Managing blood clot prevention in cancer patients with catheter-related DVT

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This trial evaluates a management strategy for patients with cancer who have experienced catheter-related upper extremity deep vein thrombosis (DVT) after completing at least three months of therapeutic anticoagulation. The STREAM-Line management strategy involves administering a prophylactic dose of apixaban to prevent further clot formation as long as the patient has an active cancer or a central venous catheter. Follow-up assessments will occur at 90 and 180 days to monitor safety and efficacy. The goal is to determine the safety of this approach in preventing recurrent DVT in this high-risk population.

Why it matters

Who can join: the full rules

Inclusion Criteria:

Adult patients (≥ 18 years old) with active cancer, defined as cancer (other than localized non-melanoma skin cancer) diagnosed or treated within 6 months, or the presence of metastatic, recurrent, or progressive malignancy, ongoing anticancer therapy, or hematological malignancy not in complete remission.

Objectively confirmed catheter-related upper extremity DVT and treated with any standard therapeutic anticoagulation (including LMWH dose reduction to 75% after the first month) for at least 3 months.

Able and willing to provide informed consent.

Exclusion Criteria:

Active bleeding or other reasons for which anticoagulation is contraindicated.

Other indications requiring ongoing therapeutic dose of anticoagulation as deemed necessary by treating physicians (such as atrial fibrillation, mechanical heart valve, etc.).

Anticoagulation has been permanently stopped or reduced to prophylactic dose for \> 5 days prior to enrollment for any reasons.

Pregnancy or breast feeding in patients who are prescribed a direct oral anticoagulant.

Concomitant use of strong inhibitors or inducers of both cytochrome P450 3A4 and P-glycoprotein in patients who are prescribed a direct oral anticoagulant.

Cancer is in remission and CVC is removed prior to enrollment.

Requirement of dual antiplatelet therapies.

Platelet count \< 50 x 109/L or creatinine clearance \< 30 ml/min.

Life expectancy of less than 3 months.

Where it's running

• The Ottawa Hospital
  Ottawa, Ontario, Canada Recruiting
• Sault Area Hospital
  Sault Ste. Marie, Ontario, Canada Recruiting

Study contacts

• Principal investigator: Tzu-Fei Wang, MD, MPH — Ottawa Hospital Research Institute
• Study coordinator: Tzu-Fei Wang, MD, MPH
• Email: tzwang@toh.ca
• Phone: 6137379988

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.