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NCT06841965

PHASE3

Intravenous Thrombolysis in Acute Ischemic Stroke with Active Cancer

Sponsor: Second Affiliated Hospital, School of Medicine, Zhejiang University

View on ClinicalTrials.gov

Summary

The primary hypothesis being tested in this trial is that ischemic stroke patients with active cancer will have improved clinical outcomes when given intravenous thrombolysis compared to standard care.

Official title: Th Efficacy and Safety of Intravenous Thrombolysis in Acute Ischemic Stroke with Cancer

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

INTERVENTIONAL

Enrollment

280

Start Date

2025-03-01

Completion Date

2027-12-31

Last Updated

2025-02-24

Healthy Volunteers

Conditions

Stroke Acute Ischemic Stroke

Interventions

DRUG

Intravenous thrombolysis

Patients will receive standard dose intravenous alteplase (0.9 mg/kg, the first 10% administered as an initial bolus and the remainder over a 1-hour period, with a maximum dose of 90 mg)，intravenous Tenecteplase(0.25mg/kg，administered as a single intravenous bolus injection over 5 - 10 seconds，with a maximum dose of 25 mg), intravenous reteplase (a bolus of 18 mg followed by a second bolus of 18 mg after 30 minutes) and intravenous prourokinase (rhPro-UK) (15 mg bolus followed by a 20 mg infusion over 30 minutes).

Inclusion Criteria: 1. Patients with clinical signs of acute ischemic stroke within 24 hours of onset or awakening with stroke (if within 24 hours from the midpoint of sleep). Patients with AIS within 4.5-24 hours of onset must meet the IVT inclusion criteria specified in the guideline 2. Patients with active cancer (Active cancer was defined as cancer diagnosed within the previous 6 months; recurrent, regionally advanced or metastatic cancer, or cancer for which treatment had been administered within 6 months, or haematological cancer without complete remission.) 3. Patients ≥ 18 years old 4. Informed consent has been obtained depending on local ethics requirements. Exclusion Criteria: (1) Intended to proceed to endovascular treatment; (2) Pre-stroke mRS score \> 2 (3) Contraindications for IVT： 1. Intracranial hemorrhage (including parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, epidural hematoma, etc.) 2. Previous history of intracranial hemorrhage 3. Severe head trauma or stroke history within the last 3 months 4. Intracranial tumors, giant intracranial aneurysms 5. Intracranial or spinal surgery within the recent 3 months 6. Major surgical procedures within the last 2 weeks 7. Gastrointestinal or urinary tract bleeding within the last 3 weeks 8. Active visceral bleeding 9. Aortic arch dissection 10. Arterial puncture in a site within the last 1 week that is not easy to compress and stop bleeding 11. Elevated blood pressure: Systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 100 mmHg 12. Acute bleeding tendency, including platelet count \< 100 × 10⁹/L or other conditions 13. Received low-molecular-weight heparin treatment within 24 hours 14. Oral anticoagulants (warfarin) with INR \> 1.7 or PT \> 15 s; Receiving heparin treatment with aPTT above the upper limit of the normal range within the last 24 hours of onset, Receiving thrombin inhibitors and factor Xa inhibitors within the last 48 hours of onset. 15. Blood sugar \< 2.8 or \> 22.22 mmol/L 16. Head CT or MRI indicates large-area infarction (infarction area ≥ 1/3 of the middle cerebral artery supply area) (4) The judgment is left to the discretion of the investigator