A trial to find out if dalteparin can improve treatment for lung cancer (FRAGMATIC)

Cancer type:

Lung cancer
Non small cell lung cancer
Small cell lung cancer




Phase 3

This trial wanted to see if the blood thinning drug dalteparin (Fragmin) could reduce the number of blood clots people had during treatment for lung cancer. And to find out if it could help stop cancer cells spreading through the bloodstream to other parts of the body. Cancer Research UK supported this trial.

More about this trial

Surgery, chemotherapy or radiotherapy can all be used to treat lung cancer. You may have more than one of these treatments.

Blood clots are quite common in people who have lung cancer. And cancer treatment can increase the risk of blood clots. Dalteparin is a blood thinning drug (anti coagulant) that is widely used to prevent and treat blood clots. Doctors thought that dalteparin might also affect how cancer cells spread through the bloodstream, but they didn’t know this for sure.

The aims of this trial were

  • to see if having dalteparin as well as standard treatment was better than having standard treatment alone for lung cancer
  • to see if people having dalteparin injections had fewer blood clots than people who didn’t have the injections
  • to learn more about the side effects of having regular dalteparin injections at the same time as standard treatment for lung cancer

Summary of results

The trial team found that dalteparin didn’t help people with lung cancer to live longer. But it did reduce the number of blood clots.

2,202 people took part in this phase 3 trial. Half had standard treatment Open a glossary item. The other half had dalteparin with standard treatment.

FRAGMATIC trial diagram

The trial team followed people up after their treatment. After just under 2 years they looked at the average length of time people lived. For both groups it was about 10 months.

They also looked at the average length of time it took for the cancer to spread. For both groups it was about 9 weeks.

The number of people who developed blood clots was:

  • 61 of those who had dalteparin
  • 107 of those who didn’t have dalteparin

The side effects were similar for both groups except that those who had dalteparin reported having

  • more diarrhoea
  • more episodes of bleeding

The trial team concluded that although having dalteparin reduces the number of blood clots, having it also increased the risk of bleeding and so should not be given to everyone with lung cancer. There was also no increase in people living longer. They say that future research should concentrate on looking at giving blood thinning drugs to specific groups of people with lung cancer who have been identified as having a higher risk of developing a blood clot.  

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Fergus Macbeth

Supported by

Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
NIHR Clinical Research Network: Cancer
Velindre NHS Trust
Wales Cancer Trials Unit (WCTU)

Other information

This is Cancer Research UK trial number CRUK/06/007.

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Around 1 in 5 people take part in clinical trials

3 phases of trials

Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.

Last reviewed:

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