A trial of chemotherapy with or without dalteparin for advanced pancreatic cancer (FRAGEM)

This trial was looking at gemcitabine with or without the blood thinning drug dalteparin (Fragmin) to see which plan worked best to treat advanced pancreatic cancer.

Some cancers release certain chemicals that help the blood to clot, or coagulate. This is called ‘activating the coagulation system’. It increases the risk of a blood clot developing in a blood vessel. The number of people with pancreatic cancer that develop a blood clot is 1 in 4 (25%). This is a higher rate than for any other cancer.

If someone develops a blood clot, they are treated as soon as possible with a drug that will thin the blood (an anti coagulant). This helps to disperse the clot, and prevent any more forming. But a blood clot can be life threatening, and it is not always possible to get treatment in time.

Doctors thought that it may be better to give all patients with advanced pancreatic cancer a daily injection of an anti coagulant called dalteparin (Fragmin), starting when they begin chemotherapy treatment. They hoped this would stop a clot forming in the first place. But these drugs have side effects too, and doctors were not sure which approach would be best for patients.

In this trial they compared gemcitabine and dalteparin together, to gemcitabine alone. The aim of the trial was to see how many patients in each group developed blood clots, and to see if dalteparin effected how well patients did.