Mesalamine administration to prevent development of colorectal cancer in Lynch syndrome

Prior treatment

• Participation in another clinical study investigating another IMP within 3 months prior to screening
• Regular use of NSAIDs or COX-2 inhibitors: daily use in more than 3 continuous months within the last year
• Colorectal surgery within the previous 6 months

Other illness

• Severe liver disease or liver failure (elevation of liver enzymes above 3xULN)
• Current or history of serious psychiatric disorder or alcohol/drug abuse that in the opinion of the investigator may impact the assessment of IMP safety and efficacy or protocol adherence
• Patients with history of stage 3 and 4 colorectal cancer (CRC) are excluded
• Presence of any metastatic disease
• Hypersensitivity to 5-ASA

Lab values

• Renal insufficiency (GFR <30ml/min/1.73m2)
• Prior history of myocarditis or pericarditis. Other severe acute or chronic medical condition (such as severe chronic lung (COPD, including asthma), kidney or heart diseases), duodenal ulcer, haemorrhagic diathesis or psychiatric condition or other abnormal clinical sign or laboratory abnormality that may increase the risk associated with study participation or ability to comply with study procedures, IMP administration and, in the judgment of the investigator, would make the subject inappropriate for entry into this study

Other

• Presence of colorectal endoscopically non-removable malign neoplasia (patient can be included if the adenoma is removed)
• Unwillingness to participate or who is considered unable to give an informed consent
• Pregnant or breastfeeding women
• Carriers of germline mutations in PMS2
• Regular use of acetylsalicylic acid (ASA or aspirin): daily use of ≥100mg in more than 3 continuous months within the last year
• Patients after any subtotal or total colectomy

• Proven tumor-free (including patients in which the polyps are removed endoscopically) carriers of a germline pathologic mutation on one of the MMR genes including MLH1, MSH2 (including EpCAM) and MSH6
• Male or female subjects with the age > 30 years
• Females who have been post-menopausal more than one (1) year or females of childbearing potential using a highly efficient method of contraception with less than 1% failure rate (i.e. oral hormonal contraceptives, hormone implants, hormone injections, sterilization, hormonal or copper intrauterine device, sterilized/vasectomized partner, or diaphragm in combination with a condom, spermicide or birth control pills) or should agree to abstain from heterosexual activity during treatment period. Females of childbearing potential must have a negative pregnancy test at screening and randomization
• Signed written informed consent prior to inclusion in the study