- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05284552
Tinzaparin And Biomarkers After Neoadjuvant Treatment of Ovarian Cancer
The Effect of Tinzaparin on Biomarkers in FIGO Stage III-IV Ovarian Cancer Patients Undergoing Neoadjuvant Chemotherapy - A Randomized Pilot Study
Background:
Previous findings have indicated antineoplastic properties of tinzaparin (Innohep®), a commonly used anti-coagulant. Earlier studies have mainly investigated the antineoplastic effects of tinzaparin in animal models and in human cell-lines. In this pilot study the aim is to examine the potential antitumoral effects of tinzaparin in vivo in women with epithelial ovarian cancer (EOC).
Study objectives:
Primary objective: The primary objective of the study is to evaluate the effects of tinzaparin on changes in levels of CA-125 in EOC patients who receive neoadjuvant chemotherapy (NACT).
Secondary objectives: The secondary objective of the study is to explore the impact of tinzaparin on the dynamic of a spectrum of immunological and coagulation factors in EOC patients who receive NACT. Besides, the compliance of tinzaparin injections and adverse events caused by tinzaparin will be described.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Preben Kjölhede, MD, PhD
- Phone Number: 3187 +46101030000
- Email: preben.kjolhede@regionostergotland.se
Study Contact Backup
- Name: Anna Karlsson, MD
- Phone Number: 3117 +46101030000
- Email: anna.br.karlsson@regionostergotland.se
Study Locations
-
-
-
Eksjö, Sweden, 575 81
- Recruiting
- Department of Obstetrics and Gynecology, Highland Hospital
-
Contact:
- Malena Tiefenthal Thrane, MD
- Phone Number: +46102410000
- Email: malena.tiefenthal.thrane@rjl.se
-
Principal Investigator:
- Malena Tiefenthal Thrane, MD
-
Sub-Investigator:
- Catarina Notelid Claus, MD
-
Sub-Investigator:
- Hanna Reimerson, MD
-
Gothenburg, Sweden, 41345
- Recruiting
- Department of Oncology, Sahlgrenska University Hospital
-
Contact:
- Karin Bergmark, MD, PhD
- Phone Number: +46313421000
- Email: Karin.Bergmark@vgregion.se
-
Principal Investigator:
- Karin Bergmark, MD, PhD
-
Sub-Investigator:
- Pernilla Dahm-Kähler, MD, PhD
-
Sub-Investigator:
- Boglarka Fekete, MD
-
Jönköping, Sweden, 55305
- Recruiting
- Department of Obstetrics and Gynecology, Ryhov County Hospital
-
Contact:
- Laila Falknäs, MD
- Phone Number: +46102410000
- Email: laila.falknas@rjl.se
-
Principal Investigator:
- Laila Falknäs, MD
-
Sub-Investigator:
- Christiane Sackbrook, MD
-
Sub-Investigator:
- Anke Zbikowski, MD
-
Sub-Investigator:
- Narmin Rasul, MD
-
Linköping, Sweden, 58185
- Recruiting
- Department of Oncology, Linköping University Hospital
-
Contact:
- Gabriel Lindahl, MD, PhD
- Phone Number: +46101030000
- Email: gabriel.lindahl@regionostergotland.se
-
Principal Investigator:
- Gabriel Lindahl, MD, PhD
-
Sub-Investigator:
- Annika Holmquist, MD, PhD
-
Sub-Investigator:
- Oscar Derke, MD
-
Sub-Investigator:
- Ulrica Beiron, MD
-
Sub-Investigator:
- Tommy Leijon, MD
-
Umeå, Sweden, 90719
- Recruiting
- Department of Obstetrics and Gynaecology, Norrland University Hospital
-
Contact:
- Ulrika Ottander, MD, PhD
- Phone Number: +46907850000
- Email: Ulrika.Ottander@umu.se
-
Principal Investigator:
- Ulrika Ottander, MD, PhD
-
Sub-Investigator:
- Charlotte Öfverman, MD, PhD
-
Sub-Investigator:
- Pernilla Israelsson, MD, PhD
-
Värnamo, Sweden, 33152
- Recruiting
- Department of Obstetrics and Gynecology, Värnamo Hospital
-
Contact:
- Shefqet Halili, MD
- Phone Number: +46102410000
- Email: shefqet.halili@rjl.se
-
Principal Investigator:
- Shefqet Halili, MD
-
Västervik, Sweden, 593 81
- Recruiting
- Department of Obstetrics and Gynecology, Västervik Hospital
-
Contact:
- Anders Rosenmüller, MD
- Phone Number: +4649086000
- Email: anders.rosenmuller@regionkalmar.se
-
Principal Investigator:
- Anders Rosenmüller, MD
-
Sub-Investigator:
- Helena Avenström, MD
-
-
Östergötland
-
Linköping, Östergötland, Sweden, 58185
- Active, not recruiting
- Department of Obstetrics and Gynecology, University Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- The subject has given written consent to participate in the study.
- Age 18 and above
- Epithelial ovarian, fallopian tube or peritoneal cancer, or abdominal cancer where a biopsy indicates an origin from the ovary, fallopian tube or peritoneum.
- Histology diagnosis of either high grade serous carcinoma, endometrioid carcinoma or clear cell carcinoma.
- FIGO stage III-IV disease.
- Selected for NACT with platinum double regimen at a multidisciplinary conference at Department of Oncology at Linköping University Hospital
- Receive treatment at either of the University Hospital in Linköping, or the hospitals in Jönköping (Ryhov Hospital), Eksjö (Highland Hospital, Eksjö), Västervik (Västervik hospital), Kalmar (County Hospital, Kalmar), Värnamo (Värnamo hospital).
- Planned for platinum doublet regimen.
- Prior to start of NACT pregnancy should be ruled out by menstrual history or in unclear cases by a urine human chorionic gonadotropin (hCG) test.
- Women of childbearing potential should use a safe birth control method (combined hormonal contraception, progesterone only hormonal contraception, intra uterine device, bilateral tubal occlusion, vasectomized partner, sexual abstinence, male or female condom, diaphragm with spermicide).
- World Health Organization (WHO) Performance Status 0-1
- Weight 50-150 kg
- CA-125-level ≥250 kIU/L at diagnosis
Exclusion Criteria:
- Concomitant treatment with heparins, low molecular weight heparins, warfarin or nonvitamin K antagonist oral anticoagulants. Platelet inhibitors are allowed.
- Treatment with heparins, low molecular weight heparins or non-vitamin K antagonist oral anticoagulants within the last year.
- Known or suspected allergies against any product included in the study
- Ongoing pregnancy, independent of gestational age. Breastfeeding or planned pregnancy
- EOC disclosed at Cesarean section
- Abdominal surgery or other major surgery within the last year
- Mental inability, reluctance or language difficulties that result in difficulty understanding the meaning of study participation
- Treatment or disease which, according to the investigator, can affect treatment or study results
- Known brain metastasis
- Participation or recent participation (within the last 30 days) in a clinical study with an investigational product
- Ongoing treatment of thromboembolic disease.
- Thromboembolic disease within the last year.
- Hypersensitivity to the active substance (tinzaparin) or any of the excipients.
Serious hemorrhage or conditions predisposing to serious hemorrhage. Serious hemorrhage is defined as fulfilling any one of these three criteria:
- occurs in a critical area or organ (e.g. intracranial, intraspinal, intraocular, retroperitoneal, intra-articular or pericardial, intra-uterine or intramuscular with compartment syndrome),
- causes a fall in hemoglobin level of 20 g/L (1.24 mmol/L) or more, or
- leads to transfusion of two or more units of whole blood or red blood cells.
- Severe coagulation disorder.
- Acute gastro duodenal ulcer.
- Septic endocarditis.
- Previous heparin-induced thrombocytopenia.
- WHO Performance Status >1.
- Platinum single regimen
- Estimated glomerular filtration rate (E-GFR) <30ml/min (analyzed no more than 14 days before start of treatment with investigational product)
- Platelets <100 x10^9/L (analyzed no more than 14 days before start of treatment with investigational product)
- Treatment for other known malignancy within the last year (except basal cell carcinoma)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Control Arm
|
|
Experimental: Intervention Arm
Drug: Tinzaparin (Innohep®), solution for injection.
Administration form: Subcutaneous injection.
Dosage: 4500 IU (for subjects weighing below 90 kg) or 8000 IU (for subjects weighing 90 kg and above) daily for 21-28 weeks.
|
Subcutaneous injection
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in serum levels of CA-125
Time Frame: 14 weeks
|
kIU/L
|
14 weeks
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in serum levels of CA-125
Time Frame: 21-28 weeks
|
kIU/L
|
21-28 weeks
|
Changes in blood levels of hemoglobin
Time Frame: 21-28 weeks
|
g/L
|
21-28 weeks
|
Changes in blood levels of platelets
Time Frame: 21-28 weeks
|
x10^9/L
|
21-28 weeks
|
Changes in blood levels of leucocytes
Time Frame: 21-28 weeks
|
x10^9/L
|
21-28 weeks
|
Changes in plasma levels of CRP
Time Frame: 21-28 weeks
|
mg/L
|
21-28 weeks
|
Changes in plasma levels of albumin
Time Frame: 21-28 weeks
|
g/L
|
21-28 weeks
|
Changes in plasma levels of interleukin 6
Time Frame: 21-28 weeks
|
ng/L
|
21-28 weeks
|
Changes in plasma levels of vascular endothelial growth factor
Time Frame: 21-28 weeks
|
µg/L
|
21-28 weeks
|
Self reported compliance to tinzaparin injections
Time Frame: 22-29 weeks
|
Percent
|
22-29 weeks
|
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: 22-29 weeks
|
Number
|
22-29 weeks
|
Proportion of participants with treatment-related adverse events as assessed by CTCAE v4.0
Time Frame: 22-29 weeks
|
Proportion constitutes the relative number in the group in percent
|
22-29 weeks
|
Objectively confirmed venous thromboembolism (VTE), i.e. pulmonary embolism, lower-limb deep vein thrombosis or upper extremity deep vein thrombosis. Death due to VTE.
Time Frame: 22-29 weeks
|
Number
|
22-29 weeks
|
Objectively confirmed venous thromboembolism (VTE), i.e. pulmonary embolism, lower-limb deep vein thrombosis or upper extremity deep vein thrombosis. Death due to VTE.
Time Frame: 22-29 weeks
|
Percent
|
22-29 weeks
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Plasma levels of tissue factor
Time Frame: 21-28 weeks
|
µg/L
|
21-28 weeks
|
Plasma levels of D-dimer
Time Frame: 21-28 weeks
|
mg/L
|
21-28 weeks
|
Plasma levels of soluble P-selectin
Time Frame: 21-28 weeks
|
µg/L
|
21-28 weeks
|
Plasma levels of thrombin-antithrombin complex
Time Frame: 21-28 weeks
|
µg/L
|
21-28 weeks
|
Thrombin generation potential
Time Frame: 21-28 weeks
|
lag time (min)
|
21-28 weeks
|
Thrombin generation potential
Time Frame: 21-28 weeks
|
endogenous thrombin generation potential (nmolar*min)
|
21-28 weeks
|
Thrombin generation potential
Time Frame: 21-28 weeks
|
peak nmol/L
|
21-28 weeks
|
Olink Target 96 Inflammation - plasma levels a panel of 92 inflammation associated proteins
Time Frame: 21-28 weeks
|
All 92 inflammation associated proteins are measured in pg/mL
|
21-28 weeks
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Preben Kjölhede, MD, PhD, University Hospital, Linkoeping
- Study Chair: Gabriel Lindahl, MD, PhD, University Hospital, Linkoeping
- Study Chair: Anna-Clara Spetz Holm, MD, PhD, University Hospital, Linkoeping
- Study Chair: Anna Karlsson, MD, University Hospital, Linkoeping
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Histologic Type
- Neoplasms
- Urogenital Neoplasms
- Neoplasms by Site
- Carcinoma
- Neoplasms, Glandular and Epithelial
- Genital Neoplasms, Female
- Endocrine System Diseases
- Ovarian Diseases
- Adnexal Diseases
- Gonadal Disorders
- Endocrine Gland Neoplasms
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Genital Diseases
- Genital Diseases, Female
- Ovarian Neoplasms
- Carcinoma, Ovarian Epithelial
- Molecular Mechanisms of Pharmacological Action
- Fibrinolytic Agents
- Fibrin Modulating Agents
- Anticoagulants
- Heparin, Low-Molecular-Weight
- Tinzaparin
- Dalteparin
Other Study ID Numbers
- The TABANETOC-trial
- 2021-000135-31 (EudraCT Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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