hospital
City
Nedlands
State/Province
Western Australia
Country
Australia
Facility Name
St John of God Hospital Subiaco
City
Subiaco
State/Province
Western Australia
Country
Australia
Facility Name
Beijing University Cancer Hospital
City
Beijing
State/Province
Beijing
Country
China
Facility Name
The First People's Hospital of Foshan City
City
Foshan
State/Province
Guangdong
ZIP/Postal Code
528000
Country
China
Facility Name
Sixth Affiliated Hospital
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
510655
Country
China
Facility Name
Guangdong General Hospital
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
Sun Yat Sen University Cancer Center
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
Zhongshan City People's Hospital
City
Zhongshan
State/Province
Guangdong
Country
China
Facility Name
Jinan Central Hospital
City
Jinan
State/Province
Shandong
Country
China
Facility Name
Yantai Yuhuangding Hospital
City
Yantai
State/Province
Shandong
Country
China
Facility Name
The Second Affiliated Hospital of Zhejiang University
City
Hangzhou
State/Province
Zhejiang
Country
China
Facility Name
Queen Mary Hospital - Hong Kong
City
Hong Kong
Country
China
Facility Name
Affiliated Hospital of Nantong University
City
Nantong
Country
China
Facility Name
Kidwai Memorial Institute of Oncology
City
Bangalore
ZIP/Postal Code
560029
Country
India
Facility Name
G. Kuppuswamy Naidu Memorial Hospital
City
Coimbatore
ZIP/Postal Code
641 037
Country
India
Facility Name
Nizam's Institute of Medical Sciences
City
Hyderabad
ZIP/Postal Code
500 082
Country
India
Facility Name
Tata Memorial Hospital
City
Mumbai
ZIP/Postal Code
400012
Country
India
Facility Name
All India Institute of Medical Sciences
City
New Delhi
ZIP/Postal Code
110029
Country
India
Facility Name
Regional Cancer Center
City
Trivandrum
ZIP/Postal Code
695011
Country
India
Facility Name
Christian Medical College and Hospital
City
Vellore
ZIP/Postal Code
632002
Country
India
Facility Name
Dharmais Cancer Hospital
City
Jakarta
ZIP/Postal Code
11420
Country
Indonesia
Facility Name
Cipto Mangunkusumo General Hospital
City
Jakarta
Country
Indonesia
Facility Name
Rumah Sakit RSUP Dr. Sardjito
City
Yogyakarta
ZIP/Postal Code
55284
Country
Indonesia
Facility Name
Hallym University Sacred Heart Hospital
City
Anyang-si
State/Province
Gyeonggi-do
Country
Korea, Republic of
Facility Name
Severance Hospital
City
Seoul
Country
Korea, Republic of
Facility Name
Ajou University Hospital
City
Suwon-si
Country
Korea, Republic of
Facility Name
Sarawak General Hospital
City
Kuching
State/Province
Sarawak
Country
Malaysia
Facility Name
Hospital Kuala Lumpur
City
Kuala Lumpur
ZIP/Postal Code
50586
Country
Malaysia
Facility Name
University of Malaysia Medical Center
City
Kuala Lumpur
ZIP/Postal Code
59100
Country
Malaysia
Facility Name
University Kebangsaan Malaysia Medical Center
City
Kuala Lumpur
Country
Malaysia
Facility Name
Christchurch Public Hospital
City
Christchurch
ZIP/Postal Code
8140
Country
New Zealand
Facility Name
Dunedin Hospital
City
Dunedin
Country
New Zealand
Facility Name
King Fahad Medical City
City
Riyadh
ZIP/Postal Code
11525
Country
Saudi Arabia
Facility Name
National Cancer Centre - Singapore
City
Singapore
ZIP/Postal Code
169610
Country
Singapore
Facility Name
Johns Hopkins Singapore International Medical Center
City
Singapore
Country
Singapore
Facility Name
National Cancer Institute
City
Maharagama
Country
Sri Lanka
Facility Name
Shuang Ho Hospital
City
Taipei
ZIP/Postal Code
23561
Country
Taiwan
Facility Name
Koo Foundation Sun Yat Sen Cancer Centre
City
Taipei
Country
Taiwan
Facility Name
Taipei Medical University Hospital
City
Taipei
Country
Taiwan
Facility Name
Wan Fang Hospital
City
Taipei
Country
Taiwan

12. IPD Sharing Statement

Citations:
PubMed Identifier
32293940
Citation
Segelov E, Prenen H, Day D, Macintyre CR, Foo EMJ, Ali R, Wang Q, Wei X, Lopes GL Jr, Ding K, Chen G, Chia JWK, Toh HC; ASCOLT Investigators. Impact of the COVID-19 Epidemic on a Pan-Asian Academic Oncology Clinical Trial. JCO Glob Oncol. 2020 Apr;6:585-588. doi: 10.1200/GO.20.00072. No abstract available.
Results Reference
derived
PubMed Identifier
22168568
Citation
Ali R, Toh HC, Chia WK; ASCOLT Trial Investigators. The utility of Aspirin in Dukes C and High Risk Dukes B Colorectal cancer--the ASCOLT study: study protocol for a randomized controlled trial. Trials. 2011 Dec 14;12:261. doi: 10.1186/1745-6215-12-261.
Results Reference
derived
Links:
URL
https://www.ascolt.org
Description
Trial Website

Learn more about this trial

Aspirin for Dukes C and High Risk Dukes B Colorectal Cancers

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