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Dolcanatide in Preventing Colorectal Cancer in Healthy Volunteers

Primary Purpose

Colorectal Carcinoma

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Dolcanatide
Laboratory Biomarker Analysis
Placebo Administration
Questionnaire Administration
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Colorectal Carcinoma

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • PRE-REGISTRATION INCLUSION
  • Able to understand and willingness to sign a written informed consent document and follow study procedures
  • Willing to abstain from grapefruit juice during study
  • Willing to employ adequate contraception for men and women of childbearing potential; Note: acceptable methods include double barrier methods, intrauterine device (IUD), postmenopausal status documented by serum follicle stimulating hormone (FSH), and/or documentation of surgical sterilization
  • Willing to provide blood and tissue specimens for research purposes
  • REGISTRATION INCLUSION
  • Normal organ function and have normal laboratory findings without clinically significant findings
  • Leukocytes >= 3 x 10^3/microliter (B/L)
  • Absolute neutrophil count >= 1.5 x 10^3/microliter (B/L)
  • Platelets >= 100 x 10^3/microliter (B/L)
  • Total bilirubin within normal institutional limits
  • Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/ alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 1.5 x institutional upper limit of normal (ULN)
  • Creatinine =< institutional upper limit of normal
  • Body mass index < 35 kg/m^2
  • No findings in the rectum of advanced adenoma, chronic inflammation, or cancer

Exclusion Criteria:

  • PRE-REGISTRATION EXCLUSION
  • Documented history of advanced adenomas (>= 1 cm in maximal diameter, >= 3 in total number, villous morphology, or high-grade dysplasia) or colorectal cancer
  • Family history of polyposis syndrome (e.g., familial adenomatous polyposis [FAP], hereditary nonpolyposis colorectal cancer [HNPCC]) or colorectal cancer (first degree relatives younger than 60 years old)
  • History of gastroparesis
  • History of surgery involving the luminal gastrointestinal (GI) tract, including bariatric surgery; exception: prior appendectomy >= 60 days prior to pre-registration is not an exclusion criterion
  • History of celiac disease
  • Inflammatory bowel disease (Crohn's disease, ulcerative colitis)
  • Previous diagnosis of irritable bowel syndrome, chronic constipation, functional bowel disorders, colonic motility disorder, or opioid-induced constipation
  • Any malignancy within 3 years of baseline; exception: participants with a history of basal cell or squamous cell skin cancer may be enrolled at the discretion of the investigator
  • Currently receiving any other investigational agents
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to dolcanatide or to any of the excipients
  • History of difficulty with sigmoidoscopy or abnormal colorectal anatomy
  • Uncontrolled current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Pregnant or lactating women
  • Current use of laxatives more than 3 times per week
  • Current use of >= 5 cigarettes/day
  • Current use of >= 3 alcoholic drinks/day
  • Use of anti-coagulants or anti-platelet agents within 5 days prior to anticipated sigmoidoscopy; exception: individuals taking aspirin will not be excluded and will not be subject to a wash-out period
  • History of bleeding/coagulation problems
  • Any medical condition reported by the participant or documented in the medical record that is judged by the investigator to constitute a risk to safe participation
  • Known or suspected mechanical gastrointestinal obstruction
  • REGISTRATION EXCLUSION
  • Sigmoidoscopy finding requiring clinical intervention
  • Use of any illicit or illegal substances detected by urinary drug screen

Sites / Locations

  • Thomas Jefferson University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Arm A (dolcanatide)

Arm B (placebo)

Arm Description

Participants receive dolcanatide PO QD for 7 days.

Participants receive placebo PO QD for 7 days.

Outcomes

Primary Outcome Measures

Pharmacological Effect on Cyclic Guanosine Monophosphate (cGMP) Levels for Dolcanatide Arm Versus (vs.) Placebo, as Measured by the Differences in Mean cGMP Levels After 7 Days of Intervention
Pharmacological effect on cyclic guanosine monophosphate (cGMP) levels for dolcanatide arm versus (vs.) placebo, where this effect is defined as the arithmetic difference in mean cGMP levels before and after 7 days of dolcanatide from subject biopsies. This represents the increase in cGMP stimulated by 7 days of dolcanatide in an individual subject. The mean cGMP value will be calculated based on 6 biopsies collected from the rectum during a flexible sigmoidoscopy procedure. Each biopsy was analyzed in triplicate using a commercially available EIA kit.

Secondary Outcome Measures

Pharmacodynamic (PD) Response Rate
Each participant will be assessed for PD response. The calculation is based on the standardized difference in means for the pharmacological effect on cGMP levels at the participant level, where a subject with a z >= 1.645 will be considered a PD responder. A participant with a z < 1.645 will be considered a non-responder. The PD response rate (percentage) of patients are summarized below by arm.
Percentage of Participants With Grade 3 or Higher Diarrhea Per National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
The overall adverse event rates (percentages) for grade 3 or higher adverse events regardless of attribution to treatment are reported below. The percentages below are summarized for Diarrhea.

Full Information

First Posted
October 2, 2017
Last Updated
May 19, 2021
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT03300570
Brief Title
Dolcanatide in Preventing Colorectal Cancer in Healthy Volunteers
Official Title
Phase I Double-Blind, Placebo-Controlled Trial of 27 mg Dolcanatide (SP-333) to Demonstrate Colorectal Bioactivity in Healthy Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Completed
Study Start Date
July 27, 2018 (Actual)
Primary Completion Date
January 2, 2019 (Actual)
Study Completion Date
May 17, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cancer Institute (NCI)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This phase I trial studies how well dolcanatide works in preventing colorectal cancer in healthy participants. Dolcanatide is similar to a natural hormone released into the intestine. It is thought that people who have low levels of the hormone are more likely to get colon cancer. It may be possible to prevent colon cancer by giving a drug that is similar to the hormone, such as dolcanatide.
Detailed Description
PRIMARY OBJECTIVES: I. To identify the ability of dolcanatide (SP333), when administered as a single daily dose of 27 mg x 7 days, to induce a direct pharmacological effect on cGMP levels, based on biopsy samples from the rectum obtained pre- and post-intervention, as compared to placebo. SECONDARY OBJECTIVES: I. To assess the pharmacodynamic (PD) response rate between arms (dolcanatide versus placebo). II. To confirm the safety and tolerability of dolcanatide, as compared to placebo. OUTLINE: Participants are randomized to 1 of 2 arms. ARM A: Participants receive dolcanatide orally (PO) once daily (QD) for 7 days. ARM B: Participants receive placebo PO QD for 7 days. After completion of study, participants are followed up at 21 and 51 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Carcinoma

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
27 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm A (dolcanatide)
Arm Type
Experimental
Arm Description
Participants receive dolcanatide PO QD for 7 days.
Arm Title
Arm B (placebo)
Arm Type
Placebo Comparator
Arm Description
Participants receive placebo PO QD for 7 days.
Intervention Type
Drug
Intervention Name(s)
Dolcanatide
Other Intervention Name(s)
SP 333, SP-333, SP333
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
Laboratory Biomarker Analysis
Intervention Description
Correlative studies
Intervention Type
Other
Intervention Name(s)
Placebo Administration
Intervention Description
Given PO
Intervention Type
Other
Intervention Name(s)
Questionnaire Administration
Intervention Description
Ancillary studies
Primary Outcome Measure Information:
Title
Pharmacological Effect on Cyclic Guanosine Monophosphate (cGMP) Levels for Dolcanatide Arm Versus (vs.) Placebo, as Measured by the Differences in Mean cGMP Levels After 7 Days of Intervention
Description
Pharmacological effect on cyclic guanosine monophosphate (cGMP) levels for dolcanatide arm versus (vs.) placebo, where this effect is defined as the arithmetic difference in mean cGMP levels before and after 7 days of dolcanatide from subject biopsies. This represents the increase in cGMP stimulated by 7 days of dolcanatide in an individual subject. The mean cGMP value will be calculated based on 6 biopsies collected from the rectum during a flexible sigmoidoscopy procedure. Each biopsy was analyzed in triplicate using a commercially available EIA kit.
Time Frame
Baseline to 7 days
Secondary Outcome Measure Information:
Title
Pharmacodynamic (PD) Response Rate
Description
Each participant will be assessed for PD response. The calculation is based on the standardized difference in means for the pharmacological effect on cGMP levels at the participant level, where a subject with a z >= 1.645 will be considered a PD responder. A participant with a z < 1.645 will be considered a non-responder. The PD response rate (percentage) of patients are summarized below by arm.
Time Frame
Baseline to 7 days
Title
Percentage of Participants With Grade 3 or Higher Diarrhea Per National Cancer Institute Common Terminology Criteria for Adverse Events Version 4.0
Description
The overall adverse event rates (percentages) for grade 3 or higher adverse events regardless of attribution to treatment are reported below. The percentages below are summarized for Diarrhea.
Time Frame
Up to 21 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: PRE-REGISTRATION INCLUSION Able to understand and willingness to sign a written informed consent document and follow study procedures Willing to abstain from grapefruit juice during study Willing to employ adequate contraception for men and women of childbearing potential; Note: acceptable methods include double barrier methods, intrauterine device (IUD), postmenopausal status documented by serum follicle stimulating hormone (FSH), and/or documentation of surgical sterilization Willing to provide blood and tissue specimens for research purposes REGISTRATION INCLUSION Normal organ function and have normal laboratory findings without clinically significant findings Leukocytes >= 3 x 10^3/microliter (B/L) Absolute neutrophil count >= 1.5 x 10^3/microliter (B/L) Platelets >= 100 x 10^3/microliter (B/L) Total bilirubin within normal institutional limits Aspartate aminotransferase (AST) (serum glutamic-oxaloacetic transaminase [SGOT])/ alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 1.5 x institutional upper limit of normal (ULN) Creatinine =< institutional upper limit of normal Body mass index < 35 kg/m^2 No findings in the rectum of advanced adenoma, chronic inflammation, or cancer Exclusion Criteria: PRE-REGISTRATION EXCLUSION Documented history of advanced adenomas (>= 1 cm in maximal diameter, >= 3 in total number, villous morphology, or high-grade dysplasia) or colorectal cancer Family history of polyposis syndrome (e.g., familial adenomatous polyposis [FAP], hereditary nonpolyposis colorectal cancer [HNPCC]) or colorectal cancer (first degree relatives younger than 60 years old) History of gastroparesis History of surgery involving the luminal gastrointestinal (GI) tract, including bariatric surgery; exception: prior appendectomy >= 60 days prior to pre-registration is not an exclusion criterion History of celiac disease Inflammatory bowel disease (Crohn's disease, ulcerative colitis) Previous diagnosis of irritable bowel syndrome, chronic constipation, functional bowel disorders, colonic motility disorder, or opioid-induced constipation Any malignancy within 3 years of baseline; exception: participants with a history of basal cell or squamous cell skin cancer may be enrolled at the discretion of the investigator Currently receiving any other investigational agents History of allergic reactions attributed to compounds of similar chemical or biologic composition to dolcanatide or to any of the excipients History of difficulty with sigmoidoscopy or abnormal colorectal anatomy Uncontrolled current illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements Pregnant or lactating women Current use of laxatives more than 3 times per week Current use of >= 5 cigarettes/day Current use of >= 3 alcoholic drinks/day Use of anti-coagulants or anti-platelet agents within 5 days prior to anticipated sigmoidoscopy; exception: individuals taking aspirin will not be excluded and will not be subject to a wash-out period History of bleeding/coagulation problems Any medical condition reported by the participant or documented in the medical record that is judged by the investigator to constitute a risk to safe participation Known or suspected mechanical gastrointestinal obstruction REGISTRATION EXCLUSION Sigmoidoscopy finding requiring clinical intervention Use of any illicit or illegal substances detected by urinary drug screen
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David S Weinberg
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Thomas Jefferson University Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States

12. IPD Sharing Statement

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Dolcanatide in Preventing Colorectal Cancer in Healthy Volunteers

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