Cancer, Venous Thromboembolism
Conditions
Keywords
chemotherapy
Brief summary
The primary objective was to compare the efficacy of once daily subcutaneous injections of Semuloparin sodium (AVE5026) with placebo in the prevention of venous thromboembolism \[VTE\] in cancer patients at high risk for VTE and who were undergoing chemotherapy. The secondary objectives were to evaluate the safety of Semuloparin sodium (AVE5026), to document Semuloparin sodium (AVE5026) exposures, to try identifying a metagene predictor of VTE and to assess the survival status at one year in this population.
Detailed description
Randomization had to take place just prior to the first study drug injection (randomization ratio 1:1). The study period per participant was variable depending on the duration of chemotherapy. It included: * a screening period up to 3 weeks, * a double-blind treatment period, * a follow-up period of 1 month. Study end date was at the latest 7 months following the randomization of the last participant (6 months treatment and 1 month follow-up).
Interventions
0.4 mL solution in ready-to-use 0.5 ml pre-filled syringe Subcutaneous injection
DRUGPlacebo (for semuloparin)
0.4 mL solution in ready-to-use 0.5 ml prefilled syringe strictly identical in appearance but without active component Subcutaneous injection
Sponsors
Sanofi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Cancer patient with metastatic or locally advanced solid tumor of lung, pancreas, stomach, colon/rectum, bladder or ovary initiating a (new) course of chemotherapy with a minimum intent of 3 months therapy
Exclusion criteria
* Required systematic venous thromboprophylaxis or curative treatment with anti-coagulant or thrombolytic; * High risk of bleeding; * Severe renal impairment (estimated creatinine clearance \<30 mL/min); * ECOG (Eastern Cooperative Oncology Group) performance status 3 & 4; * Major surgery within 4 weeks before randomization; * Known hypersensitivity to unfractionated heparin \[UFH\] or low molecular weight heparin \[LMWH\]. The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Who Experienced Venous Thromboembolism Event [VTE] or VTE-related Death | From randomization up to 3 days after last study drug injection | VTE included any symptomatic Deep Vein Thrombosis \[DVT\] of lower or upper limbs and any non-fatal Pulmonary Embolism \[PE\] as confirmed by a Central Independent Adjudication Committee \[CIAC\] after review of compression ultrasound or venography for DVT, ventilation/perfusion lung scan, pulmonary angiogram or spiral computer tomography lung scan for PE. VTE-related death included fatal PE and unexplained deaths without confirmatory autopsy. Any sudden death could be classified as fatal PE by the CIAC unless diagnostic test results strongly indicated an alternative diagnosis. |
| Time-to-first Occurrence of VTE or VTE-related Death (Cumulative Incidence Function) | From randomization up to 3 days after last study drug injection | Participants alive and not having experienced VTE were right censored at last study drug injection plus 3 days. In order to correct for competing risks (Deaths other than VTE-related death), a model of cause-specific hazards was used to estimate the Cumulative incidence Function with Prentice non-parametric estimator. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival [OS] | From randomization up to 1 year after randomization or 7 months following randomization of the last participant, whichever came first | Survival status was collected for all participants either one year after randomization, or at the study end date, (ie, 7 months following randomization of the last patient), whichever came first. OS was defined as the time from date of randomization to date of death due to any cause. Participants alive were censored at last date of contact that they were known to be alive. |
| Percentage of Participants Who Experienced Clinically Relevant Bleedings | From first study drug injection up to 3 days after last study drug injection | Clinically Relevant Bleedings included overt bleedings classified by the CIAC as: * major (fatal, in a critical area/organ, causing a drop in hemoglobin ≥2 g/dL or requiring transfusion ≥2 units of blood) * clinically relevant non-major (requiring medical intervention and not meeting criteria for major bleeding). |
| Percentage of Participants who required the initiation of curative anticoagulant or thrombolytic treatment after VTE assessment | From randomization up to 3 days after last study drug injection | Initiation of curative anticoagulant or thrombolytic treatment after VTE assessment was defined from investigator's answer to the question was the subject treated for VTE? asked after diagnostic tests for suspected VTE and after lung imaging test for tumor evaluation. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Platelets Count: Percentage of Participants With Potentially Clinically Significant Abnormalities [PCSA] | From first study drug injection up to 3 days after last study drug injection | PCSA are abnormal values considered medically important by the Sponsor according to predefined criteria based on literature review. Thresholds for platelet counts were defined as follows: * Platelets count \<50 Giga/L; * Platelets count ≥50 and \<100 Giga/L; |
| Liver Function: Percentage of Participants With Potentially Clinically Significant Abnormalities [PCSA] | From first study drug injection up to 3 days after last study drug injection | Thresholds were defined as follows: * Alanine Aminotransferase \[ALAT\] \>3 Upper Normal Limit \[ULN\]; * Total Bilirubin \[TB\] \>2 ULN; * ALAT \>3 ULN and TB \>2 ULN; Cases with ALAT \>3 ULN and TB \>2 ULN (not necessarily concomitant) were evaluated by blinded independent adjudicator to determine if they met Hy's law criteria. |
Countries
Argentina, Australia, Austria, Belarus, Belgium, Brazil, Bulgaria, Canada, Chile, China, Colombia, Croatia, Czechia, Denmark, Estonia, Finland, France, Germany, Greece, Hong Kong, Hungary, India, Indonesia, Ireland, Israel, Italy, Latvia, Lithuania, Malaysia, Mexico, Netherlands, Norway, Peru, Poland, Portugal, Romania, Russia, Serbia, Slovakia, Slovenia, South Africa, South Korea, Spain, Sweden, Switzerland, Taiwan, Ukraine, United Kingdom, United States
Outcome results
None listed