Recombinant human soluble thrombomodulin (thrombomodulin alfa) to treat disseminated intravascular coagulation in solid tumors: results of a one-arm prospective trial

Verfasser / Beitragende:
[Kazuo Tamura, Hidehiko Saito, Hidesaku Asakura, Kohji Okamoto, Jun Tagawa, Toru Hayakawa, Nobuo Aoki]
Ort, Verlag, Jahr:
2015
Enthalten in:
International Journal of Clinical Oncology, 20/4(2015-08-01), 821-828
Format:
Artikel (online)
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024 7 0 |a 10.1007/s10147-014-0768-1  |2 doi 
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245 0 0 |a Recombinant human soluble thrombomodulin (thrombomodulin alfa) to treat disseminated intravascular coagulation in solid tumors: results of a one-arm prospective trial  |h [Elektronische Daten]  |c [Kazuo Tamura, Hidehiko Saito, Hidesaku Asakura, Kohji Okamoto, Jun Tagawa, Toru Hayakawa, Nobuo Aoki] 
520 3 |a Abstract : Background: Disseminated intravascular coagulation (DIC) associated with solid tumors (DIC-ST) is often encountered in clinical practice. Patients with DIC-ST are usually in poor condition and have bleeding diathesis due to advanced or metastatic diseases. Although some affected patients are treated with heparin, this strategy has not been prospectively studied. Recombinant human soluble thrombomodulin (thrombomodulin alfa, TM-α) is a new anticoagulant developed in Japan. We conducted a prospective study that evaluated the efficacy and safety of TM-α in patients with DIC-ST. Methods: A prospective one-arm study with TM-α was conducted for DIC-ST. TM-α (380U/kg) was given for 30min intravenously once daily for 6-14days. The primary efficacy endpoint was the DIC resolution rate. Change in DIC scores and improvement in bleeding symptoms and outcomes were also evaluated. Safety endpoints included the incidence of bleeding-related adverse events. Results: A total of 101 patients were treated with TM-α. The three main underlying malignant diseases were lung, stomach, and breast cancer, which accounted for 60% of all patients. The DIC resolution rate was 34.0% at the end of TM-α treatment. Improvement in DIC scores was seen in 55.2% of patients, while only 22.9% of patients had worsening of DIC scores. The overall survival rate was 55.4% on day 28. The incidence of hemorrhage related to TM-α was 12.9% until day 28. Cases of severe hemorrhage related to TM-α did not occur. Conclusions: TM-α is effective and safe for DIC-ST. This agent is the treatment of choice for the management of DIC-ST. 
540 |a Japan Society of Clinical Oncology, 2014 
690 7 |a Disseminated intravascular coagulation  |2 nationallicence 
690 7 |a Solid tumors  |2 nationallicence 
690 7 |a Anticoagulants  |2 nationallicence 
690 7 |a Thrombomodulin  |2 nationallicence 
690 7 |a Clinical trial  |2 nationallicence 
700 1 |a Tamura  |D Kazuo  |u Division of Medical Oncology, Hematology and Infectious Diseases, Department of Medicine, Fukuoka University Hospital, Nanakuma, Jonan-ku, 7-45-1, 814-0180, Fukuoka, Fukuoka, Japan  |4 aut 
700 1 |a Saito  |D Hidehiko  |u National Hospital Organization Nagoya Medical Center, Sannomaru, Naka-ku, 4-1-1, 460-0001, Nagoya, Aichi, Japan  |4 aut 
700 1 |a Asakura  |D Hidesaku  |u Third Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Takaramachi, 13-1, 920-8641, Kanazawa, Ishikawa, Japan  |4 aut 
700 1 |a Okamoto  |D Kohji  |u Center for Gastroenterology and Liver Disease, Kitakyushu Municipal Yahata Hospital, Nishihonmachi,Yahatahigashi-ku, 4-18-1, 805-0061, Kitakyushu, Fukuoka, Japan  |4 aut 
700 1 |a Tagawa  |D Jun  |u Clinical Development Center, Asahi Kasei Pharma Corporation, Kanda Jinbocho, Chiyoda-ku, 1-105, 101-8101, Tokyo, Japan  |4 aut 
700 1 |a Hayakawa  |D Toru  |u Clinical Development Center, Asahi Kasei Pharma Corporation, Kanda Jinbocho, Chiyoda-ku, 1-105, 101-8101, Tokyo, Japan  |4 aut 
700 1 |a Aoki  |D Nobuo  |u Tokyo Medical and Dental University, Yushima, Bunkyo-ku, 1-5-45, 113-8510, Tokyo, Japan  |4 aut 
773 0 |t International Journal of Clinical Oncology  |d Springer Japan  |g 20/4(2015-08-01), 821-828  |x 1341-9625  |q 20:4<821  |1 2015  |2 20  |o 10147 
856 4 0 |u https://doi.org/10.1007/s10147-014-0768-1  |q text/html  |z Onlinezugriff via DOI 
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900 7 |a Metadata rights reserved  |b Springer special CC-BY-NC licence  |2 nationallicence 
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950 |B NATIONALLICENCE  |P 700  |E 1-  |a Tamura  |D Kazuo  |u Division of Medical Oncology, Hematology and Infectious Diseases, Department of Medicine, Fukuoka University Hospital, Nanakuma, Jonan-ku, 7-45-1, 814-0180, Fukuoka, Fukuoka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Saito  |D Hidehiko  |u National Hospital Organization Nagoya Medical Center, Sannomaru, Naka-ku, 4-1-1, 460-0001, Nagoya, Aichi, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Asakura  |D Hidesaku  |u Third Department of Internal Medicine, Kanazawa University Graduate School of Medical Science, Takaramachi, 13-1, 920-8641, Kanazawa, Ishikawa, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Okamoto  |D Kohji  |u Center for Gastroenterology and Liver Disease, Kitakyushu Municipal Yahata Hospital, Nishihonmachi,Yahatahigashi-ku, 4-18-1, 805-0061, Kitakyushu, Fukuoka, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Tagawa  |D Jun  |u Clinical Development Center, Asahi Kasei Pharma Corporation, Kanda Jinbocho, Chiyoda-ku, 1-105, 101-8101, Tokyo, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Hayakawa  |D Toru  |u Clinical Development Center, Asahi Kasei Pharma Corporation, Kanda Jinbocho, Chiyoda-ku, 1-105, 101-8101, Tokyo, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Aoki  |D Nobuo  |u Tokyo Medical and Dental University, Yushima, Bunkyo-ku, 1-5-45, 113-8510, Tokyo, Japan  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t International Journal of Clinical Oncology  |d Springer Japan  |g 20/4(2015-08-01), 821-828  |x 1341-9625  |q 20:4<821  |1 2015  |2 20  |o 10147