Dalteparin in Preventing Blood Clots in Patients With Lung Cancer
FRAGMATIC - A Randomised Phase III Clinical Trial Investigating the Effect of FRAGMin Added to Standard Therapy In Patients With Lung Cancer
RATIONALE: Anticoagulants, such as dalteparin, may help prevent blood clots from forming in patients with lung cancer. It is not yet known whether dalteparin is effective in preventing blood clots in patients with lung cancer.
PURPOSE: This randomized phase III trial is studying how well dalteparin works in preventing blood clots in patients with lung cancer.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
OBJECTIVES:
Primary
- Determine whether the addition of dalteparin results in improved survival.
Secondary
- Determine venous thrombotic event-free survival and metastasis-free survival.
- Determine serious adverse events in patients treated with this drug.
- Determine the toxicity of this drug in these patients.
- Determine the quality of life, breathlessness, anxiety, and depression in patients treated with this drug.
- Determine the cost effectiveness and cost utility of this drug.
OUTLINE: This is a multicenter study. Patients are randomized to 1 of 2 treatment arms.
- Arm I (control): Patients receive anticancer treatment considered appropriate by the local medical team.
- Arm II: Patients receive anticancer treatment considered appropriate by the local medical team. Beginning before the start of the first definitive anticancer treatment, patients receive dalteparin subcutaneously daily for up to 24 weeks.
Quality of life, anxiety, depression, and dyspnea are assessed at baseline, at 12 and 24 weeks, and then at 9 and 12 months.
After completion of therapy, patients are followed at 9 months, 1 year, and then every 6 months for at least 2 years.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Locations
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England
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Aylesbury-Buckinghamshire, England, United Kingdom, HP21 8AL
- Recruiting
- Stoke Mandeville Hospital
-
Contact:
- Nicholas Bates, MD
- Phone Number: 44-1296-316-555
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Barrow in Furness, England, United Kingdom, LA14 4LF
- Recruiting
- Furness General Hospital
-
Contact:
- David Fyfe, MD
- Phone Number: 44-1524-583-510
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Blackburn, England, United Kingdom, BB2 3HH
- Recruiting
- Royal Blackburn Hospital
-
Contact:
- Wiebke Appel, MD, FRCR, MRCP
- Phone Number: 44-1772-522-792
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Blackpool, England, United Kingdom, FY3 8NR
- Recruiting
- Blackpool Victoria Hospital
-
Contact:
- Andrew C. Hindley, MD
- Phone Number: 44-177-252-2908
- Email: andrew.hindley@lthtr.nhs.uk
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Bournemouth, England, United Kingdom, BH7 7DW
- Recruiting
- Royal Bournemouth Hospital
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Bristol, England, United Kingdom, BS2 8ED
- Recruiting
- Bristol Haematology and Oncology Centre
-
Contact:
- Stephen J. Falk, MD
- Phone Number: 44-1935-384-559
- Email: stephen.falk@ubht.nhs.uk
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Burnley, England, United Kingdom, BB10 2PQ
- Recruiting
- Burnley General Hospital
-
Contact:
- Wiebke Appel, MD, FRCR, MRCP
- Phone Number: 44-772-522-792
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Burton-upon-Trent, England, United Kingdom, DE13 0RB
- Recruiting
- Queen's Hospital
-
Contact:
- A.D. Chetiyawardana, MD
- Phone Number: 44-283-566-333
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Bury St. Edmunds, England, United Kingdom, IP33 2QZ
- Recruiting
- West Suffolk Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1284-713-195
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Coventry, England, United Kingdom, CV2 2DX
- Recruiting
- Walsgrave Hospital
-
Contact:
- Caroline Humber, MD
- Phone Number: 44-2476-967-478
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Darlington, England, United Kingdom, DL3 6HX
- Recruiting
- Darlington Memorial
-
Contact:
- Clive Peedell, MD
- Phone Number: 44-1643-850-850
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Derby, England, United Kingdom, DE1 2QY
- Recruiting
- Derbyshire Royal Infirmary
-
Contact:
- Muthu Kumar, MD
- Phone Number: 44-1332-347-141 ext. 2437
- Email: muthu.kumar@derbyhospitals.nhs.uk
-
Doncaster, England, United Kingdom, DN2 5LT
- Recruiting
- Doncaster Royal Infirmary
-
Contact:
- Contact Person
- Phone Number: 44-130-236-6666
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Dorchester, England, United Kingdom, DT1 2JY
- Recruiting
- Dorset County Hospital
-
Contact:
- Mike Bayne, MD
- Phone Number: 44-1202-448-648
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Dudley, England, United Kingdom, DY1 2HQ
- Recruiting
- Russells Hall Hospital
-
Contact:
- Simon Grumett, MD
- Phone Number: 44-384-456-111
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Gateshead, England, United Kingdom, NE9 6SX
- Recruiting
- Queen Elizabeth Hospital
-
Contact:
- Fiona McDonald, MD
- Phone Number: 44-191-256-3567
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High Wycombe, England, United Kingdom
- Recruiting
- Wycombe General Hospital
-
Contact:
- Nicholas Bates, MD
- Phone Number: 44-865-225-601
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Kidderminster Worcestershire, England, United Kingdom, DY11 6RJ
- Recruiting
- Kidderminster Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1562-513-093
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Lancaster, England, United Kingdom, LA1 4RP
- Recruiting
- Royal Lancaster Infirmary
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Contact:
- David Fyfe, MD
- Phone Number: 44-1524-583-510
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London, England, United Kingdom, EC1A 7BE
- Recruiting
- Saint Bartholomew's Hospital
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Contact:
- Paula Wells, MD
- Phone Number: 44-207-601-8044
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London, England, United Kingdom, E11 1NR
- Recruiting
- Whipps Cross Hospital
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Contact:
- Paula Wells, MD
- Phone Number: 44-20-7601-8044
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London, England, United Kingdom, N18 1QX
- Recruiting
- Helen Rollason Cancer Care Centre at North Middlesex Hospital
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Contact:
- Contact Person
- Phone Number: 44-20-7472-6115
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London, England, United Kingdom, N19 5NF
- Recruiting
- Whittington Hospital
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Contact:
- Siow M. Lee, MD, PhD, FRCP
- Phone Number: 44-20-7288-5227
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London, England, United Kingdom, NW1 2PG
- Recruiting
- University College Hospital
-
Contact:
- Siow M. Lee, MD, PhD, FRCP
- Phone Number: 44-20-7288-5227
- Email: sm.lee@uclh.org
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London, England, United Kingdom, NW3 2QG
- Recruiting
- UCL Cancer Institute
-
Contact:
- Contact Person
- Phone Number: 44-20-7472-6115
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Luton, England, United Kingdom, LU4 0DZ
- Recruiting
- Luton and Dunstable Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1582-497-513
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Middlesbrough, England, United Kingdom, TS4 3BW
- Recruiting
- James Cook University Hospital
-
Contact:
- Clive Peedell, MD
- Phone Number: 44-643-850-850
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Milton Keynes, England, United Kingdom, MK6 5LD
- Recruiting
- Milton Keynes General Hospital
-
Contact:
- Hany Eldeeb, MD
- Phone Number: 44-1604-523-815
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Newcastle-Upon-Tyne, England, United Kingdom, NE7 7DN
- Recruiting
- Newcastle Upon Tyne Hospitals NHS Trust
-
Contact:
- Contact Person
- Phone Number: 44-191-256-3555
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Norfolk, England, United Kingdom, NR31 6LA
- Recruiting
- James Paget Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1603-287-674
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North Shields, England, United Kingdom, NE29 8NH
- Recruiting
- North Tyneside Hospital
-
Contact:
- Contact Person
- Phone Number: 44-191-256-3555
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North Yorkshire, England, United Kingdom, DL6 1JG
- Recruiting
- Friarage Hospital
-
Contact:
- Clive Peedell, MD
- Phone Number: 44-643-850-850
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Northampton, England, United Kingdom, NN1 5BD
- Recruiting
- Northampton General Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1604-543-789
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Northwood, England, United Kingdom, HA6 2RN
- Recruiting
- Mount Vernon Cancer Centre at Mount Vernon Hospital
-
Contact:
- Jeanette Dickson, MD
- Phone Number: 44-923-844-551
- Email: jeanette.dickson@nhs.net
-
Norwich, England, United Kingdom, NR4 7UY
- Recruiting
- Norfolk and Norwich University Hospital
-
Contact:
- Tom W. Roques, MD
- Phone Number: 44-603-287-671
- Email: tom.roques@nnuh.nhs.uk
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Nottingham, England, United Kingdom, NG5 1PB
- Recruiting
- Nottingham City Hospital
-
Contact:
- Contact Person
- Phone Number: 44-115-969-1169
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Nuneaton, England, United Kingdom, CV10 7DJ
- Recruiting
- George Eliot Hospital
-
Contact:
- Mark Hocking, MD
- Phone Number: 44-2476-967-490
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Plymouth, England, United Kingdom, PL6 8DH
- Recruiting
- Derriford Hospital
-
Contact:
- Dennis Yiannakis, MD
- Phone Number: 44-1752-439-103
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Poole Dorset, England, United Kingdom, BH15 2JB
- Recruiting
- Dorset Cancer Centre
-
Contact:
- Virginia Laurence, MD
- Phone Number: 44-1202-448-262
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Preston, England, United Kingdom, PR2 9HT
- Recruiting
- Rosemere Cancer Centre at Royal Preston Hospital
-
Contact:
- Geraldine Skailes, MD
- Phone Number: 44-1772-522-913
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Reading, England, United Kingdom, RG1 5AN
- Recruiting
- Berkshire Cancer Centre at Royal Berkshire Hospital
-
Contact:
- Richard Brown, MD
- Phone Number: 44-118-322-8343
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Redditch, Worcestershire, England, United Kingdom, B98 7UB
- Recruiting
- Alexandra Healthcare NHS
-
Contact:
- Joanna Hamilton, MD
- Phone Number: 44-2476-967-477
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Scarborough, England, United Kingdom, YO12 6QL
- Recruiting
- Scarborough General Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1482-701-151
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Sheffield, England, United Kingdom, S1O 2SJ
- Recruiting
- Cancer Research Centre at Weston Park Hospital
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Contact:
- Penella J. Woll, MD, PhD
- Phone Number: 44-14-226-5235
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Slough, Berkshire, England, United Kingdom, SL2 4HL
- Recruiting
- Wexham Park Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1753-634-191
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South Shields, England, United Kingdom, NE34 0PL
- Recruiting
- South Tyneside District Hospital
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Contact:
- Goudarz Mazdai, MD, PhD
- Phone Number: 44-191-202-4010
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Stafford, England, United Kingdom, ST16 3SA
- Recruiting
- Staffordshire General Hospital
-
Contact:
- Caroline Brammer, MD
- Phone Number: 44-902-695-201
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Stoke-On-Trent, England, United Kingdom, ST4 7LN
- Recruiting
- University Hospital of North Staffordshire
-
Contact:
- Contact Person
- Phone Number: 44-1782-554-974
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Sutton, England, United Kingdom, SM2 5PT
- Recruiting
- Royal Marsden - Surrey
-
Contact:
- Contact Person
- Phone Number: 44-20-8661-3278
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Warwick, Warwickshire, England, United Kingdom, CV34 5BJ
- Recruiting
- South Warwickshire Hospital
-
Contact:
- Caroline Humber, MD
- Phone Number: 44-2476-967-478
-
Weston-super-Mare, England, United Kingdom, BS23 4TQ
- Recruiting
- Weston General Hospital
-
Contact:
- Christopher J. Williams, DM, FRCP
- Phone Number: 44-1934-881-136
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Wolverhampton, England, United Kingdom, WV10 0QP
- Recruiting
- New Cross Hospital
-
Contact:
- David Ferry, MD
- Phone Number: 44-1245-516-598
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Yeovil, England, United Kingdom, BA21 4AT
- Recruiting
- Yeovil District Hospital
-
Contact:
- Stephen J. Falk, MD
- Phone Number: 44-932-384-559
- Email: stephen.falk@swest.uhs.uk
-
-
Wales
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Bangor, Wales, United Kingdom, LL57 2PW
- Recruiting
- Ysbyty Gwynedd
-
Contact:
- Nick Stuart, MD
- Phone Number: 44-1248-384-150
- Email: nick.stuart@nww-tr.wales.nus.uk
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Cardiff, Wales, United Kingdom, CF14 2TL
- Recruiting
- Velindre Cancer Center at Velindre Hospital
-
Contact:
- Fergus Macbeth, MD
- Phone Number: 44-292-031-6232
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Llandough, Wales, United Kingdom, CF64 2XX
- Recruiting
- LLandough Hospital
-
Contact:
- Fergus Macbeth, MD
- Phone Number: 44-29-2061-5888
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Llantrisant, Wales, United Kingdom, CF72 8XR
- Recruiting
- Royal Glamorgan Hospital
-
Contact:
- Contact Person
- Phone Number: 44-2920-615-888
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Mid Glamorgan, Wales, United Kingdom, CF47 9DT
- Recruiting
- Prince Charles Hospital
-
Contact:
- Fergus Macbeth, MD
- Phone Number: 44-29-2061-5888
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Newport Gwent, Wales, United Kingdom, NP9 2UB
- Recruiting
- Royal Gwent Hospital
-
Contact:
- Contact Person
- Phone Number: 44-1633-623-623
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Rhyl, Denbighshire, Wales, United Kingdom, LL 18 5UJ
- Recruiting
- Glan Clwyd Hospital
-
Contact:
- Angel Garcia-Alonso, MD
- Phone Number: 44-1745-583-910
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
DISEASE CHARACTERISTICS:
- Histopathological or cytological diagnosis of primary bronchial carcinoma (small cell or non-small cell lung cancer) within the past 6 weeks
- No other intrathoracic tumors (e.g., carcinoid tumor, mesothelioma, lymphoma, or lung metastases from another primary site)
- No clinically apparent brain metastases
PATIENT CHARACTERISTICS:
- ECOG performance status 0-3
- Platelet count ≥ 100,000/mm³
- Serum creatinine ≤ 150 µmol/L
- Willing and able to self-administer dalteparin by daily subcutaneous injection or have it administered by a caregiver
- Not pregnant or nursing
- Fertile female patients must use effective contraception (if sexually active)
- No hemorrhagic stroke within the past 3 months
- No known bleeding disorder
- No hemoptysis of CTC ≥ grade 2 (i.e., symptomatic hemoptysis requiring medical intervention)
- No central venous catheter requiring the use of thromboprophylaxis
- No known hypersensitivity to dalteparin, heparin, or other low molecular weight heparins (e.g., history of confirmed or suspected immunologically mediated heparin-induced thrombocytopenia; acute gastroduodenal ulcer; or subacute endocarditis)
- No prior illness likely to interfere with study treatment or comparisons
PRIOR CONCURRENT THERAPY:
- No prior treatment likely to interfere with study treatment or comparisons
- More than 12 months since prior and no concurrent therapeutic anticoagulation
- No concurrent ketorolac (Toradol®)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
|---|
|
Overall survival
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
|---|
|
Toxicity
|
|
Serious adverse events
|
|
Cost effectiveness
|
|
Venous thrombotic event-free survival
|
|
Metastasis-free survival
|
|
Quality of life as measured by EQ-5D
|
|
Breathlessness (dyspnea) as measured by the Cancer Dyspnea Scale
|
|
Anxiety and depression as measured by the Hospital Anxiety and Depression Scale
|
|
Cost utility
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Fergus Macbeth, MD, Velindre NHS Trust
Publications and helpful links
General Publications
- Rutjes AW, Porreca E, Candeloro M, Valeriani E, Di Nisio M. Primary prophylaxis for venous thromboembolism in ambulatory cancer patients receiving chemotherapy. Cochrane Database Syst Rev. 2020 Dec 18;12:CD008500. doi: 10.1002/14651858.CD008500.pub5.
- Griffiths GO, Burns S, Noble SI, Macbeth FR, Cohen D, Maughan TS. FRAGMATIC: a randomised phase III clinical trial investigating the effect of fragmin added to standard therapy in patients with lung cancer. BMC Cancer. 2009 Oct 6;9:355. doi: 10.1186/1471-2407-9-355.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Respiratory Tract Diseases
- Neoplasms
- Lung Diseases
- Neoplasms by Site
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Embolism and Thrombosis
- Lung Neoplasms
- Thromboembolism
- Molecular Mechanisms of Pharmacological Action
- Fibrinolytic Agents
- Fibrin Modulating Agents
- Anticoagulants
- Heparin, Low-Molecular-Weight
- Tinzaparin
- Dalteparin
Other Study ID Numbers
Other Study ID Numbers
- CDR0000561532
- WCTU-FRAGMATIC
- Velindre-FRAGMATIC
- WCTU-02
- EU-20753
- PFIZER-WCTU-02
- EUDRACT-2005-002438-37
- ISRCTN80812769
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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