A Study Comparing Abelacimab to Dalteparin in the Treatment of Gastrointestinal/Genitourinary Cancer and Associated VTE (MAGNOLIA)

  • End date
    Jun 21, 2024
  • participants needed
  • sponsor
    Anthos Therapeutics, Inc.
Updated on 4 October 2022
venous thromboembolism
deep vein thrombosis
pulmonary embolism
anticoagulation therapy
deep venous thrombosis of lower extremity


This is a Phase 3, multicenter, open-label, blinded endpoint study to evaluate the effect of abelacimab relative to dalteparin on venous thromboembolism (VTE) recurrence and bleeding in patients with gastrointestinal (GI)/genitourinary (GU) cancer associated VTE (Magnolia)


Cancer associated thrombosis (CAT) is a severe medical condition which is characterized by high incidence of Venous thromboembolism (VTE) recurrence and high risk for bleeding. Patients with intact GI and GU cancer have increased bleeding risk with oral direct anticoagulants (DOACs), Guidelines advice caution with those DOACs or state preference for low molecular weight heparin (LMWH) in this population. The ANT-008 study will compare treatment with abelacimab monthly administration to LMWH daily subcutaneous (sc) administration over 6-month treatment. The study outcomes include VTE recurrence, bleeding event and treatment discontinuation at 6 months

Condition Venous Thromboembolism, Deep Venous Thrombosis, Pulmonary Embolism
Treatment dalteparin, Abelacimab
Clinical Study IdentifierNCT05171075
SponsorAnthos Therapeutics, Inc.
Last Modified on4 October 2022


Yes No Not Sure

Inclusion Criteria

Male or female subjects ≥18 years old or other legal maturity age according to the country of residence
Confirmed GI (colorectal, pancreatic, gastric, esophageal, gastro-esophageal junction or hepatobiliary) or confirmed GU (renal, ureteral, bladder, prostate, or urethra) cancers if
Unresectable, locally advanced, metastatic, or non-metastatic GI/GU cancer and
No intended curative surgery during the study
Confirmed symptomatic or incidental proximal lower limb acute deep vein thrombosis
(DVT) (i.e., popliteal, femoral, iliac, and/or inferior vena cava vein
thrombosis) and/or a confirmed symptomatic pulmonary embolism (PE), or an
incidental PE in a segmental, or larger pulmonary artery. Patients are
eligible within 72 hours from diagnosis of the qualifying VTE
Anticoagulation therapy with LMWH for at least 6 months is indicated
Able to provide written informed consent

Exclusion Criteria

Thrombectomy, insertion of a caval filter, or use of a fibrinolytic agent to treat the current (index) occurrence of DVT and/or PE
More than 72 hours of pre-treatment with therapeutic doses of UFH, LMWH, or other anticoagulants
An indication to continue treatment with therapeutic doses of an anticoagulant other than for VTE treatment prior to randomization (e.g., atrial fibrillation, mechanical heart valve, prior VTE)
PE leading to hemodynamic instability (systolic BP <90 mmHg or shock)
Acute ischemic or hemorrhagic stroke or intracranial hemorrhage, in the last 4 weeks preceding screening
Brain trauma, or cerebral or a spinal cord surgery in the 4 weeks preceding screening
Need for aspirin in a dosage of more than 100 mg/day or, any other antiplatelet agent alone or in combination with aspirin
Bleeding requiring medical attention at the time of randomization or in the preceding 4 weeks
Planned major surgery at baseline
History of heparin induced thrombocytopenia
Primary brain cancer or untreated intracranial metastasis
Eastern Cooperative Oncology Group (ECOG) performance status of 3 or 4 at screening
Life expectancy of <3 months at randomization
Calculated creatinine clearance (CrCl) <30 mL/min
Platelet count <50,000/ mm3
Hemoglobin <8 g/dL
Acute hepatitis, chronic active hepatitis, liver cirrhosis; or an alanine aminotransferase ≥3 times and/or bilirubin ≥2 times the upper limit of normal in the absence of clinical explanation
Uncontrolled hypertension (systolic blood pressure [BP] > 180 mm Hg or diastolic BP >100 mm Hg despite antihypertensive treatment)
Women of child-bearing potential (WOCBP) who are unwilling or unable to use highly effective contraceptive measures during the study from screening up to 3 days after last treatment of dalteparin or 100 days after administration of abelacimab
Sexually active males with sexual partners of childbearing potential must agree to use a condom or other reliable contraceptive measure up to 3 days after last treatment of dalteparin or 100 days after administration of abelacimab
Pregnant or breast-feeding women
History of hypersensitivity to any of the study drugs (including dalteparin) or its excipients, to drugs of similar chemical classes, or any contraindication listed in the label for dalteparin
Subjects with any condition that in the judgement of the Investigator would place the subject at increased risk of harm if he/she participated in the study
Use of other investigational (not-registered) drugs within 5 half-lives prior to enrollment or until the expected pharmacodynamic effect has returned to baseline, whichever is longer. Participation in academic non-interventional studies or interventional studies, comprising testing different strategies or different combinations of registered drugs is permitted
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