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Chemoprevention in Lynch syndrome

Lookup NU author(s): Professor Sir John BurnORCiD, Professor John Mathers

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Abstract

CAPP1 tested aspirin 600 mg/day and/or resistant starch 30 g/day in 200 adolescent FAP carriers. Aspirin treatment resulted in a non-significant reduction in polyp number and a significant reduction in polyp size among patients treated with aspirin for more than 1 year. CAPP2 RCT used the same interventions in 937 Lynch syndrome patients, the first RCT to have cancer prevention as the primary endpoint. Aspirin did not reduce the risk of colorectal neoplasia in a mean treatment period of 29 months but double blind post intervention follow-up has revealed 48 participants developed 53 CRCs. Per protocol analysis showed 63 % fewer colon cancers with aspirin (p = 0.008) apparent from 4 years, with a similar effect on other LS cancers. Resistant starch was not beneficial at long term followup. CAPP3 will involve a double blind dose non-inferiority trial comparing 100, 300 or 600 mg daily in 3,000 gene carriers. We can now recommend aspirin in people at high risk of colorectal cancer.

Publication metadata

Author(s): Burn J, Mathers JC, Bishop DT

Publication type: Article

Publication status: Published

Journal: Familial Cancer

Year: 2013

Volume: 12

Issue: 4

Pages: 707-718

Print publication date: 01/12/2013

Online publication date: 24/07/2013

Acceptance date: 24/06/2013

ISSN (print): 1389-9600

ISSN (electronic): 1573-7292

Publisher: Springer

URL: http://dx.doi.org/10.1007/s10689-013-9650-y

DOI: 10.1007/s10689-013-9650-y

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