Apixaban for Cancer-Associated Venous Thromboembolism

To the Editor: In the API-CAT trial (April 10 issue), 1 Mahé and colleagues confirm that a reduced dose of apixaban (2.5 mg twice daily) is noninferior to a full dose (5.0 mg) of the drug for preventing recurrent venous thromboembolism among patients with cancer-associated thrombosis. The reduced dose was also associated with significantly lower clinically relevant bleeding (12.1% vs. 15.6%; adjusted subhazard ratio, 0.75; 95% confidence interval, 0.58 to 0.97). However, the trial raises several critical points that remain unaddressed, which necessitates further exploration to improve anticoagulation in oncology. Tumor-specific molecular profiles, such as mutations in the gene encoding isocitrate . . .