A Study Comparing Abelacimab to Apixaban in the Treatment of Cancer-associated VTE
- Conditions
- Deep Venous ThrombosisPulmonary EmbolismVenous Thromboembolism
- Interventions
- Registration Number
- NCT05171049
- Lead Sponsor
- Anthos Therapeutics, Inc.
- Brief Summary
This is a Phase 3,multicenter, randomized, open-label, blinded endpoint evaluation study comparing the effect of abelacimab relative to apixaban on venous thromboembolism (VTE) recurrence and bleeding in patients with cancer associated VTE (ASTER)
- Detailed Description
Cancer associated thrombosis (CAT) is a severe medical condition which is characterized by high incidence of Venous thromboembolism (VTE) recurrence and high risk for bleeding. The two most common treatments today are low molecular weight heparin (LMWH) and direct anticoagulants (DOACs), in which each has limitations. DOACs are administered orally and are seen as a more convenient alternative though associated with bleeding risk; further, some cancer patients have difficulty swallowing or develop vomiting which leads to unpredictable pharmacodynamic effects with oral therapy. The ANT-007 study will compare treatment with abelacimab monthly administration to apixaban twice daily administration over a 6-month treatment. The study outcomes include VTE recurrence, bleeding event and treatment discontinuation at 6 months
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 1655
-
Male or female subjects ≥18 years old or other legal maturity age according to the country of residence
-
Confirmed diagnosis of cancer (by histology, adequate imaging modality), other than basal-cell or squamous-cell carcinoma of the skin alone with one of the following:
- Active cancer, defined as either locally active, regionally invasive, or metastatic cancer at the time of randomization and/or
- Currently receiving or having received anticancer therapy (radiotherapy, chemotherapy, hormonal therapy, any kind of targeted therapy or any other anticancer therapy) in the last 6 months.
-
Confirmed symptomatic or incidental proximal lower limb deep vein thrombosis (DVT) (i.e., popliteal, femoral, iliac, and/or inferior vena cava [IVC] thrombosis) and/or a confirmed symptomatic pulmonary embolism (PE), or an incidental PE in a segmental, or larger pulmonary artery.
Patients are eligible within 120 hours from diagnosis of the qualifying VTE
- Anticoagulation therapy with a therapeutic dose of DOAC for at least 6 months is indicated
- Able to provide written informed consent
- Thrombectomy, insertion of a caval filter or use of a fibrinolytic agent to treat the current (index) DVT and/or PE
- More than 120 hours of pre-treatment with therapeutic doses of UFH, LMWH, fondaparinux, DOAC, or other anticoagulants
- An indication to continue treatment with therapeutic doses of an anticoagulant other than that VTE treatment prior to randomization (e.g., atrial fibrillation [AF], mechanical heart valve, prior VTE)
- Platelet count <50,000/mm3 at the screening visit
- PE leading to hemodynamic instability (blood pressure [BP] <90 mmHg or shock)
- Acute ischemic or hemorrhagic stroke or intracranial hemorrhage within the 4 weeks preceding screening
- Brain trauma or a cerebral or spinal cord surgery or spinal procedures such as lumbar puncture or epidural/spinal anesthesia within 4 weeks of screening
- Need for aspirin in a dosage of >100 mg/day or any other antiplatelet agent alone or in combination with aspirin
- Primary brain cancer or untreated intracranial metastases at baseline
- Acute myeloid or lymphoid leukemia
- Bleeding requiring medical attention at the time of randomization or in the preceding 4 weeks
- Planned brain, spinal cord, cardiac, vascular, major thoracic and/or major abdominal surgery in the 4 weeks following randomization
- Eastern Cooperative Oncology Group (ECOG) performance status of 3 or 4 at screening
- Life expectancy <3 months at randomization
- Calculated creatinine clearance (CrCl) <30 mL/min (Cockcroft-Gault equation) at the screening visit
- Hemoglobin <8 g/dL at the screening visit
- Acute hepatitis, chronic active hepatitis, liver cirrhosis; or an alanine aminotransferase (ALT) ≥3 x and/or bilirubin ≥2 x upper limit of normal (ULN) at the screening visit in absence of clinical explanation
- Uncontrolled hypertension (systolic BP>180 mm Hg or diastolic BP >100 mm Hg despite antihypertensive treatment)
- Women of child-bearing potential (WOCBP) who are unwilling or unable to use highly effective contraceptive measures during the study from screening up to 3 days after last treatment of apixaban or 100 days after administration of abelacimab (See Section 5.3.6. for highly effective contraceptive measures)
- Sexually active males with sexual partners of childbearing potential must agree to use a condom or other reliable contraceptive measure up to 3 days after last treatment of apixaban or 100 days after administration of abelacimab
- Pregnant or breast-feeding women
- Patients known to be receiving strong dual inducers or inhibitors of both CYP3A4 and P gp
- History of hypersensitivity to any of the study drugs (including apixaban) or excipients, to drugs of similar chemical classes, or any contraindication listed in the label for apixaban
- Subjects with any condition that in the Investigator's judgement would place the subject at increased risk of harm if he/she participated in the study
- Use of other investigational (not registered) drugs within 5 half-lives prior to enrollment or until the expected pharmacodynamic(s) (PD) effect has returned to baseline, whichever is longer. Participation in academic non-interventional studies or interventional studies, comprising testing different strategies or different combinations of registered drugs is permitted
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Apixaban Apixaban Apixaban administered orally twice a day Abelacimab Abelacimab Abelacimab intravenous administration followed by monthly administration of the same dose subcutaneously
- Primary Outcome Measures
Name Time Method Time to first event of centrally adjudicated VTE recurrence consisting of new proximal deep venous thrombosis, new pulmonary embolism (PE) or fatal PE, including unexplained death for which PE cannot be ruled out 6 months
- Secondary Outcome Measures
Name Time Method Time to first event of ISTH-adjudicated major or clinically relevant non-major (CRNM) bleeding events 6 months Net clinical benefit defined as survival without VTE recurrence, or major or CRNM bleeding 6 months
Trial Locations
- Locations (211)
Bon Secour Hospital
🇮🇪Cork, Ireland
University of Colorado Anschutz Medical Campus
🇺🇸Aurora, Colorado, United States
VA Connecticut Healthcare System
🇺🇸West Haven, Connecticut, United States
Washington DC VAMC
🇺🇸Washington, District of Columbia, United States
University of Miami Health
🇺🇸Miami, Florida, United States
NorthShore University Health System
🇺🇸Evanston, Illinois, United States
University of Kentucky, Markey Cancer Center
🇺🇸Lexington, Kentucky, United States
Brigham and Women's Hospital
🇺🇸Boston, Massachusetts, United States
Beth Israel Deaconess Medical Center
🇺🇸Boston, Massachusetts, United States
Henry Ford Health System
🇺🇸Detroit, Michigan, United States
Washington University
🇺🇸Saint Louis, Missouri, United States
Memorial Sloan Kettering Cancer Center-Middletown
🇺🇸Middletown, New Jersey, United States
Memorial Sloan Kettering Cancer Center-Commack
🇺🇸Commack, New York, United States
Memorial Sloan Kettering Cancer Center-West Harrison
🇺🇸Harrison, New York, United States
Memorial Sloan Kettering Cancer Center
🇺🇸New York, New York, United States
Lipson Cancer Institute
🇺🇸Rochester, New York, United States
Duke University Medical Center
🇺🇸Durham, North Carolina, United States
Cleveland Clinic Foundation
🇺🇸Cleveland, Ohio, United States
University of Oklahoma Health Sciences Center
🇺🇸Oklahoma City, Oklahoma, United States
University of Pennsylvania - Penn Blood Disorders Center
🇺🇸Philadelphia, Pennsylvania, United States
Temple University Hospital
🇺🇸Philadelphia, Pennsylvania, United States
MD Anderson Cancer Center
🇺🇸Houston, Texas, United States
University of Texas Mays Cancer Center
🇺🇸San Antonio, Texas, United States
Sentara Pulmonary, Critical Care, and Sleep Specialists
🇺🇸Norfolk, Virginia, United States
Gundersen Health System
🇺🇸La Crosse, Wisconsin, United States
Blood Center of Wisconsin
🇺🇸Milwaukee, Wisconsin, United States
Blacktown Hospital
🇦🇺Blacktown, New South Wales, Australia
Concord Repatriation General Hospital
🇦🇺Concord, New South Wales, Australia
Westmead Hospital
🇦🇺Westmead, New South Wales, Australia
Box Hill Hospital
🇦🇺Box Hill, Victoria, Australia
Monash Medical Centre Clayton
🇦🇺Clayton, Victoria, Australia
Northern Health
🇦🇺Epping, Victoria, Australia
Perth Blood Institute
🇦🇺Perth, Australia
The Alfred Hospital
🇦🇺Prahran, Australia
LKH - Universitätsklinikum Graz
🇦🇹Graz, Austria
LK Wiener Neustadt
🇦🇹Neustadt, Austria
Medical University of Vienna
🇦🇹Vienna, Austria
University of Calgary
🇨🇦Calgary, Alberta, Canada
University of Alberta Hospital
🇨🇦Edmonton, Alberta, Canada
Hamilton Health Sciences, Juravinski Hospital and Cancer Centre
🇨🇦Hamilton, Ontario, Canada
Ottawa Hospital
🇨🇦Ottawa, Ontario, Canada
Niagara Health System
🇨🇦Saint Catharines, Ontario, Canada
Sault Area Hospital
🇨🇦Sault-Sainte-Marie, Ontario, Canada
Toronto General Hospital
🇨🇦Toronto, Ontario, Canada
Jewish General Hospital
🇨🇦Montréal, Quebec, Canada
McGill University Health Centre
🇨🇦Québec, Canada
Queen Elizabeth II Health Sciences Centre
🇨🇦Nova Scotia, Canada
Beijing Shijitan Hosp.
🇨🇳Beijing, China
Peking University Third Hospital
🇨🇳Beijing, China
CHU de Grenoble - Hôpital Albert Michallon
🇫🇷Grenoble, France
Jilin Province Tumor Hospital
🇨🇳Ch'ang-ch'un, China
Southern Medical University - Zhujiang Hospital
🇨🇳Guangdong, China
Nanfang Hospital of Southern Medical University
🇨🇳Guangzhou, China
The Sixth Affiliated Hospital of Sun Yat-Sen University
🇨🇳Guangzhou, China
Huizhou Municipal Central Hospital
🇨🇳Huizhou, China
Nanjing First Hospital
🇨🇳Nanjing, China
Jiangsu Province Hospital
🇨🇳Nanjing, China
The First Affiliated Hospital of Wenzhou Medical University
🇨🇳Wenzhou, China
Union Hospital Tongji Medical College Huazhong University of Science &Technology
🇨🇳Wuhan, China
Tongji Hospital, Tongji Medical College
🇨🇳Wuhan, China
1st Affiliate Hospital of Xi'an Jiao
🇨🇳Xi'an, China
Masarykuv onkologicky ustav
🇨🇿Brno, Czechia
University Hospital Hradec Kralove
🇨🇿Hradec Kralove, Czechia
Nemocnice Na Pleši s.r.o.
🇨🇿Nová Ves Pod Pleší, Czechia
Onkologická klinika VFN a 1. LF UK
🇨🇿Prague, Czechia
Thomayerova nemocnice
🇨🇿Praha, Czechia
CHU Amiens - Hopital Nord
🇫🇷Amiens, France
CHU Angers - Hôpital Hôtel Dieu
🇫🇷Angers, France
CHU de Brest - Hôpital de la Cavale Blanche
🇫🇷Brest, France
CHU Clermont Ferrand - Hopital Gabriel Montpied
🇫🇷Clermont-Ferrand, France
Hôpital Louis Mourier
🇫🇷Colombes, France
CHU Dijon - Hôpital Bocage Central
🇫🇷Dijon, France
University of Pécs
🇭🇺Pécs, Hungary
CH Le Puy en Velay
🇫🇷Le Puy-en-Velay, France
CHU de Limoges - Hôpital Dupuytren
🇫🇷Limoges, France
Hopital Timone Adultes
🇫🇷Marseille, France
Centre hospitalier des pays de Morlaix
🇫🇷Morlaix, France
Hôpital Européen Georges Pompidou
🇫🇷Paris, France
Groupe Hospitalier Pitie-Salpetriere
🇫🇷Paris, France
Hospices Civils de Lyon (HCL) - Centre Hospitalier Lyon-Sud
🇫🇷Pierre-Bénite, France
CHU de Rouen - Hôpital de Bois Guillaume
🇫🇷Rouen, France
CHU de Saint-Etienne - Hopital Nord
🇫🇷Saint-Étienne, France
CHU Strasbourg - Nouvel Hôpital Civil
🇫🇷Strasbourg, France
Nouvel Hôpital Civil de Strasbourg
🇫🇷Strasbourg, France
Centre Hospitalier Intercommunal de Toulon
🇫🇷Toulon, France
CHU de Toulouse - Hôpital Rangueil
🇫🇷Toulouse, France
CHU de Nancy - Hôpital de Brabois Adultes
🇫🇷Vandœuvre-lès-Nancy, France
Staedtisches Klinikum Dresden Standort Dresden-Friedrichstadt
🇩🇪Dresden, Germany
Universitaetsklinikum Carl Gustav Carus TU Dresden
🇩🇪Dresden, Germany
Praxis für Gefäßmedizin
🇩🇪Görlitz, Germany
Universitaetsklinikum Hamburg-Eppendorf
🇩🇪Hamburg, Germany
Universitätsklinik der Christian-Albrechts-Universität
🇩🇪Kiel, Germany
Universitätsklinik Leipzig
🇩🇪Leipzig, Germany
Universitaetsklinikum Magdeburg A.oe.R
🇩🇪Magdeburg, Germany
Klinikum der Universitaet Muenchen
🇩🇪Muenchen, Germany
Orszagos Onkologiai Intezet
🇭🇺Budapest, Hungary
Debreceni Egyetem
🇭🇺Debrecen, Hungary
Markhot Ferenc Oktatokorhaz es Rendelointezet
🇭🇺Eger, Hungary
Bacs-Kiskun County Hospital
🇭🇺Kecskemét, Hungary
Cork University Hospital
🇮🇪Cork, Ireland
Beaumont Hospital
🇮🇪Dublin, Ireland
Msdyrt Midericordiae University Hospital
🇮🇪Dublin, Ireland
University Hospital, Limerick
🇮🇪Limerick, Ireland
IRCCS Istituto Tumori Giovanni Paolo II
🇮🇹Bari, Italy
Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII
🇮🇹Bergamo, Italy
Arcispedale S. Maria Nuova Azienda Ospedaliera di Reggio Emilia
🇮🇹Reggio Emilia, Italy
Presidio Ospedaliero di Castelfranco Veneto
🇮🇹Castelfranco Veneto, Italy
SS. ma Annunziata
🇮🇹Chieti, Italy
Ospedale Civile Dell Annunziata
🇮🇹Cosenza, Italy
Ospedale Degli Infermi
🇮🇹Faenza, Italy
Azienda Ospedaliero Universitaria San Martino
🇮🇹Genova, Italy
Presidio Ospedaliero della Misericordia
🇮🇹Grosseto, Italy
Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo
🇮🇹Milano, Italy
A.O.U. Policlinico di Modena
🇮🇹Modena, Italy
Istituto Nazionale Tumori Fondazione G. Pascale
🇮🇹Napoli, Italy
Azienda Ospedale - Università Padova
🇮🇹Padova, Italy
Azienda Ospedaliero Universitaria di Parma
🇮🇹Parma, Italy
Universit degli Studi di Perugia - Azienda Ospedaliera di Perugia
🇮🇹Perugia, Italy
Azienda Ospedaliero Universitaria Pisana
🇮🇹Pisa, Italy
Fondazione Policlinico Universitario A. Gemelli IRCCS.
🇮🇹Roma, Italy
Istituto Clinico Humanitas
🇮🇹Rozzano, Italy
Ospedale Santa Maria di Cà Foncello
🇮🇹Treviso, Italy
Azienda Ospedaliero-Universitaria Santa Maria della Misericordia
🇮🇹Udine, Italy
Università dell'Insubria
🇮🇹Varese, Italy
Ospedale SS. Giovanni e Paolo
🇮🇹Venezia, Italy
Ospedalemichele e Pietro ferrer
🇮🇹Verduno, Italy
Ospedale San Bortolo di Vicenza
🇮🇹Vicenza, Italy
National Cancer Center Hospital
🇯🇵Tsukiji, Tokyo, Japan
Chibaken Saiseikai Narashino Hospital
🇯🇵Chiba, Japan
Kyushu University Hospital
🇯🇵Fukuoka, Japan
Tokai University Hospital
🇯🇵Isehara, Japan
Yokohama Minami Kyosai Hospital
🇯🇵Kanagawa, Japan
Kobe University Hospital
🇯🇵Kobe, Japan
Kumamoto University Hospital
🇯🇵Kumamoto, Japan
Kyoto University Hospital
🇯🇵Kyoto, Japan
Mie University Hospital
🇯🇵Mie, Japan
Tokyo Saiseikai Central Hospital
🇯🇵Minato-Ku, Japan
Tohoku University Graduate School of Medicine
🇯🇵Miyagi, Japan
Okayama Medical Center
🇯🇵Okayama, Japan
Osaka International Cancer Institute
🇯🇵Osaka, Japan
International University of Health and Welfare MITA Hospital
🇯🇵Tokyo, Japan
Juntendo University Hospital
🇯🇵Tokyo, Japan
Kyorin University Hospital
🇯🇵Tokyo, Japan
Myongji Hospital
🇰🇷Goyang-si, Gyeonggi-do, Korea, Republic of
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Gyeonggi-do, Korea, Republic of
Yongin Severance Hospital, Yonsei University Health System
🇰🇷Yongin-si, Gyeonggi-do, Korea, Republic of
Hallym University Sacred Heart Hospital
🇰🇷Anyang, Korea, Republic of
SoonChunHyang University Hospital Bucheon
🇰🇷Bucheon, Korea, Republic of
Daegu Catholic University Medical Center
🇰🇷Daegu, Korea, Republic of
Kyung Hee University Hospital at Gangdong
🇰🇷Gangdong, Korea, Republic of
Jeonbuk National University Hospital
🇰🇷Jeonju, Korea, Republic of
Dong-A University Hospital
🇰🇷Seogu, Korea, Republic of
Soonchunhyang University Seoul Hospital
🇰🇷Yongsan, Korea, Republic of
Ewha Womans University Mokdong Hospital
🇰🇷Yangcheon, Korea, Republic of
Daugavpils Regional Hospital
🇱🇻Daugavpils, Latvia
Liepaja Regional Hospital
🇱🇻Liepāja, Latvia
Pauls Stradins Clinical University Hospital
🇱🇻Riga, Latvia
Riga East Clinical University hospital
🇱🇻Riga, Latvia
Meander Medisch Centrum
🇳🇱Amersfoort, Netherlands
Onze Lieve Vrouwe Gasthuis, Locatie Oost
🇳🇱Amsterdam, Netherlands
Rode Kruis Ziekenhuis
🇳🇱Beverwijk, Netherlands
Haga Ziekenhuis
🇳🇱Den Haag, Netherlands
Albert Schweitzer Ziekenhuis, Dordwijk
🇳🇱Dordrecht, Netherlands
Universitair Medisch Centrum Groningen
🇳🇱Groningen, Netherlands
Tergooiziekenhuizen, Hilversum
🇳🇱Hilversum, Netherlands
Amsterdam University Medical Center
🇳🇱Holland, Netherlands
Spaarne Gasthuis (Kennemer Gasthuis) - Haarlem-Zuid
🇳🇱Hoofddorp, Netherlands
Leids Universitair Medisch Centrum
🇳🇱Leiden, Netherlands
Radboud Universitair Medisch Centrum
🇳🇱Nijmegen, Netherlands
Ikazia Ziekenhuis
🇳🇱Rotterdam, Netherlands
Østfold Hospital Kalnes
🇳🇴Fredrikstad, Norway
Akershus Univeristy Hospital
🇳🇴Lørenskog, Norway
Oslo University Hospital, Dep of Haematology
🇳🇴Oslo, Norway
Complejo Hospital Vall D'Heborn
🇪🇸Barcelona, Spain
Hospital Clinic de Barcelona
🇪🇸Barcelona, Spain
Hospital de la Santa Creu I Sant Pau
🇪🇸Barcelona, Spain
Hospital Universitario Del Vinalopo
🇪🇸Elche, Spain
Hospital General Universitario de Elche
🇪🇸Elche, Spain
Hospital Universitario Virgen de las Nieves
🇪🇸Granada, Spain
Hospital Universitario Ciudad de Jaen
🇪🇸Jaén, Spain
Hospital Universitario Lucus Augusti
🇪🇸Lugo, Spain
Hospital General Universitario Gregorio Marañon
🇪🇸Madrid, Spain
Clinica Universidad de Navarra
🇪🇸Pamplona, Spain
Hospital Universitario Infanta Leonor
🇪🇸Madrid, Spain
MD Anderson Cancer Centre
🇪🇸Madrid, Spain
Hospital Universitario Clinico San Carlos
🇪🇸Madrid, Spain
Hospital Universitario Puerta de Hierro Majadahonda
🇪🇸Majadahonda, Spain
Complejo Hospitalario Universitario de Orense
🇪🇸Ourense, Spain
Corporacio Sanitaria Parc Tauli
🇪🇸Sabadell, Spain
Hospital Universitario Marques de Valdecilla
🇪🇸Santander, Spain
Complejo Hospitalario Universitario de Santiago
🇪🇸Santiago De Compostela, Spain
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain
Länssjukhuset Sundsvall-Härnösand
🇸🇪Sundsvall, Sweden
Inselspital - Universitaetsspital Bern
🇨🇭Bern, Switzerland
Hopital Universitaire Geneve
🇨🇭Geneve, Switzerland
Centre Hospitalier Universitaire Vaudois
🇨🇭Lausanne, Switzerland
University of Zürich
🇨🇭Zürich, Switzerland
Kaohsiung Medical University Chung-Ho Memorial Hospital
🇨🇳Kaohsiung, Taiwan
Far Eastern Memorial Hospital
🇨🇳New Taipei City, Taiwan
China Medical University Hospital
🇨🇳Taichung, Taiwan
Taichung Veterans General Hospital
🇨🇳Taichung, Taiwan
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
Koo Foundation Sun Yat-Sen Cancer Center
🇨🇳Taipei, Taiwan
Tri-Service General Hospital
🇨🇳Taipei, Taiwan
University Hospital of Wales
🇬🇧Cardiff, England, United Kingdom
University Hospitals of North Midlands
🇬🇧Stoke-on-Trent, England, United Kingdom
Castle Hill Hospital, Department of Oncology & Haematology
🇬🇧Cottingham, ENG, United Kingdom
Barts Health NHS Trust
🇬🇧London, ENG, United Kingdom
The Newcastle Upon Tyne Hospitals
🇬🇧Newcastle upon Tyne, ENG, United Kingdom
Queen Elizabeth University Hospital Campus
🇬🇧Glasgow, SCO, United Kingdom