CAPP News

Abstract for presentation at InSiGHT Meeting - 22/06/2009

The following abstract will be presented at the InSiGHT Conference on Thursday 25th June 2009. 

Burn J, Mathers JC, Gerdes AM, Bisgaard ML, Evans G, Eccles D, Lindblom A, Macrae F, Maher ER, Mecklin JP, Möslein G, Olschwang S, Ramesar R, Vasen HFA, Wijnen J, Barker G, Elliott F, Lynch H, Bishop DT and the CAPP2 Consortium

Cancer occurrence during follow-up of the CAPP2 Study – Aspirin use for up to four years significantly reduces Lynch syndrome cancers for up to 10 years

The CAPP2 Study evaluated 600mg enteric coated aspirin and/or 30gms of Novelose (resistant starch) in a double blind factorial RCT in 1071 carriers of Lynch syndrome over a treatment period of 1 to 4 years, mean 29 months.  The results, reported in December 2008¹ showed that there was no difference between the treatment and placebo groups for new colorectal neoplasia.  Follow-up data for 667 participants for up to 120 months (mean 51m) is now available.  Analysis reveals a striking reduction in subsequent cancers; overall, 103 participants have developed 111 Lynch syndrome cancers.  Despite equal numbers being randomised to aspirin or placebo, cancer sufferers in the aspirin group are outnumbered 2 to 1.  Lifetable analysis for time to first Lynch syndrome cancer reveals a hazard ration of 0.62 (0.41,0.96) p=0..03.  There is a clear effect of duration of treatment: <24months on treatment OR 0.90 (0.45,1.81)  p=0.78,   treated >24 months OR 0.50 (0.28,0.86) p=0.01.

A dose finding study is under development.  CAPP3 will involve open label randomisation to a multiarm study using doses from 75mg to 600mg

Reference:

1.         Burn J, Bishop DT, Mecklin J-P, et al. Effect of Aspirin or Resistant Starch on Colorectal Neoplasia in the Lynch Syndrome. N Engl J Med 2008;359(24):2567-78.