Abelacimab vs Apixaban for Cancer-Related Blood Clots

(ASTER Trial)

This trial aims to compare two treatments, abelacimab (an experimental treatment) and apixaban, to determine which is more effective at preventing the recurrence of blood clots and reducing bleeding in people with cancer. Blood clots, such as deep vein thrombosis (DVT) or pulmonary embolism (PE), often affect those with cancer. Participants must have an active cancer diagnosis and have recently experienced a blood clot in a major vein or lung artery. The trial seeks to identify the most effective and safe treatment option for managing these clots in cancer patients. As a Phase 3 trial, it represents the final step before FDA approval, offering participants the opportunity to contribute to potentially groundbreaking treatment advancements.

The trial does not specify if you need to stop taking your current medications, but it does require that you do not have an indication to continue treatment with other anticoagulants. It's best to discuss your specific medications with the trial team.

In earlier studies, abelacimab has been shown to be safe for patients with cancer-related blood clots. Research suggests it could be a good option for long-term treatment because most people tolerate it well. One study found that the main safety concern was bleeding, though this was uncommon. The treatment remains under study, so more information is needed to fully understand its safety.

Apixaban, however, is already approved and commonly used for treating blood clots, with well-known safety. Most people tolerate it well, but like many blood thinners, it can increase the risk of bleeding.

Unlike the standard of care for cancer-related blood clots, which typically involves oral anticoagulants like Apixaban, Abelacimab offers a unique approach with its novel mechanism. Abelacimab targets factor XI, a key player in blood clot formation, and is administered initially through an intravenous dose followed by monthly subcutaneous injections. This method could potentially improve patient compliance and reduce the risk of bleeding, a common complication with current options. Researchers are excited about Abelacimab because it promises a new way to manage clotting with potentially fewer side effects and more convenient dosing.

Research shows that abelacimab, one of the treatments tested in this trial, is a promising blood thinner for treating blood clots in cancer patients. Earlier studies have shown its potential to prevent strokes with a low risk of causing bleeding. Abelacimab targets a specific part of the blood clotting process, which might offer advantages over traditional treatments. In contrast, apixaban, the other treatment option in this trial, is already a well-known treatment for blood clots and has proven effective in reducing the risk of clots in cancer patients. This study compares both treatments to determine which one better prevents clots from returning and causes less bleeding.¹²³⁶⁷