UHNM cancer patients first in UK to take part in pioneering clinical trials
Patients at University Hospitals of North Midlands NHS Trust (UHNM) are amongst the first in the UK to take part in pioneering clinical trials to help reduce the risk of blood clots during cancer treatment.
UHNM has signed up for two global anticoagulation trials for patients who develop blood clots like deep vein thrombosis or a pulmonary embolism during cancer treatment.
The MAGNOLIA and ASTER trials will test the use abelacimab, a new drug shown to be up to 80 per cent more effective than previous standards of care.
Dr Shahid Gilani, Specialist Doctor in Clinical Oncology at UHNM and Principal Investigator for the trials said: “Cancer is the single most important risk factor for developing thrombosis which rises even further during chemotherapy, immunotherapy, and other targeted treatments. The Cancer Associated Thrombosis (CAT) service was set up in 2020 at UHNM to provide specialised care for cancer patients with clots, improve communication among healthcare professionals, offer patient education and support, and foster research in this field. To advance this research, we were invited to take part in the MAGNOLIA and ASTER trials in cancer patients at UHNM.
“There are already several anticoagulation drugs available to treat clots including Low Molecular Weight Heparin (LMHW) and various Direct Oral Anticoagulants (DOACs). However, they pose an increased risk of bleeding in cancer patients and are not safe in those with poor liver and kidney functions. DOACs also interact with many anti-cancer drugs and need an intact gastrointestinal tract. Due to these difficulties, we needed a breakthrough to find next-generation drugs without these problems.
“Recently a new class of drugs has come up. One of them is abelacimab, which works differently from previous anti-clot drugs and can be taken by once-a-month injection rather than daily injections. A study of abelacimab in the United States with patients undergoing knee replacement surgery showed an 80 per cent reduction in clotting after surgery, and a separate trial involving patients with cardiovascular disease was stopped early due to a 70 per cent reduction in bleeding compared to other treatments. Abelacimab was granted a fast-track designation by the US Federal Drug Authority (FDA) for use in cancer patients, but we needed a randomised controlled trial to support it.”
One of the first patients to sign up for the ASTER trial was Matthew Cooper, who was diagnosed with a seminoma, a rare germ cell cancer in his lung in July 2023.
The 51-year-old from Leek developed a pulmonary embolism after catching sepsis during his chemotherapy treatment.
Matthew, who has now finished four rounds of chemotherapy and is cancer-free said: “As a result of the pulmonary embolism I was placed on anticoagulation drugs, so was approached as to whether I’d be interested in taking part in the ASTER trial by Dr Gilani and his colleagues.
“At the time I didn’t even realise they carried out clinical research trials at UHNM but decided to sign up after being given the confidence by Dr Gilani who I spoke with at length about it and after reading the information materials provided to me.
“I have nothing but praise and positivity for the care provided by UHNM. The teams including the oncology department have been exemplary, and it’s so far so good with regards to the trial. Dr Gilani is always at the end of the phone and when we meet, I feel I can ask him as many or as few questions as I want.
“I’ve been through a lot since the start of my journey and feel taking part in the trial is something worthwhile and a very small way of giving something back and helping to advance things for fellow patients.”
The trials are being held in 120 centres across 22 countries worldwide.
UHNM became the first hospital Trust in the UK to recruit a patient to the MAGNOLIA trial, with a focus on kidney and gastric cancers. Patients enrolled on the trials will either be injected with abelacimab or existing drugs for six months.
In May Dr Gilani was invited to present CAT clinic management at the 12th International Conference on Thrombosis and Haemostasis Issues in Cancer (ICTHIC) at the University of Bergamo, Italy.
Dr Gilani said: “It’s good news that we have this drug in a trial setting, and if it proves successful, it will become the next generation class of drugs to treat blood clots in cancer patients.
“Many cancer patients suffer from bleeding and clots, and I feel these trials can give them hope. I’m proud to be the principal investigator leading the trial, which has been made possible thanks to the support from my colleagues at UHNM especially our multidisciplinary team including Dr Rajanee Bhana, Dr Deepak Chandra, Dr David Sutton, Dr Kamaraj Karunanithi and Ms Ana Fotu.’’