The purpose of the study is to find out whether the drug celecoxib has beneficial effects on people with pre-cancerous lesions of the pancreas.
Efforts at finding a successful chemotherapy for pancreatic cancer have been disappointing. Some patients are at increased risk of pancreatic cancer or may have pre-malignant pancreatic lesions which predispose them to later pancreatic cancer development. In these individuals, chemopreventative measures may block future development of pancreatic cancer. Human tissue studies, cell culture and animal models of pancreatic cancer strongly suggests that cyclooxygenase-2 (COX-2) may be a successful target for chemoprevention. COX-2 is overexpressed in human pancreatic cancers. Elevated COX-2 expression correlates with progression of premalignant precursors of pancreatic cancer in development models of hamster pancreatic cancer. Human tissue studies confirm increases in COX-2 expression with progression of premalignant precursors called intraductal papillary mucinous neoplasms (IPMNs) and pancreatic intraepithelial neoplasms (PanINs). Moreover, COX-2 inhibitors appear to have chemopreventative efficacy in the PC-1 homograft model of hamster pancreatic cancer. Demographic studies have suggested COX-2 inhibitors may confer protection from pancreatic cancer. We propose to conduct a pilot/phase II trial to determine the chemopreventative effects of the COX-2 inhibitor celecoxib in patients with premalignant pancreatic lesions. Patients registered to the study will take celecoxib twice daily for 6-8 weeks prior to surgery (if patient decides to have surgery for his/her condition). If subject is not a surgical candidate or puts off surgical treatment, subject will take celecoxib for 6 months.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
8
400 mg BID 6-8 weeks prior to surgery
400 mg BID for 6 months prior to follow-up EUS or ERCP
Indiana University Hospital
Indianapolis, Indiana, United States
Concentration of PGE2 in Urine at Baseline, Surgery, 1 wk, 4wks, and 6 Months
Measured by Elisa at participant level - only participant level data available; not summarized across group
Time frame: Baseline, surgery, 1 wk, 4 wks, and 6 months
Concentration of PGE2 in Serum at Baseline, Surgery, 1 wk, 4wks, and 6 Months
Measured by Elisa at participant level - only participant level data available; not summarized across group
Time frame: Baseline, surgery, 1 wk, 4 wks, and 6 months
Concentration of PGEM in Urine at Baseline, Surgery, 1 wk, 4wks, and 6 Months
Measured by Elisa at participant level - only participant level data available; not summarized across group
Time frame: Baseline, surgery, 1 wk, 4 wks, and 6 months
Concentration of PGEM in Serum at Baseline, Surgery, 1 wk, 4wks, and 6 Months
Measured by Elisa at participant level - only participant level data available; not summarized across group
Time frame: Baseline, surgery, 1 wk, 4 wks, and 6 months
Number of Participants With Clinical Changes in IPMN Progression.
Examine the short term effect of celecoxib on clinical progression of IPMN in the surgical arm; Examine the long term effect of celecoxib on clinical progression of IPMN in the medical arm.
Time frame: Baseline, 6 months, 1 year
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