ICARE Newsletter Summer 2016

Cancer Chemoprevention in Individuals with Familial Adenomatous Polyposis (FAP)

Prior research has demonstrated that NSAIDs significantly reduce colonic and rectal polyp burden among individuals with FAP although their impact on outcomes remains to be determined.1,2 Recent data extended these results to the small intestine through completion of a randomized clinical trial among patients with FAP which demonstrated that use of sulindac and erlotinib compared with placebo led to lower duodenal (part of the small intestine) polyp burden at six months.3 However, grade 1 or 2 adverse events (i.e., side effects) were more common in the group that received the drug (the majority of which included an acne-like rash) which may limit use of these medications at the doses given in this study. Given results of this preliminary study, it is important to evaluate these drugs in a larger population of patients with FAP with a longer follow-up period to determine if these observations lead to improved clinical outcomes among these individuals.

1Giardiello FM, et al. N Engl J Med. 1993;328(18):1313-1316.PMID: 8385741.
2Giardiello FM, et al. N Engl J Med. 2002;346 (14):1054-1059.PMID:11932472.
3Samadder NJ, et al. JAMA. 2016 Mar 22-29;315(12):1266-75.PMID: 27002448.