NCT04304651

Brief Summary

Venous thromboembolism (VTE) can be the earliest sign of cancer. Identifying occult cancers at the time of VTE diagnosis may lead to significant improvement of patients' care. This is also an upmost issue for patients who want to know if an underlying cancer might have triggered the VTE. An individual patient-level data meta-analysis (IPDMA) supports extensive screening strategies for occult cancer especially based on FDG PET/CT, and suggests that the best target population for cancer screening would be patients with unprovoked VTE older than 50 years of age (6.7% in patients aged 50 years or more vs. 1.0% in patients of less than 50 years (OR: 7.1, 95% CI: 3.1 to 16%).

Trial Health

80
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
1,276

participants targeted

Target at P75+ for not_applicable

Timeline
53mo left

Started Sep 2020

Longer than P75 for not_applicable

Geographic Reach
2 countries

20 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress57%
Sep 2020Sep 2030

First Submitted

Initial submission to the registry

March 7, 2020

Completed
4 days until next milestone

First Posted

Study publicly available on registry

March 11, 2020

Completed
6 months until next milestone

Study Start

First participant enrolled

September 8, 2020

Completed
6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 8, 2026

Expected
4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

September 8, 2030

Last Updated

December 16, 2024

Status Verified

December 1, 2024

Enrollment Period

6 years

First QC Date

March 7, 2020

Last Update Submit

December 13, 2024

Conditions

Keywords

venous thrombosispulmonary embolismscreeningoccult cancer

Outcome Measures

Primary Outcomes (1)

  • Occult cancer missed by screening strategies

    Occult cancer "missed" by cancer screening defined as proven cancer diagnosed (either biopsy proven cancer or cancer diagnosis approved by adjudication committee in the absence of biopsy proven cancer) from the time of cancer screening completion to the end of the 1-year follow-up period, and not detected at the time of screening. In other words, "missed" means the number of new cancers diagnosed in patients considered not to have cancer after having completed the assigned cancer screening strategy (i.e false negative results of screening strategies).

    At 1 year of follow-up

Secondary Outcomes (7)

  • Occult cancer diagnosed by screening strategies

    At 1 month

  • Early vs Adanced-stage cancers

    At 1 year of follow-up

  • Cancer-related mortality

    At 5 years of follow-up

  • Cost effectiveness analysis

    At 1 year of follow-up

  • Recurrent VTE

    At 1 year of follow-up

  • +2 more secondary outcomes

Study Arms (2)

Limited cancer screening

ACTIVE COMPARATOR

Limited screening alone.

Diagnostic Test: Limited cancer screening

Limited cancer screening + FDG PET/CT

EXPERIMENTAL

Limited screening + FDG PET/CT

Diagnostic Test: Limited cancer screening + FDG PET/CT

Interventions

The limited cancer screening will include: 1) a complete medical history and physical examination; 2) complete blood count; 3) liver function tests (AST, ALT, ALP, bilirubin); and 4) chest X-ray. In women, a breast examination, Pap smear/pelvic examination (if \< 70 years old and previously sexually active) and mammogram will be performed, if not conducted in last year. In men, similarly, prostate examination and PSA testing will be performed, if not conducted in the last year. All patients will undergo colon cancer screening as per local practice.

Limited cancer screening

The limited cancer screening (as described above) in combination with a FDG PET/CT.

Limited cancer screening + FDG PET/CT

Eligibility Criteria

Age50 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients aged 50 years or older with a new diagnosis of first unprovoked proximal deep vein thrombosis (DVT) and/or pulmonary embolism (PE) will be eligible to participate into the study.
  • Unprovoked VTE is defined as the absence of any of the following predisposing factors:
  • active malignancy (known malignancy, progressive and/or treated during the last 5 years) except for adequately treated basal or squamous cell carcinoma; Patients whose state of health suggests the presence of cancer at the time of diagnosis of VTE cannot be included in the protocol
  • recent (less than 3 months) paralysis, paresis or plaster immobilization of the lower extremities;
  • recently bedridden for period of 3 or more days, or major surgery, within the previous 12 weeks requiring general or regional anaesthesia;
  • previous unprovoked VTE;
  • known thrombophilia (hereditary or acquired)

You may not qualify if:

  • Patients will be excluded from the study if they have any of the following criteria:
  • Refusal or inability to provide informed consent;
  • Hypersensitivity to 18F-FDG or any of the excipients according to the product monograph;
  • Unavailable to follow-up.
  • VTE while on anticoagulation (e.g apixaban, rivaroxaban, edoxaban, dabigatran, warfarin)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (20)

University of Calgary

Calgary, Alberta, Canada

NOT YET RECRUITING

University of Manitoba

Winnipeg, Manitoba, Canada

NOT YET RECRUITING

McMaster University

Hamilton, Ontario, Canada

NOT YET RECRUITING

London Health Sciences Centre

London, Ontario, Canada

NOT YET RECRUITING

Hopital Montfort

Ottawa, Ontario, Canada

RECRUITING

Ottawa Hospital Research Institute

Ottawa, Ontario, Canada

RECRUITING

Sunnybrook Research Institute

Toronto, Ontario, Canada

RECRUITING

University Health Network

Toronto, Ontario, Canada

RECRUITING

Jewish General Hospital

Montreal, Quebec, Canada

RECRUITING

McGill University Health Centre

Montreal, Quebec, Canada

NOT YET RECRUITING

CH des Pays de Morlaix

Morlaix, France, 29600, France

RECRUITING

CH Agen

Agen, France

RECRUITING

CHU Angers

Angers, France

RECRUITING

Brest University Hospital

Brest, France

RECRUITING

CHU de Clermont-Ferrand

Clermont-Ferrand, France

RECRUITING

CHU de Dijon

Dijon, France

RECRUITING

CHU de Limoges

Limoges, France

RECRUITING

Hôpital Européen Georges Pompidou

Paris, France

RECRUITING

CHU Saint-Etienne

Saint-Etienne, France

RECRUITING

Hôpital Saint Musse - CH Toulon

Toulon, France

RECRUITING

Related Publications (3)

  • Robin P, Le Roux PY, Planquette B, Accassat S, Roy PM, Couturaud F, Ghazzar N, Prevot-Bitot N, Couturier O, Delluc A, Sanchez O, Tardy B, Le Gal G, Salaun PY; MVTEP study group. Limited screening with versus without (18)F-fluorodeoxyglucose PET/CT for occult malignancy in unprovoked venous thromboembolism: an open-label randomised controlled trial. Lancet Oncol. 2016 Feb;17(2):193-199. doi: 10.1016/S1470-2045(15)00480-5. Epub 2015 Dec 8.

    PMID: 26672686BACKGROUND
  • Carrier M, Lazo-Langner A, Shivakumar S, Tagalakis V, Zarychanski R, Solymoss S, Routhier N, Douketis J, Danovitch K, Lee AY, Le Gal G, Wells PS, Corsi DJ, Ramsay T, Coyle D, Chagnon I, Kassam Z, Tao H, Rodger MA; SOME Investigators. Screening for Occult Cancer in Unprovoked Venous Thromboembolism. N Engl J Med. 2015 Aug 20;373(8):697-704. doi: 10.1056/NEJMoa1506623. Epub 2015 Jun 22.

    PMID: 26095467BACKGROUND
  • van Es N, Le Gal G, Otten HM, Robin P, Piccioli A, Lecumberri R, Jara-Palomares L, Religa P, Rieu V, Rondina M, Beckers MM, Prandoni P, Salaun PY, Di Nisio M, Bossuyt PM, Buller HR, Carrier M. Screening for Occult Cancer in Patients With Unprovoked Venous Thromboembolism: A Systematic Review and Meta-analysis of Individual Patient Data. Ann Intern Med. 2017 Sep 19;167(6):410-417. doi: 10.7326/M17-0868. Epub 2017 Aug 22.

    PMID: 28828492BACKGROUND

MeSH Terms

Conditions

Embolism and ThrombosisVenous ThrombosisPulmonary Embolism

Condition Hierarchy (Ancestors)

Vascular DiseasesCardiovascular DiseasesThrombosisLung DiseasesRespiratory Tract DiseasesEmbolism

Central Study Contacts

Aurélien DELLUC

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
SCREENING
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

March 7, 2020

First Posted

March 11, 2020

Study Start

September 8, 2020

Primary Completion (Estimated)

September 8, 2026

Study Completion (Estimated)

September 8, 2030

Last Updated

December 16, 2024

Record last verified: 2024-12

Data Sharing

IPD Sharing
Will share

All collected data that underlie results in a publication

Shared Documents
STUDY PROTOCOL
Time Frame
Data will be available beginning three years and ending fifteen years following the final study report completion
Access Criteria
Data access requests will be reviewed by the internal committee of Brest UH. Requestors will be required to sign and complete a data access agreement.

Locations