Enoxaparin Thromboprophylaxis in Cancer Patients With Elevated Tissue Factor Bearing Microparticles (MicroTEC)
A Randomized Controlled Trial of Enoxaparin Thromboprophylaxis in Cancer Patients With Elevated Tissue Factor Bearing Microparticles
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiesteder
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California
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Los Angeles, California, Forenede Stater, 90033
- University of Southern California-Keck School of Medicine
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Massachusetts
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Boston, Massachusetts, Forenede Stater, 02114
- Massachusetts General Hospital
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Boston, Massachusetts, Forenede Stater, 02115
- Beth Israel Deaconess Medical Center
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Boston, Massachusetts, Forenede Stater, 02130
- VA Boston Healthcare System
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Danvers, Massachusetts, Forenede Stater, 01923
- Mass General/North Shore Cancer Center
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-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
Histologically confirmed malignancy that is metastatic or unresectable and for which standard curative therapies do not exist. Eligible malignancies include:
- Adenocarcinoma of the pancreas (locally advanced or metastatic)
- Colorectal (stage IV)
- Non-small cell lung (unresectable stage III or IV)
- Relapsed ovarian or stage IV
- Surgically unresectable or metastatic gastric adenocarcinoma
- First or second line therapy (within 4 weeks of initiating therapy).
- Minimum age 18 years
- Life expectancy of greater than 6 months
- ECOG Performance Status 0, 1, or 2 (Karnofsky 60% or greater).
- Participants must have normal organ and marrow function as outlined in the protocol.
Exclusion Criteria:
- Participants may not be receiving any other study agents.
- Known brain metastases should be excluded from this clinical trial because of their poor prognosis and higher potential for intracranial hemorrhage.
- Prior history of documented venous thromboembolic event or pulmonary embolism within the last 5 years years (excluding central line associated events whereby patients completed anticoagulation > 3 months previously)
- Active bleeding or high risk for bleeding (e.g. known acute gastrointestinal ulcer)
- Any history of significant hemorrhage (requiring hospitalization or transfusion) outside of a surgical setting within the last 5 years
- History of allergic reactions attributed to compounds of similar chemical or biologic composition to enoxaparin or heparin.
- History of heparin-induced thrombocytopenia
- Presence of coagulopathy (PT or PTT> 1.5 x upper limit of normal)
- Familial bleeding diathesis
- Known diagnosis of disseminated intravascular coagulation
- Currently receiving anticoagulant therapy
- Current use of aspirin (>81mg daily), Clopidogrel (Plavix), cilostazol (Pletal), aspirin-dipyridamole (Aggrenox), or regular use of non-steroidal anti-inflammatory agents more than twice weekly. Maximum dose of ibuprofen is 400mg no more than twice per week.
- Uncontrolled intercurrent illness including, but not limited to, ongoing active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Forebyggelse
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: High TFMP: Enoxaparin
Patients received enoxaparin 40 mg subcutaneously once daily for 2 months (60 days).Only patients with high TFMP status at baseline were randomized to treatment or observation.
|
Andre navne:
|
|
Ingen indgriben: High TFMP: Observation
Patients undergo observation until evaluation with a lower extremity ultrasound at 2 months (day 60).
Only patients with high TFMP status at baseline were randomized to treatment or observation.
|
|
|
Ingen indgriben: Low TFMP: Observation
Patients undergo observation until evaluation with a lower extremity ultrasound at 2 months (day 60).
Patients with low TFMP status at baseline were directly assigned to observation.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
2-Month Cumulative Incidence of VTE
Tidsramme: Assessment with lower extremity ultrasound occured at day 60/ month 2
|
2-month cumulative incidence of venous thromboembolism (VTE) is the probability of experiencing within 2 months of study entry the following events: any symptomatic proximal or distal lower extremity deep vein thrombosis, symptomatic pulmonary embolism or fatal pulmonary embolism diagnosed by autopsy, or asymptomatic proximal deep vein thrombosis diagnosed by screening compression ultrasound.
|
Assessment with lower extremity ultrasound occured at day 60/ month 2
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence of Major Hemorrhage Events
Tidsramme: Assessed during the 60 day therapy
|
Incidence is the number of patients experiencing at least one major hemorrhage events as defined according to International Society on Thrombosis and Haemostasis (ISTH) guidelines.
(Schulman and Kearon 2005)
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Assessed during the 60 day therapy
|
|
Overall Survival
Tidsramme: Assessed up to approximately 30 months
|
Overall survival is defined as the time from study entry to death or date last known alive and estimated using Kaplan-Meier (KM) methods.
|
Assessed up to approximately 30 months
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Jeffrey Zwicker, MD, Beth Israel Deaconess Medical Center
Publikationer og nyttige links
Generelle publikationer
- 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(12):CD008500. doi: 10.1002/14651858.CD008500.pub5.
- Zwicker JI, Liebman HA, Bauer KA, Caughey T, Campigotto F, Rosovsky R, Mantha S, Kessler CM, Eneman J, Raghavan V, Lenz HJ, Bullock A, Buchbinder E, Neuberg D, Furie B. Prediction and prevention of thromboembolic events with enoxaparin in cancer patients with elevated tissue factor-bearing microparticles: a randomized-controlled phase II trial (the Microtec study). Br J Haematol. 2013 Feb;160(4):530-7. doi: 10.1111/bjh.12163. Epub 2012 Dec 13.
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 08-378
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