Anti-tumour effect of low molecular weight heparin in localised lung cancer: a phase III clinical trial

The anti-tumour and anti-metastatic properties of heparins have not been tested in patients with early stage cancer. Whether adjuvant low molecular weight heparin (LMWH) tinzaparin impacts the survival of patients with resected non-small cell lung cancer (NSCLC) was investigated.Patients with comple...

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Published in:The European respiratory journal Vol. 52; no. 4
Main Authors: Meyer, Guy, Besse, Benjamin, Doubre, Hélène, Charles-Nelson, Anaïs, Aquilanti, Sandro, Izadifar, Armine, Azarian, Reza, Monnet, Isabelle, Lamour, Corinne, Descourt, Renaud, Oliviero, Gérard, Taillade, Laurent, Chouaid, Christos, Giraud, Frederique, Falcoz, Pierre-Emmanuel, Revel, Marie-Pierre, Westeel, Virginie, Dixmier, Adrien, Tredaniel, Jean, Dehette, Stéphanie, Decroisette, Chantal, Prevost, Alain, Pichon, Eric, Fabre, Elizabeth, Soria, Jean-Charles, Friard, Sylvie, Stern, Jean-Baptiste, Jabot, Laurence, Dennewald, Georges, Pavy, Gérard, Petitpretz, Patrick, Tourani, Jean-Marc, Alifano, Marco, Chatellier, Gilles, Girard, Philippe
Format: Journal Article
Language:English
Published: England 01.10.2018
Subjects:
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - surgery
Chemotherapy, Adjuvant
Female
France - epidemiology
Heparin, Low-Molecular-Weight - therapeutic use
Humans
Injections, Subcutaneous
Lung Neoplasms - drug therapy
Lung Neoplasms - surgery
Male
Middle Aged
Neoplasm Staging
Survival Analysis
Tinzaparin - therapeutic use
France
ISSN:1399-3003, 1399-3003
Online Access:Get more information
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Summary:The anti-tumour and anti-metastatic properties of heparins have not been tested in patients with early stage cancer. Whether adjuvant low molecular weight heparin (LMWH) tinzaparin impacts the survival of patients with resected non-small cell lung cancer (NSCLC) was investigated.Patients with completely resected stage I, II or IIIA NSCLC were randomly allocated to receive subcutaneous tinzaparin 100 IU·kg once a day for 12 weeks or no treatment in addition to standard of care. The trial was open-label with blinded central adjudication of study outcomes. The primary outcome was overall survival.In 549 patients randomised to tinzaparin (n=269) or control (n=280), mean±sd age was 61.6±8.9 years, 190 (34.6%) patients had stage II-III disease, and 220 (40.1%) patients received adjuvant chemotherapy. Median follow-up was 5.7 years. There was no significant difference in overall survival between groups (hazard ratio (HR) 1.24, 95% CI 0.92-1.68; p=0.17). There was no difference in the cumulative incidence of recurrence between groups (subdistribution HR 0.94, 95% CI 0.68-1.30; p=0.70).Adjuvant tinzaparin had no detectable impact on overall and recurrence-free survival of patients with completely resected stage I-IIIA NSCLC. These results do not support further clinical evaluation of LMWHs as anti-tumour agents.
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ISSN:1399-3003
1399-3003
DOI:10.1183/13993003.01220-2018