Practical guidance for direct oral anticoagulant use in the treatment of venous thromboembolism in primary and metastatic brain tumor patients

Q: What is the clinical evidence from this study?

Study design: Review. Population: Venous thromboembolism in primary and metastatic brain tumors. Intervention: Direct oral anticoagulants (DOACs).

Surabhi Ranjan; Denise Leung; Ashley Ghiaseddin; Jennie Taylor; Mina Lobbous; Andrew Dhawan; Joshua Budhu; Elizabeth Coffee; Kaitlyn Melnick; Sajeel Chowdhary; Christine Lu‐Emerson; Sylvia C. Kurz; Joy Burke; Keng Lam; Mallika Patel; Erin Dunbar; Nimish Mohile; Katherine B. Peters

doi:10.1002/cncr.35220

Why the study?

Managing VTE in patients with primary and metastatic brain tumors is challenging due to ICH risk, and prospective clinical trials evaluating DOAC safety and efficacy in this population are lacking.

How should DOACs be used to treat VTE in patients with primary and metastatic brain tumors?

Structured PICO

How should DOACs be used to treat VTE in patients with primary and metastatic brain tumors?

P

Population

Patients with primary and metastatic brain tumors (BT) and venous thromboembolism (VTE)

I

Intervention

Direct oral anticoagulants (DOACs)

O

Outcome

Safety and efficacy (specifically risk of intracranial hemorrhage)safety

This expert consensus provides practical guidance for the off-label use of DOACs to treat VTE in patients with brain tumors, addressing the critical risk of intracranial hemorrhage.

Limitations

Lack of prospective clinical trials evaluating safety and efficacy of DOACs specifically in patients with brain tumors

Implication

Informs DOAC prescribing for VTE in brain tumors despite ICH risk; extends expert consensus to this high-risk population.

Abstract

Management of venous thromboembolism (VTE) in patients with primary and metastatic brain tumors (BT) is challenging because of the risk of intracranial hemorrhage (ICH). There are no prospective clinical trials evaluating safety and efficacy of direct oral anticoagulants (DOACs), specifically in patients with BT, but they are widely used for VTE in this population. A group of neuro-oncology experts convened to provide practical clinical guidance for the off-label use of DOACs in treating VTE in patients with BT. We searched PubMed for the following terms: BTs, glioma, glioblastoma (GBM), brain metastasis, VTE, heparin, low-molecular-weight heparin (LWMH), DOACs, and ICH. Although prospective clinical trials are needed, the recommendations presented aim to assist clinicians in making informed decisions regarding DOACs for VTE in patients with BT.

Discussion

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Cite This Study

Ranjan et al. (2024) conducted a review in Venous thromboembolism in primary and metastatic brain tumors. Direct oral anticoagulants (DOACs) was evaluated. Expert consensus provides practical clinical guidance for the off-label use of direct oral anticoagulants to treat venous thromboembolism in patients with primary and metastatic brain tumors.

synapsesocial.com/papers/6a12befc45487b7639a7165a https://doi.org/10.1002/cncr.35220

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Practical guidance for direct oral anticoagulant use in the treatment of venous thromboembolism in primary and metastatic brain tumor patients

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Practical guidance for direct oral anticoagulant use in the treatment of venous thromboembolism in primary and metastatic brain tumor patients

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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