Display options
Cite
Smrke A, Gross PL. Cancer-Associated Venous Thromboembolism: A Practical Review Beyond Low-Molecular-Weight Heparins. Front Med (Lausanne). 2017;4:142doi: 10.3389/fmed.2017.00142.
Smrke, A., & Gross, P. L. (2017). Cancer-Associated Venous Thromboembolism: A Practical Review Beyond Low-Molecular-Weight Heparins. Frontiers in medicine, 4142. https://doi.org/10.3389/fmed.2017.00142
Smrke, Alannah, and Gross, Peter L. "Cancer-Associated Venous Thromboembolism: A Practical Review Beyond Low-Molecular-Weight Heparins." Frontiers in medicine vol. 4 (2017): 142. doi: https://doi.org/10.3389/fmed.2017.00142
Smrke A, Gross PL. Cancer-Associated Venous Thromboembolism: A Practical Review Beyond Low-Molecular-Weight Heparins. Front Med (Lausanne). 2017 Aug 28;4:142. doi: 10.3389/fmed.2017.00142. eCollection 2017. PMID: 28894738; PMCID: PMC5581345.
Copy Download .nbib Format: NLM
Share it on

Front Med (Lausanne). 2017 Aug 28;4:142. doi: 10.3389/fmed.2017.00142. eCollection 2017.

Cancer-Associated Venous Thromboembolism: A Practical Review Beyond Low-Molecular-Weight Heparins.

Frontiers in medicine

Alannah Smrke, Peter L Gross

Affiliations

  1. Department of Medicine, McMaster University, Hamilton, ON, Canada.
  2. Thrombosis and Atherosclerosis Research Institute, Hamilton, ON, Canada.

PMID: 28894738 PMCID: PMC5581345 DOI: 10.3389/fmed.2017.00142

Abstract

Patients with cancer are at significantly higher risk of developing, and dying from, venous thromboembolism (VTE). The CLOT trial demonstrated superiority of low-molecular-weight heparins (LMWH) over warfarin for recurrent VTE and established LMWH as the standard of care for cancer-associated VTE. However, with patients living longer with metastatic cancer, long-term injections are associated with significant cost and injection fatigue. Direct oral anticoagulants (DOACs) are an attractive alternative for treatment of cancer-associated VTE. Meta-analysis of subgroup data of patients with cancer from the large DOAC VTE trials and small non-randomized studies have found no difference in VTE recurrence or major bleeding. With this limited evidence, clinicians may decide to switch their patients who require long-term anticoagulation from LMWH to a DOAC. This requires careful consideration of the interplay between the patient's cancer and treatment course, with their underlying comorbidities.

Keywords: cancer-associated thrombosis; cancer-associated venous thromboembolism; direct oral anticoagulants; low-molecular-weight heparin; pulmonary embolism; venous thromboembolism

References

  1. Arch Intern Med. 2000 Mar 27;160(6):809-15 - PubMed
  2. N Engl J Med. 2000 Dec 21;343(25):1846-50 - PubMed
  3. Arch Intern Med. 2002 Aug 12-26;162(15):1729-35 - PubMed
  4. N Engl J Med. 2003 Jul 10;349(2):146-53 - PubMed
  5. Thromb Res. 2006;118(5):555-68 - PubMed
  6. Nat Rev Cancer. 2006 Jul;6(7):546-58 - PubMed
  7. Clin Appl Thromb Hemost. 2006 Oct;12(4):389-96 - PubMed
  8. Am J Med. 2006 Dec;119(12):1062-72 - PubMed
  9. Oncologist. 2007 Aug;12(8):927-41 - PubMed
  10. N Engl J Med. 2009 Dec 10;361(24):2342-52 - PubMed
  11. N Engl J Med. 2010 Dec 23;363(26):2499-510 - PubMed
  12. PLoS Med. 2012;9(7):e1001275 - PubMed
  13. N Engl J Med. 2013 Aug 29;369(9):799-808 - PubMed
  14. N Engl J Med. 2013 Oct 10;369(15):1406-15 - PubMed
  15. Patient Prefer Adherence. 2014 Apr 08;8:453-61 - PubMed
  16. J Thromb Haemost. 2014 Jul;12(7):1116-20 - PubMed
  17. Chest. 2015 Feb;147(2):475-483 - PubMed
  18. Thromb Res. 2014 Dec;134(6):1214-9 - PubMed
  19. Semin Thromb Hemost. 2015 Mar;41(2):237-43 - PubMed
  20. Curr Oncol. 2015 Feb;22(1):49-59 - PubMed
  21. Patient Prefer Adherence. 2015 Feb 24;9:337-45 - PubMed
  22. J Thromb Haemost. 2015 Jun;13(6):1028-35 - PubMed
  23. JAMA. 2015 Aug 18;314(7):677-686 - PubMed
  24. Chest. 2016 Feb;149(2):315-352 - PubMed
  25. Thromb Res. 2016 Apr;140 Suppl 1:S191-2 - PubMed
  26. J Thromb Haemost. 2016 Nov;14(11):2107-2113 - PubMed
  27. J Thromb Thrombolysis. 2017 Feb;43(2):166-171 - PubMed
  28. J Thromb Thrombolysis. 2017 Apr;43(3):343-351 - PubMed
  29. Res Pract Thromb Haemost. 2017 May 30;1(1):14-22 - PubMed
  30. World J Surg. 1996 Jun;20(5):521-6; discussion 526-7 - PubMed
  31. Arch Intern Med. 1998 Oct 12;158(18):2001-3 - PubMed

Publication Types