Jeremy A Ross1, Marilyn M Miller2, Cristhiam M Rojas Hernandez2. 1. The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: jeremy.a.ross@uth.tmc.edu. 2. The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Abstract
PURPOSE: The standard of care for the treatment of cancer-related venous thromboembolism (VTE) is a low molecular weight heparin (LMWH) formulation. The recent development of direct oral anticoagulants (DOACs) and their approval for the treatment of VTE has resulted in several new options for treatment. If equivalent to LMWH in terms of safety and effectiveness, the use of DOACs in the treatment of cancer-related VTE would reduce the risk of VTE recurrence while potentially improving the quality of life of many cancer patients. METHODS: We performed a retrospective analysis of adult patients with cancer-related VTE treated in our benign hematology clinic. Among the 153 patients included in our final analysis, 123 (80%) were treated with LMWH and 30 (20%) were treated with DOACs. Patients had 36 different histological types of cancer. The primary outcome was the rate of recurrence of VTE evaluated at 6 and 12months after the initiation of anticoagulation. Secondary outcomes were the rate of anticoagulant-associated clinically relevant bleeding and event-free survival for VTE recurrence. RESULTS: In comparing the 2 treatment groups, there was no statistically significant difference in the cumulative rates of VTE recurrence at 6 and 12months or in the rates of major or non-major bleeding at both 6 and 12months. The median VTE recurrence-free survival rates were not reached and they were not statistically different. CONCLUSION: DOACs appear to be as safe and effective as conventional therapy for the treatment of cancer-related VTE. Results of ongoing randomized clinical studies may provide definitive evidence and clarify the role of the DOACs in the setting of malignancy.
PURPOSE: The standard of care for the treatment of cancer-related venous thromboembolism (VTE) is a low molecular weight heparin (LMWH) formulation. The recent development of direct oral anticoagulants (DOACs) and their approval for the treatment of VTE has resulted in several new options for treatment. If equivalent to LMWH in terms of safety and effectiveness, the use of DOACs in the treatment of cancer-related VTE would reduce the risk of VTE recurrence while potentially improving the quality of life of many cancerpatients. METHODS: We performed a retrospective analysis of adult patients with cancer-related VTE treated in our benign hematology clinic. Among the 153 patients included in our final analysis, 123 (80%) were treated with LMWH and 30 (20%) were treated with DOACs. Patients had 36 different histological types of cancer. The primary outcome was the rate of recurrence of VTE evaluated at 6 and 12months after the initiation of anticoagulation. Secondary outcomes were the rate of anticoagulant-associated clinically relevant bleeding and event-free survival for VTE recurrence. RESULTS: In comparing the 2 treatment groups, there was no statistically significant difference in the cumulative rates of VTE recurrence at 6 and 12months or in the rates of major or non-major bleeding at both 6 and 12months. The median VTE recurrence-free survival rates were not reached and they were not statistically different. CONCLUSION:DOACs appear to be as safe and effective as conventional therapy for the treatment of cancer-related VTE. Results of ongoing randomized clinical studies may provide definitive evidence and clarify the role of the DOACs in the setting of malignancy.
Authors: Hanno Riess; Cihan Ay; Rupert Bauersachs; Cecilia Becattini; Jan Beyer-Westendorf; Francis Cajfinger; Ian Chau; Alexander T Cohen; Alok A Khorana; Anthony Maraveyas; Marcos Renni; Annie M Young Journal: Oncologist Date: 2018-04-12
Authors: A Franco-Moreno; L Cabezón-Gutiérrez; M Palka-Kotlowsa; M Villamayor-Delgado; M García-Navarro Journal: J Thromb Thrombolysis Date: 2019-04 Impact factor: 2.300
Authors: Jan Beyer-Westendorf; Robert Klamroth; Stephan Kreher; Florian Langer; Axel Matzdorff; Hanno Riess Journal: Dtsch Arztebl Int Date: 2019-01-18 Impact factor: 5.594