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Chemoprevention of Gastric Cancer by Intervention With Helicobacter Pylori and Cyclooxygenase Pathway

Primary Purpose

Stomach Neoplasms

Status
Unknown status
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Triple therapy for H. pylori infection
Cox-2 inhibitor
Sponsored by
Hospital Authority, Hong Kong
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional prevention trial for Stomach Neoplasms focused on measuring Gastric cancer

Eligibility Criteria

45 Years - undefined (Adult, Older Adult)All Sexes

Inclusion Criteria:

  1. Subject demonstrates a willingness to participate in the study as indicated by written informed consent.
  2. Male or female subject is at least 45 years of age.
  3. Subject indicates a willingness to abstain from the use of all NSAIDs (including over-the-counter products) and aspirin for the duration of the study.
  4. Female subject of childbearing potential has been using an effective means of contraception for 1 week prior to the preliminary visit. She also has agreed to remain abstinent, or to use oral birth control pills or single-barrier contraception (partner using condom or subject using diaphragm, contraceptive sponge or IUD) beginning at the preliminary visit and continuing till the end of the study. Women who are postmenopausal or status post-hysterectomy or tubal ligation are exempt from this requirement. (Postmenopausal is defined as no menses for the previous 1 year. If cessation of menses is within 18 months, FSH must be documented as elevated into the postmenopausal range before entry).
  5. Subject is judged to be in stable health based on medical history, physical examination, and routine laboratory tests.

Exclusion Criteria:

According to medical history

  1. Subject has a bleeding diathesis or requires anticoagulant therapy.
  2. Subject has uncontrolled hypertension. (Note: Subjects with medically controlled hypertension [diastolic blood pressure <95 mm Hg, systolic blood pressure <165 mm Hg] may participate.)
  3. Subject has a history of stroke or transient ischemic attack within the past 2 years.
  4. Subject has a history of hepatitis/hepatic disease that has been active within the previous 2 years.
  5. Subject has angina or congestive heart failure, with symptoms that occur at rest or minimal activity, or has a history of myocardial infarction within the past 1 year.
  6. Subject has a history of neoplastic disease within the previous 10 years. Exceptions: subjects with malignancy successfully treated >10 years prior to screening, where, in the judgment of the investigator and treating physician, there has been no evidence of recurrence from the time of treatment through the time of screening.
  7. Subject has a history of esophageal or gastric surgery.
  8. Subject has undergone previous small or large bowel resection.
  9. Subject has a history of inflammatory bowel disease (ulcerative colitis or Crohn's disease).
  10. Subject is allergic to paracetamol or subject has hypersensitivity (e.g., all or part of the syndrome of nasal polyps, angioedema, and bronchospastic reactivity) to aspirin, paracetamol, or other NSAIDs. NOTE: Subjects with a history of idiosyncratic allergic reaction (e.g., rash) to a single NSAID in the past but who tolerated at least 2 other NSAID medications without hypersensitivity reactions may participate.
  11. Subject is expected to need chronic NSAID treatment during the trial and/or subject has been taking NSAIDs (including salicylates or other aspirin-containing compounds) on a chronic basis.
  12. Subject has had ongoing or is expected to require treatment with any of the following: Ticlopidine, clopidrogel, or regular doses of aspirin, including "low-dose" aspirin, e.g., to prevent complications of vascular disease. Subjects may not discontinue an established course of anti-platelet therapy in order to enter this study.

Sites / Locations

  • China

Outcomes

Primary Outcome Measures

Regression or prevent progression of various precancerous gastric conditions including gastric atrophy, intestinal metaplasia and dysplasia
Changes in cell proliferation, apoptosis and oncogene expressions

Secondary Outcome Measures

The incidence of gastric cancer in a high risk area

Full Information

First Posted
July 6, 2007
Last Updated
July 6, 2010
Sponsor
Hospital Authority, Hong Kong
Collaborators
The University of Hong Kong
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1. Study Identification

Unique Protocol Identification Number
NCT00498134
Brief Title
Chemoprevention of Gastric Cancer by Intervention With Helicobacter Pylori and Cyclooxygenase Pathway
Official Title
Chemoprevention of Gastric Cancer by Intervention With Helicobacter Pylori and Cyclooxygenase Pathway
Study Type
Interventional

2. Study Status

Record Verification Date
July 2010
Overall Recruitment Status
Unknown status
Study Start Date
March 2004 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
April 2013 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Hospital Authority, Hong Kong
Collaborators
The University of Hong Kong

4. Oversight

5. Study Description

Brief Summary
Gastric cancer is the second leading cause of cancer deaths in the World. In China, gastric cancer exceeds all other cancer mortality except lung cancer. Helicobacter pylori infection is an important cause of gastric cancer. We have previously started a randomized placebo-controlled chemoprevention trial in Changle in 1994 to address the issue of whether eradication of H. pylori alone is able to prevent or reduce the risk of gastric cancer. The project involved 1600 subjects and is still ongoing. On the other hand, our laboratory research indicated that an abnormally high expression of an enzyme cyclooxygenase-2 was found in gastric cancer and inhibition of this enzyme by a new drug (specific cyclooxygenase-2 inhibitor) could kill the cancer cells. The same drug is approved now for use in treatment of hereditary colon cancer syndrome (Familial Adenomatous Polyposis, FAP), in the same rationale of tumour suppressive property of this drug. We are now initiating a second chemoprevention study to assess the addition of this specific cyclooxygenase-2 inhibitor together with eradication of H. pylori on prevention or reduction of the risk of gastric cancer and to assess whether the combination can reverse pre-cancerous lesions in the stomach in the high-risk population. The proposed site is Shangdong, China with very high prevalence of pre-cancerous lesions in asymptomatic H. pylori carriers. We plan to recruit 1500 H. pylori positive subjects for this randomized placebo-controlled study. H. pylori carriers will be randomized to receive treatment for the infection or placebo, followed by specific COX-2 inhibitor or placebo for 3 years. The results will have significant impact on prevention of gastric cancer on a national scale and worldwide.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stomach Neoplasms
Keywords
Gastric cancer

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
1200 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Triple therapy for H. pylori infection
Intervention Type
Drug
Intervention Name(s)
Cox-2 inhibitor
Primary Outcome Measure Information:
Title
Regression or prevent progression of various precancerous gastric conditions including gastric atrophy, intestinal metaplasia and dysplasia
Time Frame
3 years
Title
Changes in cell proliferation, apoptosis and oncogene expressions
Time Frame
3 years
Secondary Outcome Measure Information:
Title
The incidence of gastric cancer in a high risk area
Time Frame
5-10 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
45 Years
Eligibility Criteria
Inclusion Criteria: Subject demonstrates a willingness to participate in the study as indicated by written informed consent. Male or female subject is at least 45 years of age. Subject indicates a willingness to abstain from the use of all NSAIDs (including over-the-counter products) and aspirin for the duration of the study. Female subject of childbearing potential has been using an effective means of contraception for 1 week prior to the preliminary visit. She also has agreed to remain abstinent, or to use oral birth control pills or single-barrier contraception (partner using condom or subject using diaphragm, contraceptive sponge or IUD) beginning at the preliminary visit and continuing till the end of the study. Women who are postmenopausal or status post-hysterectomy or tubal ligation are exempt from this requirement. (Postmenopausal is defined as no menses for the previous 1 year. If cessation of menses is within 18 months, FSH must be documented as elevated into the postmenopausal range before entry). Subject is judged to be in stable health based on medical history, physical examination, and routine laboratory tests. Exclusion Criteria: According to medical history Subject has a bleeding diathesis or requires anticoagulant therapy. Subject has uncontrolled hypertension. (Note: Subjects with medically controlled hypertension [diastolic blood pressure <95 mm Hg, systolic blood pressure <165 mm Hg] may participate.) Subject has a history of stroke or transient ischemic attack within the past 2 years. Subject has a history of hepatitis/hepatic disease that has been active within the previous 2 years. Subject has angina or congestive heart failure, with symptoms that occur at rest or minimal activity, or has a history of myocardial infarction within the past 1 year. Subject has a history of neoplastic disease within the previous 10 years. Exceptions: subjects with malignancy successfully treated >10 years prior to screening, where, in the judgment of the investigator and treating physician, there has been no evidence of recurrence from the time of treatment through the time of screening. Subject has a history of esophageal or gastric surgery. Subject has undergone previous small or large bowel resection. Subject has a history of inflammatory bowel disease (ulcerative colitis or Crohn's disease). Subject is allergic to paracetamol or subject has hypersensitivity (e.g., all or part of the syndrome of nasal polyps, angioedema, and bronchospastic reactivity) to aspirin, paracetamol, or other NSAIDs. NOTE: Subjects with a history of idiosyncratic allergic reaction (e.g., rash) to a single NSAID in the past but who tolerated at least 2 other NSAID medications without hypersensitivity reactions may participate. Subject is expected to need chronic NSAID treatment during the trial and/or subject has been taking NSAIDs (including salicylates or other aspirin-containing compounds) on a chronic basis. Subject has had ongoing or is expected to require treatment with any of the following: Ticlopidine, clopidrogel, or regular doses of aspirin, including "low-dose" aspirin, e.g., to prevent complications of vascular disease. Subjects may not discontinue an established course of anti-platelet therapy in order to enter this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shiu Kum Lam, Prof
Organizational Affiliation
Department of Medicine, Queen Mary Hospital/ The University of Hong Kong
Official's Role
Principal Investigator
Facility Information:
Facility Name
China
City
China
Country
China

12. IPD Sharing Statement

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Chemoprevention of Gastric Cancer by Intervention With Helicobacter Pylori and Cyclooxygenase Pathway

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