Efficacy of Vitamin D in Colorectal Cancer Chemoprevention

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Richard Benya, M.D., University of Illinois
ClinicalTrials.gov Identifier:
NCT01574027
First received: March 30, 2012
Last updated: April 5, 2012
Last verified: April 2012
  Purpose

Vitamin D's ability to prevent colorectal cancer (CRC) has been suspected for nearly 30 years, but has never been directly studied in humans. The biologically active version of vitamin D, 1,25(OH)2D3, cannot be readily used in humans because of its tendency to cause serum calcium levels to rise. In contrast, 25(OH)D3 (ie calcifediol) does not have this side effect. The investigators previous research suggests that the enzyme necessary to convert 25(OH)D3 (calcifediol) into active 1,25(OH)D3 is present in cells lining the large intestine (colon).

Aberrant crypt foci (ACF) are very small (ie microscopic) collections of abnormally shaped cells that are a commonly used marker of CRC risk. Screening colonoscopy at UIC routinely uses methods that allow ACF counting to be done as a part of standard practice. ACF's are not fixed, like polyps or cancers, but can disappear as a person's risk for developing CRC decreases.

The investigators propose giving patient's with 10 or more ACF's 25(OH)D3 (calcifediol) or placebo, and determining if there is a drug-dependant decrease in ACF number. The primary objective is to determine whether 25(OH)D3 (calcifediol) supplementation, compared to placebo, causes significant reduction of ACF number from baseline levels. The primary endpoint will be change in ACF number.


Condition Intervention Phase
Colorectal Cancer
Drug: Vitamin D3 (cholecalciferol)
Drug: Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Pharmacokinetics Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator)
Primary Purpose: Prevention

Resource links provided by NLM:


Further study details as provided by University of Illinois at Chicago:

Primary Outcome Measures:
  • Reduction in ACF biomarkers [ Time Frame: 6 months ] [ Designated as safety issue: No ]
    The investigators propose giving patient's with 10 or more ACF's 25(OH)D3 (calcifediol) or placebo, and determining if there is a drug-dependant decrease in ACF number. The primary objective is to determine whether 25(OH)D3 (calcifediol) supplementation, compared to placebo, causes significant reduction of ACF number from baseline levels. The primary endpoint will be change in ACF number.


Enrollment: 55
Study Start Date: April 2008
Study Completion Date: October 2011
Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Placebo
Some participants were given a placebo pill to take daily for the length of the study. The placebo patients were used as a control group to compare against those taking the Vitamin D supplement.
Drug: Placebo
One capsule per day for six months
Experimental: Vitamin D3 (cholecalciferol)
Other participants were administered Vitamin D3 (cholecalciferol) for the six month study duration to determine if it would decrease the number of aberrant crypt foci in the colon as compared to the baseline number.
Drug: Vitamin D3 (cholecalciferol)
One capsule per day for six months

Detailed Description:

Patients will be offered participation in this study at the time of their regularly scheduled visit to the UIC Colorectal Cancer Screening Clinic. Those agreeing will have indicated their understanding that participation will be conditional upon their having 10+ ACF at the time of their screening colonoscopy. If at screening colonoscopy 10+ ACF are found patients will:

  • undergo 3 endoscopic mucosal biopsies of the distal colon; and
  • undergo a blood draw from an i.v. already in place for sedative-narcotic administration for serum 25(OH)D3 and serum ionized calcium; and
  • be given either placebo or calcifediol and instructed to take daily for 6 months.
  • provide urine for calcium/creatine spot ratio.

At 7 and 14 days after the screening colonoscopy patients will be called on the telephone by the clinical research nurse assigned to this study to follow-up and note 25(OH)D3 (calcifediol) toxicity, if any (note that toxicity has not been described except in the case of overdose). Signs specifically looked for will include: headache, increased urination, nausea, vomiting, abdominal pain, weakness, constipation, and anorexia. If present, patient will be advised to present immediately to the UIC GCRC for physical and serological evaluation.

At 30, 90 and 120 days the patient will have agreed to present to the GCRC clinic for:

  • Capsule retrieval/count (80% compliance will be required to remain in study); and
  • Detailed history and physical, focusing specifically on signs and symptoms of hypercalcemia.
  • At day 90 only - provide urine for calcium/creatine spot ratio.

Evidence on exam, or laboratory, of hypercalcemia will result in an adverse event reporting and immediate patient discharge from this study. Signs specifically looked for include: headache, increased urination, nausea, vomiting, abdominal pain, weakness, constipation, and anorexia.

At 180 days the patient will have agreed to undergo:

  • Repeat endoscopic exam limited to the recto-sigmoid colon, also known as a "flexible sigmoidoscopy"; and
  • repeat blood draw for serum 25(OH)D3 and serum ionized calcium
  Eligibility

Ages Eligible for Study:   50 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • All non-pregnant patients 50 years of age or older with 10 or more ACFs.

Exclusion Criteria:

  • The following will be specifically looked for, and result in patients not being eligible for study enrollment:
  • Use of non-steroidal anti-inflammatory drugs or glucocorticosteroids within 60 days of study entry.
  • History of chronic IBD or prior pelvic radiation (inflammation distorts crypt pattern).
  • Intake of any vitamin D or calcium supplements within 60 days of study entry.
  • Patients with increased bleeding risk from biopsy protocol (i.e. renal failure, decompensated cirrhosis, blood dyscrasia
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01574027

Locations
United States, Illinois
University of Illinois at Chicago Medical Center
Chicago, Illinois, United States, 60612
Sponsors and Collaborators
University of Illinois at Chicago
Investigators
Principal Investigator: Richard V Benya, M.D. University of Illinois at Chicago
  More Information

No publications provided

Responsible Party: Richard Benya, M.D., MD, University of Illinois
ClinicalTrials.gov Identifier: NCT01574027     History of Changes
Other Study ID Numbers: R01CA122299
Study First Received: March 30, 2012
Last Updated: April 5, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by University of Illinois at Chicago:
Assess the efficacy of vitamin D for preventing colorectal cancer and identifying the populations likely (or unlikely) to benefit from vitamin D-based therapy.
Evaluate the ability of Vitamin D3 (cholecalciferol) to reduce ACF's in humans.

Additional relevant MeSH terms:
Colorectal Neoplasms
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Neoplasms
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Vitamins
Vitamin D
Ergocalciferols
Cholecalciferol
Micronutrients
Growth Substances
Physiological Effects of Drugs
Pharmacologic Actions
Bone Density Conservation Agents

ClinicalTrials.gov processed this record on September 29, 2014