Treatment of thromboembolism in cancer patients

IMPORTANCE OF THE FIELD: Cancer patients are at increased risk of developing venous thromboembolism (VTE). The occurrence of VTE predicts worse prognosis in cancer patients: whereas the 1-year survival in cancer patients free of thrombosis is 36%, in patients with diagnosed VTE it is 12%. The management of VTE in cancer patients is challenging because the anticoagulant treatment in these patients can be less effective and carry considerable morbidity. AREAS COVERED IN THIS REVIEW: This review covers the treatment strategies for cancer patients with VTE and highlights the new anticoagulant agents and their potential use in oncology. In writing this review, a literature search was performed using the PUB MED database with the following subject headings: cancer, venous thromboembolism and anticoagulant treatment. WHAT THE READER WILL GAIN: A comprehensive overview of the current recommendations for prevention and treatment of VTE in cancer patients. In addition, this review provides an insight into the new anticoagulant drugs potentially suitable for use in oncology, in particular idraparinux, apixaban, rivaroxaban and dabigatran etexilate. TAKE HOME MESSAGE: Low-molecular-weight heparin remains the best treatment option for initial and long term treatment of VTE in cancer patients.