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., …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
• Electronic 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