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

Autor:	Meyer G; Hôpital Européen Georges Pompidou, AP-HP, Paris, France.; Université Paris Descartes, Sorbonne Paris Cité, Paris, France.; INSERM U 970 and CIC 1418, Paris, France.; INNOVTE, Saint Etienne, France., Besse B; Institut Gustave Roussy, Villejuif, France.; Université Paris Sud, Le Kremlin Bicetre, France., Doubre H; Hôpital Foch, Suresnes, France., Charles-Nelson A; Hôpital Européen Georges Pompidou, AP-HP, Paris, France., Aquilanti S; Hôpital privé Arras les Bonettes, Arras, France., Izadifar A; Centre Cardiologique du Nord, Saint Denis, France., Azarian R; Hôpital André Mignot, Versailles, France., Monnet I; Centre Hospitalier Intercommunal de Créteil, Créteil, France., Lamour C; CHU de Poitiers, Poitiers, France.; Université de Poitiers, Poitiers, France., Descourt R; Hôpital Morvan, CHU de Brest, Brest, France., Oliviero G; Hôpital de Longjumeau, Longjumeau, France., Taillade L; Hôpital de la Pitié Salpétrière, AP-HP, Paris, France., Chouaid C; Centre Hospitalier Intercommunal de Créteil, Créteil, France., Giraud F; Hôpital Cochin, AP-HP, Paris, France., Falcoz PE; CHU de Strasbourg, Strasbourg, France., Revel MP; Université Paris Descartes, Sorbonne Paris Cité, Paris, France.; Hôpital Cochin, AP-HP, Paris, France., Westeel V; CHU de Besançon, Besançon, France., Dixmier A; Centre hospitalier régional d'Orléans, Orléans, France., Tredaniel J; Université Paris Descartes, Sorbonne Paris Cité, Paris, France.; Hopital Saint-Joseph, Paris, France., Dehette S; Centre hospitalier de Compiègne, Compiègne, France., Decroisette C; Centre hospitalier régional d'Annecy, Annecy, France., Prevost A; Institut Jean Godinot, Reims, France., Pichon E; CHU de Tours, hôpital Bretonneux, Tours, France., Fabre E; Hôpital Européen Georges Pompidou, AP-HP, Paris, France., Soria JC; Institut Gustave Roussy, Villejuif, France.; Université Paris Sud, Le Kremlin Bicetre, France., Friard S; Hôpital Foch, Suresnes, France., Stern JB; Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France., Jabot L; Centre Hospitalier Intercommunal de Créteil, Créteil, France., Dennewald G; Centre Cardiologique du Nord, Saint Denis, France., Pavy G; Hôpital privé Arras les Bonettes, Arras, France., Petitpretz P; Hôpital André Mignot, Versailles, France., Tourani JM; CHU de Poitiers, Poitiers, France.; Université de Poitiers, Poitiers, France., Alifano M; Université Paris Descartes, Sorbonne Paris Cité, Paris, France.; Hôpital Cochin, AP-HP, Paris, France., Chatellier G; Hôpital Européen Georges Pompidou, AP-HP, Paris, France.; Université Paris Descartes, Sorbonne Paris Cité, Paris, France.; INSERM U 970 and CIC 1418, Paris, France., Girard P; Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France.
Jazyk:	angličtina
Zdroj:	The European respiratory journal [Eur Respir J] 2018 Oct 04; Vol. 52 (4). Date of Electronic Publication: 2018 Oct 04 (Print Publication: 2018).
DOI:	10.1183/13993003.01220-2018
Abstrakt:	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 -1 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. Competing Interests: Conflict of interest: G. Meyer reports grants and non-financial support from Leo Pharma, outside the submitted work. Conflict of interest: B. Besse has nothing to disclose. Conflict of interest: H. Doubre has nothing to disclose. Conflict of interest: A. Charles-Nelson has nothing to disclose. Conflict of interest: S. Aquilanti reports non-financial support from Leo Pharma, outside the submitted work. Conflict of interest: A. Izadifar has nothing to disclose. Conflict of interest: R. Azarian has nothing to disclose. Conflict of interest: I. Monnet has nothing to disclose. Conflict of interest: C. Lamour has nothing to disclose. Conflict of interest: R. Descourt has nothing to disclose. Conflict of interest: G. Oliviero has nothing to disclose. Conflict of interest: L. Taillade has nothing to disclose. Conflict of interest: C. Chouaid has nothing to disclose. Conflict of interest: F. Giraud has nothing to disclose. Conflict of interest: P-E. Falcoz has nothing to disclose. Conflict of interest: M-P. Revel has nothing to disclose. Conflict of interest: V. Westeel has nothing to disclose. Conflict of interest: A. Dixmier has nothing to disclose. Conflict of interest: J. Tredaniel has nothing to disclose. Conflict of interest: S. Dehette has nothing to disclose. Conflict of interest: C. Decroisette has nothing to disclose. Conflict of interest: A. Prevost has nothing to disclose. Conflict of interest: E. Pichon has nothing to disclose. Conflict of interest: E. Fabre has nothing to disclose. Conflict of interest: J-C. Soria has nothing to disclose. Conflict of interest: S. Friard has nothing to disclose. Conflict of interest: J-B. Stern has nothing to disclose. Conflict of interest: L. Jabot has nothing to disclose. Conflict of interest: G. Dennewald has nothing to disclose. Conflict of interest: G. Pavy has nothing to disclose. Conflict of interest: P. Petitpretz has nothing to disclose. Conflict of interest: J-M. Tourani has nothing to disclose. Conflict of interest: M. Alifano has nothing to disclose. Conflict of interest: Dr. Chatellier has nothing to disclose. Conflict of interest: P. Girard reports personal fees and non-financial support from Leo Pharma, outside the submitted work. (Copyright ©ERS 2018.)
Databáze:	MEDLINE
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