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Study Summary
No. 2006-0458:.......Breast; Gastrointestinal; Lung; Lymphoma; Myeloma; Ovary; Prostate......Carmen Escalante......General Internal Medicine/Ambulatory Treatment & Emergency Care
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Study Summary Title
Study Summary
Number:
2006-0458
Study Title:A Randomized, Double-blind, Placebo-controlled Study of Apixaban for the Prevention of Thromboembolic Events in Patients Undergoing Treatment for Advanced Cancer: A Phase 2 Pilot Study
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Physician New Patient Referral
Name:Carmen EscalantePatients Call:800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Dept:General Internal Medicine/Ambulatory Treatment & Emergency CareReferring MD
Call:
800-392-1611 (in U.S.A.) 713-792-6161 (outside U.S.A.)
Phone:713-792-2148
Contact us about clinical trials
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General Information
Disease Group:Breast
Gastrointestinal
Lung
Lymphoma
Myeloma
Ovary
Prostate
Supported By:N/A
Phase of Study:Phase IIReturn
Visit:
Patients receiving chemotherapy weekly or every 3 weeks, visits will be at
baseline, weeks 3, 6 and 9. Patients receiving chemotherapy every 2 or 4 weeks,
visits will be at baseline, weeks 4 and 8. All patients will have a final visit
at Week 12.
Treatment
Agents:
Apixaban
BMS-562247
Home Care:N/A
Treatment Loc:Independent Multicenter Arrangements
Estimated
Length of Stay
in Houston:
N/A
Description/
Intervention:
The goal of this clinical research study is to learn if apixaban can help to
control the development of blood clots in patients with advanced cancer who are
receiving chemotherapy. The safety of this drug will also be studied.
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Study Objectives / Outcomes
Primary Objective:
To establish, in patients undergoing chemotherapy for advanced or metastatic cancer, if apixaban will be well tolerated and accepted for the prevention of thrombosis as measured by the proportion of patients remaining free of 1) major bleeding or 2) clinically relevant non-major bleeding over the 12 week treatment period.

Secondary Objectives:
To provide information on dose selection for further studies in this population based on the tolerability of apixaban as reflected by the primary objective. Results of this pilot will be considered together with results from studies of apixaban for prophylaxis or treatment of deep vein thrombosis (DVT) in other patient populations, which due to their substantially larger size are expected to provide more extensive dose-response information.

To assess the incidence of major bleeding;

To assess singly and as a composite, the incidence of symptomatic fatal and non-fatal pulmonary embolism (PE) and symptomatic DVT;

To assess grade 3 or higher adverse events (AE)s considered to be probably or certainly related to study drug;

To assess PK profile of apixaban in the study population;

To assess the effect(s) of apixaban on selected biomarkers in the study population.
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Study Status Information
Study Activation / Registration Date:02/16/2007
IRB Review and Approval Date:10/18/2006
Study Type:Phase Ii Or Phase I/Ii
Recruitment Status:Terminated
Projected Accrual:160
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Enrollment Eligibility
If you do not meet the enrollment eligibility, there may be other treatment options for you. Please Contact the Referral Office for more information.

Inclusion Criteria:1) Patients receiving either first or second line chemotherapy for advanced or metastatic cancers including, but not limited to, lung, breast, gastrointestinal (colon, rectum, pancreas, stomach), bladder, ovarian or prostate cancer; cancer of unknown primary origin, myeloma and selected lymphomas (Note: lymphomas where chemotherapy is expected to cause marked thrombocytopenia, e.g. Burkitt's, are not eligible).

2) Able to begin study medication =/< 6 weeks of starting either first or second line chemotherapy.

3) Expected course of chemotherapy >/= 90 days after start of chemotherapy.

4) Men and women, aged 18 years or more. Apixiban has not been studied in children at this point. Once more information on Apixaban is known, the age limit will be lowered to obtain parental consent. Note: Patients receiving bevacizumab (Avastin™) are eligible to participate provided that bevacizumab is used for indications approved by local country law.

Exclusion Criteria:1) Women of child-bearing potential (WOCBP) who are unwilling or unable to use an acceptable method of contraception to avoid pregnancy for the entire study period. Examples of acceptable birth control methods include: birth control pills, an intrauterine device (IUD), or a double-barrier method (diaphragm with spermicide or condom with spermicide).

2) WOCBP using a prohibited contraceptive method.

3) Women who are pregnant or breastfeeding.

4) Women with a positive pregnancy test on enrollment or prior to study drug administration.

5) Prior history of documented DVT or PE.

6) Active bleeding or high risk for bleeding (e.g. known acute gastrointestinal ulcer).

7) Serious hemorrhage requiring hospitalization, transfusion, or surgical intervention within 4 weeks of study entry.

8) Familial bleeding diathesis.

9) Overt metastatic cancer to the brain.

10) Expected survival less than 6 months or ECOG performance equal to or more than 3.

11) Patients who are candidates for bone marrow transplantation within the 12 week treatment period or 30 day follow-up period.

12) Uncontrolled hypertension: (SBP > 200 mmHg and/or DBP > 110 mmHg). Note: All patients with "consistently (greater than 2 separate readings at different sittings, as per JNC VII guidelines) increased blood pressure" (>/= 140/90 mm Hg) will be referred for further assessment and treatment of HTN at the time of trial entry. Patients with a systolic BP >/= 160 mm Hg or diastolic BP >/= 100 mm Hg (Hypertension, Stage 2 per JNC-VII guidelines 5) will not be entered into the trial on that day but referred for further HTN management and, once below these ranges, can be entered into the trial.

13) Presence of coagulopathy (e.g. INR > 1.5 or platelet count < 100x10^9/L if not yet on chemotherapy or < 50 x 10^9/L if receiving chemotherapy); platelet count must be > 100 x 10^9/L prior to starting study medication.

14) One or more of the following: ALT > 3 x ULN, total bilirubin > 2 x ULN, calculated creatinine clearance (Cl subscript cr) < 30 mL/min.

15) Unable to take oral medications.

16) Presently receiving anticoagulant therapy (e.g. mechanical heart valves, atrial fibrillation, etc. Note: patients receiving low dose warfarin, e.g. 1 mg, for CVC may be enrolled provided warfarin is discontinued 3 days prior to study entry.)

17) Use of aspirin (ASA) more than 165 mg/day. Washout period: 7days.

18) Use of Clopidogrel (Plavix). Washout period: 7days.

19) Receiving bevacizumab (Avastin) for off-label/investigational indications.

20) Use of Azole antifungals (e.g., ketoconazole), HIV protease inhibitors (e.g., ritonavir) and macrolide antibiotics (e.g., erythromycin). Washout period: 6 months. Note: Topical azole antifungal agents are permitted.

21) Use of Aggrenox (aspirin-dipyridamole). Washout period: 7 days

22) Use of Pletal (cilostazol). Washout period: 7 days.

23) Use of Nexavar (sorafenib). Washout period: 3months.

24) Use of Sutent (sunitinib). Washout period: 3 months.

25) Use of vitamin E and gingko.

26) Participation in another pharmacotherapeutic study of an investigational agent within 30 days.

27) Prisoners or patients who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (e.g., infectious disease) illness.

28) Geographically inaccessible for follow-up.

29) Failure to provide written informed consent.

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Links
Registration Number: NCT00320255
Study Information on Clinical Trials Registry (clinicaltrials.gov)

Other Links:
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Results


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