Advertisement
Journal of Clinical Oncology  
Search for:
Limit by:
  Browse by Subject or Issue
Home Search or Browse JCO My JCO Subscriptions Customer Service Site Map

Journal of Clinical Oncology, Vol 22, No 10 (May 15), 2004: pp. 1944-1948
© 2004 American Society of Clinical Oncology.
DOI: 10.1200/JCO.2004.10.002
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a colleague
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Save to my personal folders
Right arrow Download to citation manager
Right arrowRights & Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kakkar, A. K.
Right arrow Articles by Williamson, R. C.N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kakkar, A. K.
Right arrow Articles by Williamson, R. C.N.
Social Bookmarking
Add to CiteULike   Add to Complore   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

Low Molecular Weight Heparin, Therapy With Dalteparin, and Survival in Advanced Cancer: The Fragmin Advanced Malignancy Outcome Study (FAMOUS)

Ajay K. Kakkar, Mark N. Levine, Zbigniew Kadziola, Nicholas R. Lemoine, Vanessa Low, Heman K. Patel, Gordon Rustin, Michael Thomas, Mary Quigley, Robin C.N. Williamson

From the Department of Surgical Oncology and Technology, and Cancer Research UK Laboratories, Imperial College; Thrombosis Research Institute; and Department of Surgery, Hammersmith Hospital, London; Mount Vernon Hospital Cancer Centre, Northwood, Hertfordshire; Department of Surgery, Bristol Royal Infirmary, Bristol; Department of Oncology, Oldchurch Hospital, Romford, Essex, United Kingdom; and Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.

Address reprint requests to Ajay K. Kakkar, MD, PhD, Department of Surgical Oncology and Technology, Imperial College, Faculty of Medicine, Hammersmith Campus, Du Cane Rd, London W12 0NN, United Kingdom; e-mail: akkakkar{at}tri-london.ac.uk

PURPOSE: In experimental systems, interference with coagulation can affect tumor biology. Furthermore, it has been suggested that low molecular weight heparin therapy may prolong survival in patients with cancer. The primary aim of this study was to assess survival at 1 year of patients with advanced cancer.

PATIENTS AND METHODS: Patients with advanced malignancy (N = 385) were randomly assigned to receive either a once-daily subcutaneous injection of dalteparin (5,000 IU), a low molecular weight heparin, or placebo for 1 year.

RESULTS: The Kaplan-Meier survival estimates at 1, 2, and 3 years after randomization for patients receiving dalteparin were 46%, 27%, and 21%, respectively, compared with 41%, 18%, and 12%, respectively, for patients receiving placebo (P = .19). In an analysis not specified a priori, survival was examined in a subgroup of patients (dalteparin, n = 55; and placebo, n = 47) who had a better prognosis and who were alive 17 months after randomization. In these patients, Kaplan-Meier survival estimates at 2 and 3 years from randomization were significantly improved for patients receiving dalteparin versus placebo (78% v 55% and 60% v 36%, respectively, P = .03). The rates of symptomatic venous thromboembolism were 2.4% and 3.3% for dalteparin and placebo, respectively, with bleeding rates of 4.7% and 2.7%, respectively.

CONCLUSION: Dalteparin administration did not significantly improve 1-year survival rates in patients with advanced malignancy. However, the observed improved survival in a subgroup of patients with a better prognosis suggests a potential modifying effect of dalteparin on tumor biology.

Supported by Pharmacia Corp, New York, NY.

Authors' disclosures of potential conflicts of interest are found at the end of this article.


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 Ann OncolHome page
A. A. Khorana
Cancer and thrombosis: implications of published guidelines for clinical practice
Ann. Onc., June 26, 2009; (2009) mdp068v1.
[Abstract] [Full Text] [PDF]

Home page
 Cleveland Clinic Journal of MedicineHome page
B. BABU and T. L. CARMAN
Cancer and clots: All cases of venous thromboembolism are not treated the same
Cleveland Clinic Journal of Medicine, February 1, 2009; 76(2): 129 - 135.
[Abstract] [Full Text] [PDF]

Home page
 Am Soc Clin Oncol Ed BookHome page
C. W. Francis and N. Kuderer
Effects of Anticoagulants on Survival for Patients with Cancer
ASCO Educational Book, January 1, 2009; 2009(1): 326 - 330.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Surg. Oncol.Home page
N. H. Osborne, T. W. Wakefield, and P. K. Henke
Venous Thromboembolism in Cancer Patients Undergoing Major Surgery
Ann. Surg. Oncol., December 1, 2008; 15(12): 3567 - 3578.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
C. Ay, R. Simanek, R. Vormittag, D. Dunkler, G. Alguel, S. Koder, G. Kornek, C. Marosi, O. Wagner, C. Zielinski, et al.
High plasma levels of soluble P-selectin are predictive of venous thromboembolism in cancer patients: results from the Vienna Cancer and Thrombosis Study (CATS)
Blood, October 1, 2008; 112(7): 2703 - 2708.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
Authors/Task Force Members, A. Torbicki, A. Perrier, S. Konstantinides, G. Agnelli, N. Galie, P. Pruszczyk, F. Bengel, A. J.B. Brady, D. Ferreira, et al.
Guidelines on the diagnosis and management of acute pulmonary embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)
Eur. Heart J., September 2, 2008; 29(18): 2276 - 2315.
[Full Text] [PDF]

Home page
 BloodHome page
D. E. Gerber, J. B. Segal, M. Y. Levy, J. Kane, R. J. Jones, and M. B. Streiff
The incidence of and risk factors for venous thromboembolism (VTE) and bleeding among 1514 patients undergoing hematopoietic stem cell transplantation: implications for VTE prevention
Blood, August 1, 2008; 112(3): 504 - 510.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
C. Fotopoulou, A. duBois, A. N. Karavas, R. Trappe, B. Aminossadati, B. Schmalfeldt, J. Pfisterer, and J. Sehouli
Incidence of Venous Thromboembolism in Patients With Ovarian Cancer Undergoing Platinum/Paclitaxel-Containing First-Line Chemotherapy: An Exploratory Analysis by the Arbeitsgemeinschaft Gynaekologische Onkologie Ovarian Cancer Study Group
J. Clin. Oncol., June 1, 2008; 26(16): 2683 - 2689.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
W. H. Geerts, D. Bergqvist, G. F. Pineo, J. A. Heit, C. M. Samama, M. R. Lassen, and C. W. Colwell
Prevention of Venous Thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest, June 1, 2008; 133(6_suppl): 381S - 453S.
[Abstract] [Full Text] [PDF]

Home page
 AM J HOSP PALLIAT CAREHome page
K. A. Kierner, V. Gartner, M. Schwarz, and H. H. Watzke
Use of Thromboprophylaxis in Palliative Care Patients: A Survey Among Experts in Palliative Care, Oncology, Intensive Care, and Anticoagulation
American Journal of Hospice and Palliative Medicine, May 1, 2008; 25(2): 127 - 131.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Nguyen, S.-J. Lee, E. Libby, and C. Verschraegen
Rate of Thromboembolic Events in Mesothelioma
Ann. Thorac. Surg., March 1, 2008; 85(3): 1032 - 1038.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
J. E. Italiano Jr, J. L. Richardson, S. Patel-Hett, E. Battinelli, A. Zaslavsky, S. Short, S. Ryeom, J. Folkman, and G. L. Klement
Angiogenesis is regulated by a novel mechanism: pro- and antiangiogenic proteins are organized into separate platelet {alpha} granules and differentially released
Blood, February 1, 2008; 111(3): 1227 - 1233.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
G. H. Lyman, A. A. Khorana, A. Falanga, D. Clarke-Pearson, C. Flowers, M. Jahanzeb, A. Kakkar, N. M. Kuderer, M. N. Levine, H. Liebman, et al.
American Society of Clinical Oncology Guideline: Recommendations for Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer
J. Clin. Oncol., December 1, 2007; 25(34): 5490 - 5505.
[Abstract] [Full Text] [PDF]

Home page
 FASEB J.Home page
N. Hostettler, A. Naggi, G. Torri, R. Ishai-Michaeli, B. Casu, I. Vlodavsky, and L. Borsig
P-selectin- and heparanase-dependent antimetastatic activity of non-anticoagulant heparins
FASEB J, November 1, 2007; 21(13): 3562 - 3572.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
A. A. Khorana
The NCCN Clinical Practice Guidelines on Venous Thromboembolic Disease: Strategies for Improving VTE Prophylaxis in Hospitalized Cancer Patients
Oncologist, November 1, 2007; 12(11): 1361 - 1370.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
A. Varki
Trousseau's syndrome: multiple definitions and multiple mechanisms
Blood, September 15, 2007; 110(6): 1723 - 1729.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
J.-S. Wang, C.-Y. Chang, S.-E. Chow, Y.-W. Chen, and C.-M. Yang
Exercise modulates platelet-nasopharyngeal carcinoma cell aggregation and subsequent tissue factor and matrix metalloproteinase activities
J Appl Physiol, September 1, 2007; 103(3): 763 - 770.
[Abstract] [Full Text] [PDF]

Home page
 CA Cancer J ClinHome page
R. D. Loberg, D. A. Bradley, S. A. Tomlins, A. M. Chinnaiyan, and K. J. Pienta
The Lethal Phenotype of Cancer: The Molecular Basis of Death Due to Malignancy
CA Cancer J Clin, July 1, 2007; 57(4): 225 - 241.
[Abstract] [Full Text] [PDF]

Home page
 J Oncol Pharm PractHome page
J. Nishioka and S. Goodin
Low-molecular-weight heparin in cancer-associated thrombosis: treatment, secondary prevention, and survival
Journal of Oncology Pharmacy Practice, June 1, 2007; 13(2): 85 - 97.
[Abstract] [PDF]

Home page
 Eur Heart JHome page
R. De Caterina, S. Husted, L. Wallentin, G. Agnelli, F. Bachmann, C. Baigent, J. Jespersen, S. D. Kristensen, G. Montalescot, A. Siegbahn, et al.
Anticoagulants in heart disease: current status and perspectives
Eur. Heart J., April 10, 2007; (2007) ehl492v1.
[Full Text] [PDF]

Home page
 Neuro OncolHome page
R. Simanek, R. Vormittag, M. Hassler, K. Roessler, M. Schwarz, C. Zielinski, I. Pabinger, and C. Marosi
Venous thromboembolism and survival in patients with high-grade glioma
Neuro-oncol, April 1, 2007; 9(2): 89 - 95.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
G Meyer
Does low-molecular-weight heparin influence cancer-related mortality?
Ann. Onc., March 1, 2007; 18(3): 609 - 610.
[Full Text] [PDF]

Home page
 JCOHome page
H. K. Chew, T. Wun, D. J. Harvey, H. Zhou, and R. H. White
Incidence of Venous Thromboembolism and the Impact on Survival in Breast Cancer Patients
J. Clin. Oncol., January 1, 2007; 25(1): 70 - 76.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
A Fennerty
Venous thromboembolic disease and cancer.
Postgrad. Med. J., October 1, 2006; 82(972): 642 - 648.
[Abstract] [Full Text] [PDF]

Home page
 Molecular Cancer TherapeuticsHome page
G. W. Yip, M. Smollich, and M. Gotte
Therapeutic value of glycosaminoglycans in cancer.
Mol. Cancer Ther., September 1, 2006; 5(9): 2139 - 2148.
[Abstract] [Full Text] [PDF]

Home page
 Integr Cancer TherHome page
M. F. McCarty and K. I. Block
Toward a Core Nutraceutical Program for Cancer Management
Integr Cancer Ther, June 1, 2006; 5(2): 150 - 171.
[Abstract] [PDF]

Home page
 Mayo Clin Proc.Home page
K. Sideras, P. L. Schaefer, S. H. Okuno, J. A. Sloan, L. Kutteh, T. R. Fitch, S. R. Dakhil, R. Levitt, S. R. Alberts, R. F. Morton, et al.
Low-Molecular-Weight Heparin in Patients With Advanced Cancer: A Phase 3 Clinical Trial
Mayo Clin. Proc., June 1, 2006; 81(6): 758 - 767.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
J. C Chambers
Prophylactic heparin in palliative care: ...to a challenging idea.
BMJ, March 25, 2006; 332(7543): 729 - 729.
[Full Text]

Home page
 Arch Intern MedHome page
H. K. Chew, T. Wun, D. Harvey, H. Zhou, and R. H. White
Incidence of venous thromboembolism and its effect on survival among patients with common cancers.
Arch Intern Med, February 27, 2006; 166(4): 458 - 464.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
L. Y. Han, C. N. Landen Jr, A. A. Kamat, A. Lopez, D. P. Bender, P. Mueller, R. Schmandt, D. M. Gershenson, and A. K. Sood
Preoperative Serum Tissue Factor Levels Are an Independent Prognostic Factor in Patients With Ovarian Carcinoma
J. Clin. Oncol., February 10, 2006; 24(5): 755 - 761.
[Abstract] [Full Text] [PDF]

Home page
 Cancer Res.Home page
H. Laubli, J. L. Stevenson, A. Varki, N. M. Varki, and L. Borsig
L-Selectin Facilitation of Metastasis Involves Temporal Induction of Fut7-Dependent Ligands at Sites of Tumor Cell Arrest
Cancer Res., February 1, 2006; 66(3): 1536 - 1542.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
K. Kroger, D. Weiland, C. Ose, N. Neumann, S. Weiss, C. Hirsch, K. Urbanski, S. Seeber, and M. E. Scheulen
Risk factors for venous thromboembolic events in cancer patients
Ann. Onc., February 1, 2006; 17(2): 297 - 303.
[Abstract] [Full Text] [PDF]

Home page
 ASH Education BookHome page
A. Y. Y. Lee
Thrombosis and Cancer: The Role of Screening for Occult Cancer and Recognizing the Underlying Biological Mechanisms
Hematology, January 1, 2006; 2006(1): 438 - 443.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
P. Prandoni
How I treat venous thromboembolism in patients with cancer
Blood, December 15, 2005; 106(13): 4027 - 4033.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
J. Hasan, S. D. Shnyder, A. R. Clamp, A. T. McGown, R. Bicknell, M. Presta, M. Bibby, J. Double, S. Craig, D. Leeming, et al.
Heparin Octasaccharides Inhibit Angiogenesis In vivo
Clin. Cancer Res., November 15, 2005; 11(22): 8172 - 8179.
[Abstract] [Full Text] [PDF]

Home page
 Am J Health Syst PharmHome page
S. Goodin
Selecting an anticoagulant for recurrent venous thromboembolism in cancer
Am. J. Health Syst. Pharm., November 15, 2005; 62(22_Supplement_5): S10 - S13.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
J. L. Stevenson, S. H. Choi, and A. Varki
Differential Metastasis Inhibition by Clinically Relevant Levels of Heparins--Correlation with Selectin Inhibition, Not Antithrombotic Activity
Clin. Cancer Res., October 1, 2005; 11(19): 7003 - 7011.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
E. Arbit, M. Alifano, G. Benedetti, and R. Trisolini
Low-Molecular-Weight Heparin and Outcomes
Chest, July 1, 2005; 128(1): 471 - 472.
[Full Text] [PDF]

Home page
 JCOHome page
N. R. Lemoine
Antithrombotic Therapy in Cancer
J. Clin. Oncol., April 1, 2005; 23(10): 2119 - 2120.
[Full Text] [PDF]

Home page
 JCOHome page
A. Y.Y. Lee, F. R. Rickles, J. A. Julian, M. Gent, R. I. Baker, C. Bowden, A. K. Kakkar, M. Prins, and M. N. Levine
Randomized Comparison of Low Molecular Weight Heparin and Coumarin Derivatives on the Survival of Patients With Cancer and Venous Thromboembolism
J. Clin. Oncol., April 1, 2005; 23(10): 2123 - 2129.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
M. Ozkan, B. Eser, O. Er, G. G. Dogu, and M. Altinbas
Inhibition of Angiogenesis: Thalidomide or Low-Molecular-Weight Heparin?
J. Clin. Oncol., March 20, 2005; 23(9): 2113 - 2113.
[Full Text] [PDF]

Home page
 CirculationHome page
S. Z. Goldhaber
Tamoxifen: Preventing Breast Cancer and Placing the Risk of Deep Vein Thrombosis in Perspective
Circulation, February 8, 2005; 111(5): 539 - 541.
[Full Text] [PDF]

Home page
 BloodHome page
J. S. Palumbo, K. E. Talmage, J. V. Massari, C. M. La Jeunesse, M. J. Flick, K. W. Kombrinck, M. Jirouskova, and J. L. Degen
Platelets and fibrin(ogen) increase metastatic potential by impeding natural killer cell-mediated elimination of tumor cells
Blood, January 1, 2005; 105(1): 178 - 185.
[Abstract] [Full Text] [PDF]

Home page
 ASH Education BookHome page
J. A. Lopez, C. Kearon, and A. Y.Y. Lee
Deep Venous Thrombosis
Hematology, January 1, 2004; 2004(1): 439 - 456.
[Abstract] [Full Text] [PDF]


About
JCO		 Editorial
Roster		 Advertising
Information		 Librarians &
Institutions		 Rights &
Permissions		 PDA Services

Copyright © 2004 by the American Society of Clinical Oncology, Online ISSN: 1527-7755. Print ISSN: 0732-183X
Terms and Conditions of Use
  HighWire Press HighWire Press™ assists in the publication of JCO Online