The Prevention of Progression to Pancreatic Cancer Trial (The 3P-C Trial) (NCT04207944) | Clinical Trial Compass
Active — Not RecruitingPhase 2
The Prevention of Progression to Pancreatic Cancer Trial (The 3P-C Trial)
United States100 participantsStarted 2020-07-10
Plain-language summary
This is a multi-center randomized double-blind placebo controlled trial of patients with high-risk intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. The primary objective is to evaluate the effect of sulindac on the presence or absence of progression of IPMN after up to 3 years of treatment.
Patients without contraindications will be considered to be eligible and will be required to have a cross-sectional imaging study of the pancreas by CT scan or MRI within 3 months of study entry to document residual IPMNs and to rule out any evidence of pancreatic cancer. Patients will be randomized to receive either sulindac (200 mg p.o. BID) plus standard radiographic and endoscopic surveillance or placebo plus standard radiographic and endoscopic surveillance. Randomization will be stratified by (1) whether the patient had high-grade dysplasia identified in the initial resection specimen (resected patients only) and (2) whether the patient is taking metformin at the time of randomization.
Who can participate
Age range21 Years – 85 Years
SexALL
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Inclusion criteria
✓. Subject is a man or woman between the ages of 21 and 85 (inclusive) years.
✓. Subject has high-risk IPMN as defined below.
✓. Patient (previously resected) has undergone partial pancreatectomy for non-invasive IPMN AND has new or residual cyst(s) \> 1 cm and/or
✓. Patient (not previously resected) has a radiographic lesion of the pancreas consistent with IPMN as documented by: Cyst fluid CEA \> 192 ng/ml OR presence of GNAS or RNF 43 mutation noted in cyst fluid OR MRI imaging confirmation of "likely", "probable" or "confirmed" communication with main pancreatic duct
✓. Subjects has ECOG of 0-2
✓. Subject is medically fit to undergo EUS.
✓. Female subjects who are of childbearing potential or are capable of becoming pregnant must be willing to use appropriate methods of contraception for the length of the study.
✓. Subject is able to provide written informed consent.
Exclusion criteria
What they're measuring
1
Percent of patients with IPMN progression as measured by a composite of several indicators
. Subject has pathologic evidence of pancreatic adenocarcinoma.
✕. Subject takes a systemic corticosteroid or NSAID more than 3 times per week.
✕. Subject has a known history of or currently existing allergy to NSAIDs, aspirin induced asthma, gastric ulcers, non-iatrogenic intestinal perforation, or gastrointestinal bleeding from NSAID usage for which intervention was required..
✕. Subject has an ongoing history of renal insufficiency (eGFR \<50 mL/minute/1.73 m2), cardiovascular disease, gastrointestinal disorder, or any other condition that serves as a contraindication to the use of sulindac in the opinion of the treating investigator.
✕. Myocardial infarction or coronary artery bypass grafting within six months of study entry.
✕. Diagnosis of Congestive Heart Failure.
✕. Severe adverse drug reaction to contrast agents that cannot be managed with routine premedication prior to imaging.
✕. Diagnosis for (other) prior malignancy (except in situ and non-melanoma skin cancers) and are actively receiving antineoplastic or immuno therapy within 90 days of randomization.