Key result
DOACs prevent recurrent VTE in cancer patients at least as effectively as LMWH.
Why the study?
Venous thromboembolism significantly affects morbidity and mortality in cancer patients, and the emergence of direct-acting oral anticoagulants has changed management paradigms.
Are direct-acting oral anticoagulants effective for the management and prevention of recurrent venous thromboembolism in patients with cancer?
Are direct-acting oral anticoagulants effective for the management and prevention of recurrent venous thromboembolism in patients with cancer?
This review highlights the paradigm shift towards using direct-acting oral anticoagulants as first-line therapy for managing cancer-associated thrombosis.
May guide anticoagulation choices in cancer-associated VTE; leaves open need for confirmatory RCTs across cancer subtypes.
Venous thromboembolism (VTE) can have a significant impact on the management, quality of life and mortality of patients with cancer. VTE occurs in 5-20% of patients with cancer, and malignancy is associated with up to 25% of all VTE. It is the second leading cause of death in ambulatory patients with cancer who are receiving chemotherapy. Increased rates of cancer-associated thrombosis are attributed to improved patient survival, increased awareness, surgery, antineoplastic treatments and the use of central venous access devices. Many factors influence cancer-associated thrombosis risk and are broadly categorized into patient-related, cancer-related and treatment-related risks. Direct-acting oral anticoagulants have shown themselves to be at least as effective in preventing recurrent VTE in patients with cancer with symptomatic and incidental VTE. This has led to a change in treatment paradigms so that direct-acting oral anticoagulants are now considered first-line agents in appropriately selected patients. In this article, we review the prior and recent landmark studies that have directed the treatment of cancer-associated thrombosis, and discuss specific factors that affect management as well as future treatment considerations.
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Ramcharitar et al. (2022) conducted a review in Cancer-associated thrombosis. Direct-acting oral anticoagulants (DOACs) vs. Low-molecular-weight heparin (LMWH) was evaluated. Direct-acting oral anticoagulants are at least as effective as low-molecular-weight heparin in preventing recurrent venous thromboembolism in patients with cancer.
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