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Dalteparin Low Molecular Weight Heparin for Primary Prophylaxis of Venous Thromboembolism in Brain Tumour Patients

Phase 3
Completed
Conditions
Venous Thromboembolism
Brain Tumors
Registration Number
NCT00135876
Lead Sponsor
Ontario Clinical Oncology Group (OCOG)
Brief Summary

In patients with malignant glioma, to determine the efficacy of prophylaxis with LMWH (dalteparin) compared to placebo, both commenced beyond the immediate postoperative period, for the prevention of VTE.

Detailed Description

Patients are randomized 1:1 to receive dalteparin 5,000 anti-Xa units s.c. daily versus placebo s.c. daily. The primary outcome is VTE-free survival at 6 months. Progression free survival; overall survival, toxicity, and neurocognitive performance are secondary outcome measures.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
512
Inclusion Criteria
  • Both of the following criteria must be satisfied:

    1. Patients with newly-diagnosed pathologically-confirmed WHO Grade 3 or Grade 4 glioma (anaplastic astrocytoma, glioblastoma multiforme, gliosarcoma, anaplastic oligodendroglioma, and anaplastic mixed glioma). Tumour histology is based on local pathology review only;
    2. Patients 18 years of age or older at time of randomization
Exclusion Criteria
  • If one or more of the following criteria are satisfied, the patient is not eligible for the study:

    1. The presence of acute or chronic DVT demonstrated by duplex ultrasonography (DUS) or venography. (Note: a screening DUS is not required for study entry);
    2. Inability to commence study drug within four weeks of original surgery or biopsy;
    3. Serious hemorrhage requiring hospitalization, transfusion, or surgical intervention within four weeks of potential study entry;
    4. Presence of a coagulopathy (e.g. INR >1.5 or platelet count < 100x109/L);
    5. Symptomatic intracranial or intratumoural bleeding. (Note: post-operative imaging of the brain is not required for study entry. Asymptomatic "routine" post-operative blood products in a post-surgical cavity are not an exclusion;
    6. Known acute (symptomatic or actively bleeding) gastroduodenal ulcer;
    7. Familial bleeding diathesis;
    8. Requiring long term anticoagulants for other reasons (e.g., mechanical heart valves, atrial fibrillation);
    9. Uncontrolled hypertension despite antihypertensive therapy;
    10. Significant renal failure (dependent on dialysis or creatinine of greater than three times upper limit of normal control);
    11. Prior history of documented DVT or PE;
    12. Allergy to anticoagulants (UFH, LMWH) including immune-mediated heparin-induced thrombocytopenia;
    13. Pregnant or of childbearing potential and not using adequate contraception;
    14. Geographically inaccessible for follow-up;
    15. Having an expected life span of less than 6 months;
    16. Body weight < 40 kg.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
objectively-proven symptomatic VTE (DVT or PE)
Secondary Outcome Measures
NameTimeMethod
cognition assessments
death
bleeding (major and all bleeding)
quality of life

Trial Locations

Locations (14)

Cross Cancer Institute

๐Ÿ‡จ๐Ÿ‡ฆ

Edmonton, Alberta, Canada

The Ottawa Hospital Regional Cancer Centre

๐Ÿ‡จ๐Ÿ‡ฆ

Ottawa, Ontario, Canada

Sir Charles Gairdner Hospital

๐Ÿ‡ฆ๐Ÿ‡บ

Nedlands, Western Australia, Australia

Royal Perth Hospital

๐Ÿ‡ฆ๐Ÿ‡บ

Perth, Western Australia, Australia

CancerCare Manitoba

๐Ÿ‡จ๐Ÿ‡ฆ

Winnipeg, Manitoba, Canada

Universitร  di Perugia

๐Ÿ‡ฎ๐Ÿ‡น

Perugia, Italy

The St. George Hospital

๐Ÿ‡ฆ๐Ÿ‡บ

Kogarah, New South Wales, Australia

Nova Scotia Cancer Centre

๐Ÿ‡จ๐Ÿ‡ฆ

Halifax, Nova Scotia, Canada

Ospedali Riuniti di Bergamo

๐Ÿ‡ฎ๐Ÿ‡น

Bergamo, Italy

Kellogg Cancer Center - Evanston Northwestern Healthcare

๐Ÿ‡บ๐Ÿ‡ธ

Evanston, Illinois, United States

Henry Ford Hospital

๐Ÿ‡บ๐Ÿ‡ธ

Detroit, Michigan, United States

Huntsman Cancer Institute

๐Ÿ‡บ๐Ÿ‡ธ

Salt Lake City, Utah, United States

Toronto-Sunnybrook Regional Cancer Centre

๐Ÿ‡จ๐Ÿ‡ฆ

Toronto, Ontario, Canada

Princess Margaret Hospital

๐Ÿ‡จ๐Ÿ‡ฆ

Toronto, Ontario, Canada

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