A Study of Dabigatran Etexilate as Primary Treatment of Malignancy Associated Venous Thromboembolism

Inclusion Criteria:

1. are aged 18 years or above;
2. have acute symptomatic deep vein thrombosis or pulmonary embolism with objective confirmation;
3. have active cancer, which is defined as a diagnosis of cancer other than basal cell or squamous cell carcinoma of skin within six months before enrollment, any treatment for cancer within the previous six months or recurrent or metastatic cancer.
4. Female subjects of childbearing potential should be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study medication. Subjects of childbearing potential are those who have not been surgically sterilized or have not been free from menses for \> 1 year.
5. Male subjects should agree to use an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study therapy.

Exclusion Criteria:

1. have Eastern Cooperative Oncology Group (ECOG) performance status score of \> 2 at the time of randomization;
2. have life expectancy of less than 3 months;
3. have active bleeding, are at high risk of bleeding, or have contraindications to anticoagulant treatment;
4. receive thrombectomy or fibrinolytic agent to treat the current episode of VTE;
5. receive more than 72 hours pre-treatment with therapeutic dosages of anticoagulant treatment prior to randomization to treat the current VTE episode;
6. are already on long term oral anticoagulation;
7. are on low molecular weight heparin for indications other than VTE;
8. have platelet count of less than 100 x 109/L;
9. are on dual antiplatelet therapy;
10. have a serum creatinine level of more than 220 umol/L or have a calculated creatinine clearance (CrCl) of less than 30 ml/min;
11. have alanine aminotransferase level more than 2 times the upper limit of normal range or cirrhosis;
12. have history of heparin induced thrombocytopenia;
13. are on treatment of potent inhibitors or inducers of P-glycoprotein.
14. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 120 days after the last dose of trial treatment.