Phase III randomised chemoprevention study with selenium on the recurrence of non-invasive urothelial carcinoma. The SELEnium and BLAdder cancer Trial

In Belgium, bladder cancer (BC) is the fifth most common cancer in men. The per-patient lifetime cost is high. Previous epidemiological studies have consistently reported that selenium concentrations were inversely associated with the risk of BC. We therefore hypothesised that selenium may be suitable for chemoprevention of recurrence of BC.

The Selenium and Bladder Cancer Trial (SELEBLAT) was an academic phase III placebo-controlled, double-blind, randomised clinical trial designed to determine the effect of selenium on recurrence of non-invasive urothelial carcinoma conducted in 14 Belgian hospitals. Patients were randomly assigned by a computer program to oral selenium yeast 200 μg once a day or placebo for three years, in addition to standard care. All study personnel and participants were blinded to treatment assignment for the duration of the study. All randomised patients were included in the intention to treat (ITT) and safety analyses. Per protocol analyses (PPAs) included all patients in the study three months after start date.

Between September 18, 2009 and April 18, 2013, 151 and 141 patients were randomised in the selenium and placebo group. Patients were followed until December 31, 2015. The ITT analysis resulted in 43 (28%; 95% CI, 0.21-0.35) and 45 (32%; 95% CI, 0.24-0.40) recurrences in the selenium and placebo group. The hazard ratio (HR) was 0.85 (95% CI, 0.56-1.29; p = 0.44) while the HR for the PPA resulted in 42 and 39 (28%; 95% CI, 0.20-0.35) recurrences in the selenium and placebo group (HR = 0.96 [95% CI, 0.62-1.48]; p = 0.93).

Selenium supplementation does not lower the probability of recurrence in BC patients.

European journal of cancer (Oxford, England : 1990). 2016 Oct 28 [Epub ahead of print]

Maria E Goossens, Maurice P Zeegers, Hendrik van Poppel, Steven Joniau, Koen Ackaert, Filip Ameye, Ignace Billiet, Johan Braeckman, Alex Breugelmans, Jochen Darras, Kurt Dilen, Lieven Goeman, Bertrand Tombal, Siska Van Bruwaene, Ben Van Cleyenbreugel, Frank Van der Aa, Kris Vekemans, Frank Buntinx

Department of General Practice, University of Leuven, ACHG-KU Leuven, Kapucijnenvoer 33, Blok J, Bus 7001, 3000, Leuven, Belgium. Electronic address: ., University of Maastricht, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands; CAPHRI School for Public Health and Primary Care, University of Maastricht, The Netherlands; School of Cancer Sciences, University of Birmingham, Birmingham, UK., Department of Urology, UZ Leuven, Leuven, Belgium., Department of Urology, Sint-Elisabethziekenhuis, Turnhout, Belgium., Department of Urology, AZ Maria Middelares, Gent, Belgium., Department of Urology, AZ Groeninge, Kortrijk, Belgium., Department of Urology, UZ Brussel, Brussel, Belgium., Department of Urology, Heilig Hart ziekenhuis, Leuven, Belgium., Department of Urology, AZ Damiaan, Oostende, Belgium., Department of Urology, Jessa ziekenhuis, Hasselt, Belgium., Department of Urology, Heilig Hartziekenhuis, Roeselaere, Belgium., Department of Urology, Cliniques universitaires Saint-Luc, Brussel, Belgium., Department of General Practice, University of Leuven, ACHG-KU Leuven, Kapucijnenvoer 33, Blok J, Bus 7001, 3000, Leuven, Belgium; CAPHRI School for Public Health and Primary Care, University of Maastricht, The Netherlands.