Prevention and treatment of cancer-associated thrombosis during chemotherapy

In patients with malignant neoplasms, the incidence of symptomatic venous thromboembolism (VTE) is 4–7 times higher than in the general population. The presence of distant metastases of solid tumors increases the risk of VTE. Most often, VTE develops in pancreatic and stomach cancers. Chemotherapy increases the risk of VTE development. Low-molecular-weight heparin and direct oral anticoagulants are used for the treatment of VTE in patients receiving chemotherapy. Prior to the start of chemotherapy, it is necessary to assess the risk of VTE development using the Khorana risk score. Outpatient patients with high-risk cancer (Khorana score > 3 before the start of a new systemic chemotherapy regimen) may be prescribed thromboprophylaxis.