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Sulindac in Preventing Melanoma in Healthy Participants Who Are at Increased Risk of Melanoma

Primary Purpose

Precancerous Condition

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
sulindac
placebo
laboratory biomarker analysis
Sponsored by
National Cancer Institute (NCI)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Precancerous Condition

Eligibility Criteria

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

Criteria:

  • Healthy participants at risk for developing melanoma and meeting the following criteria: must have >= 4 large (>= 5 mm and < 15 mm) atypical nevi and have 1 benign nevus amenable to biopsies
  • No histologically confirmed melanoma on the baseline biopsy
  • No more than 1 prior cutaneous melanoma
  • One prior stage I, IIA, or IIB melanoma allowed provided patients have been off treatment > 3 months
  • Modified dermoscopy score < 4.8
  • Karnofsky performance status 80-100%
  • ANC >= 1,500/mm^3
  • No family history of melanoma involving >= 2 first degree relatives
  • Platelets count >= 100,000/mm^3
  • Total bilirubin =< 2.0 mg/dL
  • AST/ALT =< 2.0 times upper limit of normal
  • Creatinine =< 1.5 mg/dL
  • Not pregnant or nursing
  • Fertile patients must use effective contraception
  • More than 6 months since prior and no concurrent tanning bed use or other methods to promote sun-tanning
  • Willing to minimize sunlight exposure by applying sunscreen/sunblock or wearing clothing to shield skin during outdoor activity during study participation
  • Willing or able to limit alcohol consumption to less than 3 servings a week during the study period
  • No frequent, chronic or moderate/severe gastrointestinal (GI) complaints
  • Upper GI problems requiring prescription or nonprescription medical remedies for symptoms of heartburn, dyspepsia, nausea, or abdominal pain > once a week on average
  • History of peptic ulcer, occult or gross intestinal bleeding
  • No prior allergic reaction to aspirin (unless subsequent dosing with other NSAIDs has been well tolerated)
  • No history of allergic reaction to lidocaine or xylocaine
  • No history of allergic reaction (e.g., urticaria, asthma, or rhinitis) or gastric intolerance attributed to compounds of similar chemical or biological composition to sulindac
  • No invasive cancer or cancer treatment within the past 5 years, except nonmelanoma skin cancer
  • No immunosuppression by medication or disease, including any of the following: AIDS, oral prednisone, immunosuppressant/immunomodulator (i.e., cyclosporine, chemotherapeutic agent, or biologic therapy)
  • No uncontrolled intercurrent illness
  • No ongoing or active infection
  • No symptomatic congestive heart failure
  • No unstable angina pectoris
  • No cardiac arrhythmia
  • No psychiatric illness/social situations that would limit compliance with study requirements
  • At least 30 days since prior participation and no concurrent enrollment or planning to enroll in another clinical trial
  • No NSAIDs for more than 5 days per month within the past 3 months and no concurrent non-study NSAIDs, except low dose aspirin (81 mg/day)
  • Willing or able to refrain from herbal medicines, above-standard vitamins, or minerals during study
  • Standard daily multivitamin/mineral supplement (i.e., therapeutic doses of calcium and vitamin D for osteoporosis) allowed
  • No concurrent lithium, phenytoin, or sulfonamides
  • WBC >= 3,000/mm^3
  • No history of bleeding or clotting disorder
  • At least 3 months since prior and no concurrent coumadin or other systemic anticoagulant other than aspirin

Sites / Locations

  • University of Arizona Health Sciences Center
  • Stanford University Hospitals and Clinics

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Arm I

Arm II

Arm Description

Participants receive oral sulindac twice daily for 8 weeks

Participants receive oral placebo twice daily for 8 weeks

Outcomes

Primary Outcome Measures

Sulindac Concentration in the Nevi (Moles)
Sulindac Sulfone, an Active Metabolite of Sulindac, Concentration in the Nevi
Sulindac Sulfide, an Active Metabolite of Sulindac, Concentration in the Nevi

Secondary Outcome Measures

Sulindac Effects on Apoptosis in Atypical Nevi
Change in the expression of a marker of apoptosis, cleaved caspase 3, in melanocytic junctional component
Sulindac Effects on Vascular Endothelial Growth Factor (VEGF) Expression in Atypical Nevi
Change in VEGF expression in melanocytic junctional component
Association Between Plasma and Target Tissue Sulindac Levels
Association Between Plasma and Target Tissue Sulindac Sulfone Levels
Association Between Plasma and Target Tissue Sulindac Sulfide Levels

Full Information

First Posted
February 10, 2009
Last Updated
November 30, 2017
Sponsor
National Cancer Institute (NCI)
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1. Study Identification

Unique Protocol Identification Number
NCT00841204
Brief Title
Sulindac in Preventing Melanoma in Healthy Participants Who Are at Increased Risk of Melanoma
Official Title
Phase II Trial of Sulindac in Individuals at Increased Risk for Melanoma
Study Type
Interventional

2. Study Status

Record Verification Date
November 2017
Overall Recruitment Status
Completed
Study Start Date
February 2009 (undefined)
Primary Completion Date
February 2011 (Actual)
Study Completion Date
February 2011 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

5. Study Description

Brief Summary
This randomized phase II trial is studying how well sulindac works in preventing melanoma in healthy participants who are at increased risk of melanoma. Sulindac may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. It is not yet known whether sulindac is more effective than a placebo in preventing melanoma in individuals with many moles and abnormal moles.
Detailed Description
PRIMARY OBJECTIVE: I. To determine sulindac and metabolite levels in healthy participants with atypical nevi and benign nevus at increased risk for melanoma treated with sulindac versus placebo. SECONDARY OBJECTIVES: I. To assess the effects of sulindac on apoptosis in atypical nevi of these participants. II. To assess the effects of sulindac on VEGF expression in atypical nevi of these participants. III. To assess sulindac and metabolite levels in plasma and its association with drug levels in the target tissue. OUTLINE: This is a multicenter study. Participants are randomized to 1 of 2 treatment arms. ARM I: Participants receive oral sulindac twice daily. ARM II: Participants receive oral placebo twice daily. In both arms, treatment continues for 8 weeks in the absence of unacceptable toxicity. Blood and tissue samples are collected at baseline and/or after completion of study therapy and analyzed for sulindac and metabolite levels via high performance liquid chromatography tandem mass spectrometry; the detection of apoptotic cells via TUNEL assay; and VEGF expression via immunohistochemistry assays. After completion of study therapy, participants are followed for 2 weeks.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
50 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm I
Arm Type
Experimental
Arm Description
Participants receive oral sulindac twice daily for 8 weeks
Arm Title
Arm II
Arm Type
Placebo Comparator
Arm Description
Participants receive oral placebo twice daily for 8 weeks
Intervention Type
Drug
Intervention Name(s)
sulindac
Other Intervention Name(s)
Aflodac, Algocetil, Clinoril, SULIN
Intervention Description
Given orally
Intervention Type
Other
Intervention Name(s)
placebo
Other Intervention Name(s)
PLCB
Intervention Description
Inactive agent
Intervention Type
Other
Intervention Name(s)
laboratory biomarker analysis
Intervention Description
Correlative studies
Primary Outcome Measure Information:
Title
Sulindac Concentration in the Nevi (Moles)
Time Frame
8 weeks
Title
Sulindac Sulfone, an Active Metabolite of Sulindac, Concentration in the Nevi
Time Frame
8 weeks
Title
Sulindac Sulfide, an Active Metabolite of Sulindac, Concentration in the Nevi
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Sulindac Effects on Apoptosis in Atypical Nevi
Description
Change in the expression of a marker of apoptosis, cleaved caspase 3, in melanocytic junctional component
Time Frame
Baseline and 8 weeks
Title
Sulindac Effects on Vascular Endothelial Growth Factor (VEGF) Expression in Atypical Nevi
Description
Change in VEGF expression in melanocytic junctional component
Time Frame
Baseline and 8 weeks
Title
Association Between Plasma and Target Tissue Sulindac Levels
Time Frame
8 weeks
Title
Association Between Plasma and Target Tissue Sulindac Sulfone Levels
Time Frame
8 weeks
Title
Association Between Plasma and Target Tissue Sulindac Sulfide Levels
Time Frame
8 weeks

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
Criteria: Healthy participants at risk for developing melanoma and meeting the following criteria: must have >= 4 large (>= 5 mm and < 15 mm) atypical nevi and have 1 benign nevus amenable to biopsies No histologically confirmed melanoma on the baseline biopsy No more than 1 prior cutaneous melanoma One prior stage I, IIA, or IIB melanoma allowed provided patients have been off treatment > 3 months Modified dermoscopy score < 4.8 Karnofsky performance status 80-100% ANC >= 1,500/mm^3 No family history of melanoma involving >= 2 first degree relatives Platelets count >= 100,000/mm^3 Total bilirubin =< 2.0 mg/dL AST/ALT =< 2.0 times upper limit of normal Creatinine =< 1.5 mg/dL Not pregnant or nursing Fertile patients must use effective contraception More than 6 months since prior and no concurrent tanning bed use or other methods to promote sun-tanning Willing to minimize sunlight exposure by applying sunscreen/sunblock or wearing clothing to shield skin during outdoor activity during study participation Willing or able to limit alcohol consumption to less than 3 servings a week during the study period No frequent, chronic or moderate/severe gastrointestinal (GI) complaints Upper GI problems requiring prescription or nonprescription medical remedies for symptoms of heartburn, dyspepsia, nausea, or abdominal pain > once a week on average History of peptic ulcer, occult or gross intestinal bleeding No prior allergic reaction to aspirin (unless subsequent dosing with other NSAIDs has been well tolerated) No history of allergic reaction to lidocaine or xylocaine No history of allergic reaction (e.g., urticaria, asthma, or rhinitis) or gastric intolerance attributed to compounds of similar chemical or biological composition to sulindac No invasive cancer or cancer treatment within the past 5 years, except nonmelanoma skin cancer No immunosuppression by medication or disease, including any of the following: AIDS, oral prednisone, immunosuppressant/immunomodulator (i.e., cyclosporine, chemotherapeutic agent, or biologic therapy) No uncontrolled intercurrent illness No ongoing or active infection No symptomatic congestive heart failure No unstable angina pectoris No cardiac arrhythmia No psychiatric illness/social situations that would limit compliance with study requirements At least 30 days since prior participation and no concurrent enrollment or planning to enroll in another clinical trial No NSAIDs for more than 5 days per month within the past 3 months and no concurrent non-study NSAIDs, except low dose aspirin (81 mg/day) Willing or able to refrain from herbal medicines, above-standard vitamins, or minerals during study Standard daily multivitamin/mineral supplement (i.e., therapeutic doses of calcium and vitamin D for osteoporosis) allowed No concurrent lithium, phenytoin, or sulfonamides WBC >= 3,000/mm^3 No history of bleeding or clotting disorder At least 3 months since prior and no concurrent coumadin or other systemic anticoagulant other than aspirin
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hsiao-Hui (Sherry) Chow
Organizational Affiliation
University of Arizona Health Sciences Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Arizona Health Sciences Center
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85724
Country
United States
Facility Name
Stanford University Hospitals and Clinics
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States

12. IPD Sharing Statement

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Sulindac in Preventing Melanoma in Healthy Participants Who Are at Increased Risk of Melanoma

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