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A Study Comparing Abelacimab to Apixaban in the Treatment of Cancer-associated VTE
ASTER
A Multicenter, Randomized, Open-label, Blinded Endpoint Evaluation, Phase 3 Study Comparing the Effect of Abelacimab Relative to Apixaban on Venous Thromboembolism (VTE) Recurrence and Bleeding in Patients With Cancer Associated VTE
3 other identifiers
interventional
1,150
20 countries
206
Brief Summary
This is a Phase 3,multicenter, randomized, open-label, blinded endpoint evaluation study comparing the effect of abelacimab relative to apixaban on venous thromboembolism (VTE) recurrence and bleeding in patients with cancer associated VTE (ASTER)
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for phase_3
Started May 2022
Typical duration for phase_3
206 active sites
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
First Submitted
Initial submission to the registry
November 22, 2021
CompletedFirst Posted
Study publicly available on registry
December 28, 2021
CompletedStudy Start
First participant enrolled
May 5, 2022
CompletedPrimary Completion
Last participant's last visit for primary outcome
February 4, 2026
CompletedStudy Completion
Last participant's last visit for all outcomes
February 4, 2026
CompletedFebruary 23, 2026
February 1, 2026
3.8 years
November 22, 2021
February 20, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Time to first event of centrally adjudicated VTE recurrence
Time to first event of centrally adjudicated venous thromboembolism (VTE) recurrence
Up to 6 months
Secondary Outcomes (8)
Time to first event of ISTH-adjudicated major or clinically relevant non-major (CRNM) bleeding events
Up to 6 months
Time to first event of VTE recurrence, ISTH adjudicated major or ISTH-adjudicated clinically relevant non-major (CRNM) bleeding events
Up to 6 months
Time to event of permanent treatment discontinuation not due to death
Up to 6 months
Time to first event of ISTH-adjudicated clinically relevant non-major (CRNM) bleeding events
Up to 6 months
Time to first event of ISTH-adjudicated major bleeding events
Up to 6 months
- +3 more secondary outcomes
Study Arms (2)
Abelacimab
EXPERIMENTALAbelacimab intravenous administration followed by monthly administration of the same dose subcutaneously
Apixaban
ACTIVE COMPARATORApixaban administered orally twice a day
Interventions
Eligibility Criteria
You may qualify if:
- Male or female subjects ≥18 years old or other legal maturity age according to the country of residence
- Confirmed diagnosis of cancer (by histology, adequate imaging modality), other than basal-cell or squamous-cell carcinoma of the skin alone with one of the following:
- Active cancer, defined as either locally active, regionally invasive, or metastatic cancer at the time of randomization and/or
- Currently receiving or having received anticancer therapy (radiotherapy, chemotherapy, hormonal therapy, any kind of targeted therapy or any other anticancer therapy) in the last 6 months.
- Confirmed symptomatic or incidental proximal lower limb deep vein thrombosis (DVT) (i.e., popliteal, femoral, iliac, and/or inferior vena cava \[IVC\] thrombosis) and/or a confirmed symptomatic pulmonary embolism (PE), or an incidental PE in a segmental, or larger pulmonary artery.
- Patients are eligible within 120 hours from diagnosis of the qualifying VTE
- Anticoagulation therapy with a therapeutic dose of DOAC for at least 6 months is indicated
- Able to provide written informed consent
You may not qualify if:
- Thrombectomy, insertion of a caval filter or use of a fibrinolytic agent to treat the current (index) DVT and/or PE
- More than 120 hours of pre-treatment with therapeutic doses of UFH, LMWH, fondaparinux, DOAC, or other anticoagulants
- An indication to continue treatment with therapeutic doses of an anticoagulant other than that VTE treatment prior to randomization (e.g., atrial fibrillation \[AF\], mechanical heart valve, prior VTE)
- Platelet count \<50,000/mm3 at the screening visit
- PE leading to hemodynamic instability (blood pressure \[BP\] \<90 mmHg or shock)
- Acute ischemic or hemorrhagic stroke or intracranial hemorrhage within the 4 weeks preceding screening
- Brain trauma or a cerebral or spinal cord surgery or spinal procedures such as lumbar puncture or epidural/spinal anesthesia within 4 weeks of screening
- Need for aspirin in a dosage of \>100 mg/day or any other antiplatelet agent alone or in combination with aspirin
- Primary brain cancer or untreated intracranial metastases at baseline
- Acute myeloid or lymphoid leukemia
- Bleeding requiring medical attention at the time of randomization or in the preceding 4 weeks
- Planned brain, spinal cord, cardiac, vascular, major thoracic and/or major abdominal surgery in the 4 weeks following randomization
- Eastern Cooperative Oncology Group (ECOG) performance status of 3 or 4 at screening
- Life expectancy \<3 months at randomization
- Calculated creatinine clearance (CrCl) \<30 mL/min (Cockcroft-Gault equation) at the screening visit
- +10 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Anthos Therapeutics, Inc.lead
- Novartis Pharmaceuticalscollaborator
Study Sites (209)
University of Colorado Anschutz Medical Campus
Aurora, Colorado, 80045, United States
VA Connecticut Healthcare System
West Haven, Connecticut, 06516-5907, United States
Washington DC VAMC
Washington D.C., District of Columbia, 20422, United States
University of Miami Health
Miami, Florida, 33136, United States
NorthShore University Health System
Evanston, Illinois, 60201, United States
University of Kentucky, Markey Cancer Center
Lexington, Kentucky, 40536-0093, United States
Brigham and Women's Hospital
Boston, Massachusetts, 02115, United States
Beth Israel Deaconess Medical Center
Boston, Massachusetts, 02215-5400, United States
Henry Ford Health System
Detroit, Michigan, 48202, United States
Washington University
St Louis, Missouri, 63110, United States
Memorial Sloan Kettering Cancer Center-Middletown
Middletown, New Jersey, 07748, United States
Memorial Sloan Kettering Cancer Center-Commack
Commack, New York, 11725, United States
Memorial Sloan Kettering Cancer Center-West Harrison
Harrison, New York, 10604, United States
Memorial Sloan Kettering Cancer Center
New York, New York, 10021-0005, United States
Lipson Cancer Institute
Rochester, New York, 14621, United States
Duke University Medical Center
Durham, North Carolina, 27710, United States
Cleveland Clinic Foundation
Cleveland, Ohio, 44195, United States
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104, United States
University of Pennsylvania - Penn Blood Disorders Center
Philadelphia, Pennsylvania, 19104, United States
MD Anderson Cancer Center
Houston, Texas, 77030, United States
University of Texas Mays Cancer Center
San Antonio, Texas, 78229, United States
Gundersen Health System
La Crosse, Wisconsin, 54601, United States
Blood Center of Wisconsin
Milwaukee, Wisconsin, 53226, United States
Blacktown Hospital
Blacktown, New South Wales, 2148, Australia
Concord Repatriation General Hospital
Concord, New South Wales, 2139, Australia
Westmead Hospital
Westmead, New South Wales, 2145, Australia
Box Hill Hospital
Box Hill, Victoria, 3128, Australia
Monash Medical Centre Clayton
Clayton, Victoria, 3168, Australia
Northern Health
Epping, Victoria, 3076, Australia
Perth Blood Institute
Perth, 6005, Australia
The Alfred Hospital
Prahran, 3181, Australia
LKH - Universitätsklinikum Graz
Graz, 8010, Austria
LK Wiener Neustadt
Neustadt, 2700, Austria
Medical University of Vienna
Vienna, 1090, Austria
University of Calgary
Calgary, Alberta, T2N 1N4, Canada
University of Alberta Hospital
Edmonton, Alberta, T6G2V2, Canada
Hamilton Health Sciences, Juravinski Hospital and Cancer Centre
Hamilton, Ontario, L8V 1C3, Canada
Ottawa Hospital
Ottawa, Ontario, K1H BL6, Canada
Niagara Health System
Saint Catharines, Ontario, L2S 0A9, Canada
Sault Area Hospital
Sault Ste. Marie, Ontario, P6A 0A8, Canada
Toronto General Hospital
Toronto, Ontario, M5G 2C4, Canada
Jewish General Hospital
Montreal, Quebec, H3T-1E2, Canada
McGill University Health Centre
Montreal, Quebec, H4A 3J1, Canada
Queen Elizabeth II Health Sciences Centre
Nova Scotia, B3H 2Y9, Canada
McGill University Health Centre
Québec, H4A 3J1, Canada
Beijing Shijitan Hosp.
Beijing, 100038, China
Peking University Third Hospital
Beijing, 100191, China
Jilin Province Tumor Hospital
Ch’ang-ch’un, 130012, China
Southern Medical University - Zhujiang Hospital
Guangdong, 510280, China
Nanfang Hospital of Southern Medical University
Guangzhou, 510515, China
The Sixth Affiliated Hospital of Sun Yat-Sen University
Guangzhou, 510655, China
Huizhou Municipal Central Hospital
Huizhou, 516001, China
Nanjing First Hospital
Nanjing, 210006, China
Jiangsu Province Hospital
Nanjing, 210029, China
The First Affiliated Hospital of Wenzhou Medical University
Wenzhou, 325000, China
Union Hospital Tongji Medical College Huazhong University of Science &Technology
Wuhan, 430023, China
Tongji Hospital, Tongji Medical College
Wuhan, 430030, China
1st Affiliate Hospital of Xi'an Jiao
Xi'an, 710061, China
Masarykuv onkologicky ustav
Brno, 65653, Czechia
University Hospital Hradec Kralove
Hradec Králové, 50005, Czechia
Nemocnice Na Pleši s.r.o.
Nová Ves pod Pleší, 26204, Czechia
Onkologická klinika VFN a 1. LF UK
Prague, 128 08, Czechia
Thomayerova nemocnice
Prague, 14059, Czechia
CHU Amiens - Hopital Nord
Amiens, 80057, France
CHU Angers - Hôpital Hôtel Dieu
Angers, 49933, France
CHU de Brest - Hôpital de la Cavale Blanche
Brest, 29609, France
CHU Clermont Ferrand - Hopital Gabriel Montpied
Clermont-Ferrand, 63003, France
Hôpital Louis Mourier
Colombes, 92700, France
CHU Dijon - Hôpital Bocage Central
Dijon, 21079, France
CHU de Grenoble - Hôpital Albert Michallon
Grenoble, 38043, France
CH Le Puy en Velay
Le Puy-en-Velay, 43000, France
CHU de Limoges - Hôpital Dupuytren
Limoges, 87042, France
Hopital Timone Adultes
Marseille, 13385, France
Centre hospitalier des pays de Morlaix
Morlaix, 29600, France
Hôpital Européen Georges Pompidou
Paris, 75015, France
Groupe Hospitalier Pitie-Salpetriere
Paris, 75651, France
Hospices Civils de Lyon (HCL) - Centre Hospitalier Lyon-Sud
Pierre-Bénite, 69310, France
CHU de Rouen - Hôpital de Bois Guillaume
Rouen, 76031, France
CHU de Saint-Etienne - Hopital Nord
Saint-Etienne, 42000, France
CHU Strasbourg - Nouvel Hôpital Civil
Strasbourg, 67091, France
Nouvel Hôpital Civil de Strasbourg
Strasbourg, 67091, France
Centre Hospitalier Intercommunal de Toulon
Toulon, 83000, France
CHU de Toulouse - Hôpital Rangueil
Toulouse, 31059, France
CHU de Nancy - Hôpital de Brabois Adultes
Vandœuvre-lès-Nancy, 54500, France
CHU de Nancy - Hôpital de Brabois Adultes
Vandœuvre-lès-Nancy, 54511, France
Staedtisches Klinikum Dresden Standort Dresden-Friedrichstadt
Dresden, 1067, Germany
Universitaetsklinikum Carl Gustav Carus TU Dresden
Dresden, 1307, Germany
Praxis für Gefäßmedizin
Görlitz, 2827, Germany
Universitaetsklinikum Hamburg-Eppendorf
Hamburg, 20246, Germany
Universitätsklinik der Christian-Albrechts-Universität
Kiel, 24105, Germany
Universitätsklinik Leipzig
Leipzig, 4103, Germany
Universitaetsklinikum Magdeburg A.oe.R
Magdeburg, 39120, Germany
Klinikum der Universitaet Muenchen
München, 80336, Germany
Debreceni Egyetem
Debrecen, H-4032, Hungary
Markhot Ferenc Oktatokorhaz es Rendelointezet
Eger, H-3300, Hungary
Bacs-Kiskun County Hospital
Kecskemét, 6000, Hungary
Bon Secour Hospital
Cork, Ireland
Cork University Hospital
Cork, Ireland
Beaumont Hospital
Dublin, V2N0, Ireland
Msdyrt Midericordiae University Hospital
Dublin, Ireland
University Hospital, Limerick
Limerick, V94 T9PX, Ireland
IRCCS Istituto Tumori Giovanni Paolo II
Bari, 70124, Italy
Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII
Bergamo, 24127, Italy
Arcispedale S. Maria Nuova Azienda Ospedaliera di Reggio Emilia
Bologna, 40133, Italy
Presidio Ospedaliero di Castelfranco Veneto
Castelfranco Veneto, 31033, Italy
SS. ma Annunziata
Chieti, 66100, Italy
Ospedale Civile Dell Annunziata
Cosenza, 87100, Italy
Ospedale Degli Infermi
Faenza, 48018, Italy
Azienda Ospedaliero Universitaria San Martino
Genova, 16132, Italy
Azienda Socio Sanitaria Territoriale Santi Paolo e Carlo
Milan, 20142, Italy
A.O.U. Policlinico di Modena
Modena, 41124, Italy
Istituto Nazionale Tumori Fondazione G. Pascale
Naples, 80131, Italy
Azienda Ospedale - Università Padova
Padua, 35128, Italy
Azienda Ospedaliero Universitaria di Parma
Parma, 43100, Italy
Universit degli Studi di Perugia - Azienda Ospedaliera di Perugia
Perugia, 6132, Italy
Azienda Ospedaliero Universitaria Pisana
Pisa, 56126, Italy
Arcispedale S. Maria Nuova Azienda Ospedaliera di Reggio Emilia
Reggio Emilia, 42123, Italy
Fondazione Policlinico Universitario A. Gemelli IRCCS.
Roma, 168, Italy
Istituto Clinico Humanitas
Rozzano, 20089, Italy
Ospedale Santa Maria di Cà Foncello
Treviso, 35128, Italy
Azienda Ospedaliero-Universitaria Santa Maria della Misericordia
Udine, 33100, Italy
Università dell'Insubria
Varese, 21100, Italy
Ospedale SS. Giovanni e Paolo
Venezia, 30122, Italy
Ospedalemichele e Pietro ferrer
Verduno, 12060, Italy
Ospedale San Bortolo di Vicenza
Vicenza, 36100, Italy
National Cancer Center Hospital
Tsukiji, Tokyo, 104-0045, Japan
Chibaken Saiseikai Narashino Hospital
Chiba, 275-0006, Japan
Kyushu University Hospital
Fukuoka, 812-8582, Japan
Tokai University Hospital
Isehara, 259-1193, Japan
Yokohama Minami Kyosai Hospital
Kanagawa, 236-0037, Japan
Kobe University Hospital
Kobe, 650-0017, Japan
Kumamoto University Hospital
Kumamoto, 860-8556, Japan
Kyoto University Hospital
Kyoto, 606-8507, Japan
Mie University Hospital
Mie, 514-8507, Japan
Tokyo Saiseikai Central Hospital
Minatoku, 108-0073, Japan
Tohoku University Graduate School of Medicine
Miyagi, 980-8574, Japan
Okayama Medical Center
Okayama, 7011192, Japan
Osaka International Cancer Institute
Osaka, 541-8567, Japan
International University of Health and Welfare MITA Hospital
Tokyo, 108-8329, Japan
Juntendo University Hospital
Tokyo, 113-8421, Japan
Kyorin University Hospital
Tokyo, 181-8611, Japan
Daugavpils Regional Hospital
Daugavpils, LV-5417, Latvia
Liepaja Regional Hospital
Liepāja, LV3414, Latvia
Pauls Stradins Clinical University Hospital
Riga, LV-1002, Latvia
Meander Medisch Centrum
Amersfoort, 1066 EC, Netherlands
Meander Medisch Centrum
Amersfoort, 3813, Netherlands
Onze Lieve Vrouwe Gasthuis, Locatie Oost
Amsterdam, 1091 AC, Netherlands
Onze Lieve Vrouwe Gasthuis, Locatie Oost
Amsterdam, 1091, Netherlands
Rode Kruis Ziekenhuis
Beverwijk, 1942, Netherlands
Albert Schweitzer Ziekenhuis, Dordwijk
Dordrecht, 3317, Netherlands
Universitair Medisch Centrum Groningen
Groningen, 9713, Netherlands
Tergooiziekenhuizen, Hilversum
Hilversum, 1213, Netherlands
Amsterdam University Medical Center
Holland, 1105AZ, Netherlands
Spaarne Gasthuis (Kennemer Gasthuis) - Haarlem-Zuid
Hoofddorp, 2134TM, Netherlands
Leids Universitair Medisch Centrum
Leiden, 2333 ZA, Netherlands
Radboud Universitair Medisch Centrum
Nijmegen, 6525, Netherlands
Ikazia Ziekenhuis
Rotterdam, 3083 AN, Netherlands
Haga Ziekenhuis
The Hague, 2545 AA, Netherlands
Østfold Hospital Kalnes
Fredrikstad, 1603, Norway
Akershus Univeristy Hospital
Lørenskog, 1478, Norway
Myongji Hospital
Goyang-si, Gyeonggi-do, 10475, South Korea
Seoul National University Bundang Hospital
Seongnam-si, Gyeonggi-do, 13620, South Korea
Yongin Severance Hospital, Yonsei University Health System
Yongin-si, Gyeonggi-do, 16995, South Korea
Hallym University Sacred Heart Hospital
Anyang, 14068, South Korea
SoonChunHyang University Hospital Bucheon
Bucheon-si, 14584, South Korea
Daegu Catholic University Medical Center
Daegu, 42472, South Korea
Jeonbuk National University Hospital
Jeonju, 54907, South Korea
Dong-A University Hospital
Seogu, 49201, South Korea
Soonchunhyang University Seoul Hospital
Seoul, 4401, South Korea
Ewha Womans University Mokdong Hospital
Yangcheon, 07985, South Korea
Soonchunhyang University Seoul Hospital
Yŏngsan, 04401, South Korea
Hospital Clinic de Barcelona
Barcelona, 8036, Spain
Hospital de la Santa Creu I Sant Pau
Barcelona, 8041, Spain
Hospital Universitario Del Vinalopo
Elche, 03001, Spain
Hospital General Universitario de Elche
Elche, 3203, Spain
Hospital Universitario Virgen de las Nieves
Granada, 18014, Spain
Hospital Universitario Ciudad de Jaen
Jaén, 23007, Spain
Hospital Universitario Lucus Augusti
Lugo, 27003, Spain
Hospital General Universitario Gregorio Marañon
Madrid, 28007, Spain
Clinica Universidad de Navarra
Madrid, 28027, Spain
Hospital Universitario Infanta Leonor
Madrid, 28031, Spain
MD Anderson Cancer Centre
Madrid, 28033, Spain
Hospital Universitario Clinico San Carlos
Madrid, 28040, Spain
Hospital Universitario Puerta de Hierro Majadahonda
Majadahonda, 28220, Spain
Complejo Hospitalario Universitario de Orense
Ourense, 32005, Spain
Clinica Universidad de Navarra
Pamplona, 31008, Spain
Corporacio Sanitaria Parc Tauli
Sabadell, 8208, Spain
Hospital Universitario Marques de Valdecilla
Santander, 39012, Spain
Complejo Hospitalario Universitario de Santiago
Santiago de Compostela, 15706, Spain
Hospital Universitario Virgen del Rocio
Seville, 41013, Spain
Länssjukhuset Sundsvall-Härnösand
Sundsvall, 85186, Sweden
Hopital Universitaire Geneve
Geneva, 1205, Switzerland
Centre Hospitalier Universitaire Vaudois
Lausanne, 1011, Switzerland
University of Zürich
Zurich, 8091, Switzerland
Kaohsiung Medical University Chung-Ho Memorial Hospital
Kaohsiung City, 807, Taiwan
Far Eastern Memorial Hospital
New Taipei City, 220, Taiwan
China Medical University Hospital
Taichung, 40447, Taiwan
Taichung Veterans General Hospital
Taichung, 40705, Taiwan
National Cheng Kung University Hospital
Tainan, 70403, Taiwan
National Taiwan University Hospital
Taipei, 100, Taiwan
Koo Foundation Sun Yat-Sen Cancer Center
Taipei, 112, Taiwan
Tri-Service General Hospital
Taipei, 114, Taiwan
University Hospital of Wales
Cardiff, England, CF14 4XW, United Kingdom
University Hospitals of North Midlands
Stafford, England, ST16 3SA, United Kingdom
University Hospitals of North Midlands
Stoke-on-Trent, England, ST4 6QG, United Kingdom
Castle Hill Hospital, Department of Oncology & Haematology
Cottingham, ENG, HU16 5JQ, United Kingdom
Barts Health NHS Trust
London, ENG, E1 188, United Kingdom
The Newcastle Upon Tyne Hospitals
Newcastle upon Tyne, ENG, NE7 7DN, United Kingdom
Queen Elizabeth University Hospital Campus
Glasgow, SCO, G514TF, United Kingdom
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Study Design
- Study Type
- interventional
- Phase
- phase 3
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
November 22, 2021
First Posted
December 28, 2021
Study Start
May 5, 2022
Primary Completion
February 4, 2026
Study Completion
February 4, 2026
Last Updated
February 23, 2026
Record last verified: 2026-02
Data Sharing
- IPD Sharing
- Will share
Novartis is committed to sharing with qualified external researchers, access to patient-level data and supporting clinical documents from eligible studies. These requests are reviewed and approved by an independent review panel on the basis of scientific merit. All data provided is anonymized to respect the privacy of patients who have participated in the trial in line with applicable laws and regulations. This trial data availability is according to the criteria and process described on www.clinicalstudydatarequest.com