Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer

Ettelaie, C.; Gardiner, E.; Maraveyas, A.; Bozas, G.; Fyfe, D.; Lofts, F.; Propper, D.; Roy, R.; Sgouros, J.; Waters, J.; Wedgwood, K.

Abstract

Background: Annualised figures show an up to 7-fold higher incidence of vascular thromboembolism (VTE) in patients with advanced pancreatic cancer (APC) compared to other common malignancies. Concurrent VTE has been shown to confer a worse overall prognosis in APC. Methods: One hundred and twenty three APC patients were randomised to receive either gemcitabine 1000 mg/m 2 or the same with weight-adjusted dalteparin (WAD) for 12 weeks. Primary end-point was the reduction of all-type VTE during the study period. NCT00462852, ISRCTN: 76464767. Findings: The incidence of all-type VTE during the WAD treatment period ( < 100 days from randomisation) was reduced from 23% to 3.4% (p = 0.002), with a risk ratio (RR)of 0.145, 95% confidence interval (CI) (0.035-0.612) and an 85% risk reduction. All-type VTE throughout the whole follow-up period was reduced from 28% to 12% (p = 0.039), RR = 0.419, 95% CI (0.187-0.935) and a 58% risk reduction. Lethal VTE < 100 days was seen only in the control arm, 8.3% compared to 0% (p = 0.057), RR = 0.092, 95% CI (0.005-1.635). Interpretation: Weight adjusted dalteparin used as primary prophylaxis for 12 weeks is safe and produces a highly significant reduction of all-type VTE during the prophylaxis period. The benefit is maintained after dalteparin withdrawal although decreases with time. © 2011 Elsevier Ltd. All rights reserved.

Citation

Ettelaie, C., Gardiner, E., Maraveyas, A., Bozas, G., Fyfe, D., Lofts, F., Propper, D., Roy, R., Sgouros, J., Waters, J., & Wedgwood, K. (2012). Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer. European Journal of Cancer, 48(9), 1283-1292. https://doi.org/10.1016/j.ejca.2011.10.017

• Journal Article Type: Article
• Acceptance Date: Oct 16, 2011
• Online Publication Date: Nov 17, 2011
• Publication Date: Jun 1, 2012
• Deposit Date: Nov 13, 2014
• Journal: European journal of cancer (Oxford, England : 1990)
• Print ISSN: 1879-0852
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 48
• Issue: 9
• Pages: 1283-1292
• DOI: https://doi.org/10.1016/j.ejca.2011.10.017
• Keywords: Cancer Research; Oncology
• Public URL: https://hull-repository.worktribe.com/output/464312
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0959804911008240?via%3Dihub
• Contract Date: Nov 13, 2014