Aspirin in Preventing Disease Recurrence in Patients With Barrett Esophagus After Successful Elimination by Radiofrequency Ablation

PRIMARY OBJECTIVES: I. To conduct a randomized, double blind, placebo-controlled phase II chemoprevention trial, investigating whether supplementation with aspirin 325 mg/day for 12 months is safe and reduces the expression of CDX2 messenger ribonucleic acid (mRNA) (a biomarker which has been associated with the risk of developing Barrett's esophagus \[BE\]) in comparison to placebo after successful radiofrequency ablation (RFA). SECONDARY OBJECTIVES: I. To assess safety at 12 months. II. To assess differences in the expression of CDX2 at 18 months, activation status of NF-kB by assessing levels of total and phosphorylated (phospho)-p65 and cytoplasmic to nuclear translocation of phospho-p65 which is likely to be affected by aspirin. III. To assess the prostanoid marker, prostaglandin E2, and prostaglandin synthases, which are known to respond to aspirin and to correlation with clinicopathological factors in the esophageal cancer. IV. To assess differences in the expression of proinflammatory cytokines known to induce activation of NFkB, i.e., TNFalpha, IL-1beta, IL-6, IL-10, IL-17A, IL-23 will be measured. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM A: Patients receive aspirin orally (PO) once daily (QD) for 12 months. ARM B: Patients receive placebo PO QD for 12 months. After completion of study treatment, patients are followed up at 1, 3, 6, 9, 12, and 18 months.