Format

Send to

Choose Destination
Cancer Prev Res (Phila). 2019 Sep 4. pii: canprevres.0167.2019. doi: 10.1158/1940-6207.CAPR-19-0167. [Epub ahead of print]

Efficacy of Difluoromethylornithine and Aspirin for Treatment of Adenomas and Aberrant Crypt Foci in Patients with Prior Advanced Colorectal Neoplasms.

Author information

1
Department of Medicine and Division of Oncology, Mayo Clinic sinicrope.frank@mayo.edu.
2
Department of Medicine and Division of Oncology, Mayo Clinic.
3
Mayo Clinic.
4
DIVISION OF GASTROENTEROLOGY AND HEPATOLOGY, Mayo Clinic.
5
Gastroenterology and Hepatology, Mayo Clinic.
6
Division of Gastroenterology and Hepatology, Mayo Clinic.
7
Division of Gastroenterology & Hepatology, Mayo Clinic.
8
Division of Cancer Prevention, National Cancer Institute.
9
Health Sciences Research, Mayo Clinic.
10
Cancer Center Statistics, Mayo Clinic.

Abstract

Difluoromethylornithine (DFMO), an inhibitor of polyamine synthesis, was shown to act synergistically with a NSAID for chemoprevention of colorectal neoplasia. We determined the efficacy and safety of DFMO plus aspirin for prevention of colorectal adenomas and regression of rectal aberrant crypt foci (ACF) in patients with prior advanced adenomas or cancer. A double-blinded, placebo-controlled trial was performed in 104 subjects (age 46- 83) randomized (1:1) to receive daily DFMO (500 mg orally) plus aspirin (325 mg) or matched placebos for one year. All polyps were removed at baseline. Adenoma number (primary endpoint) and rectal ACF (index cluster and total) were evaluated at a one year colonoscopy. ACF were identified by chromoendoscopy. Toxicity was monitored, including audiometry. Eighty-seven subjects were evaluable for adenomas or ACF modulation (n=62). At one year of treatment, adenomas were detected in 16 (38.1%) subjects in the DFMO plus aspirin arm (n= 42) versus 18 (40.9%) in the placebo arm (n= 44; p=0.790); advanced adenomas were similar (n= 3/arm). DFMO plus aspirin was associated with a statistically significant reduction in the median number of rectal ACF compared to placebo (p= 0.036). Total rectal ACF burden was also reduced in the treatment versus the placebo arm relative to baseline (74% vs 45%, p=0.020). No increase in adverse events, including ototoxicity, was observed in the treatment versus placebo arms. While adenoma recurrence was not significantly reduced by one year of DFMO plus aspirin, the drug combination significantly reduced rectal ACF number consistent with a chemopreventive effect.

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center