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An Update in Anticoagulant Therapy for Patients with Cancer-Associated Venous Thromboembolism

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Abstract

Purpose of Review

This review aims to assess the treatment options for cancer-associated venous thromboembolism (VTE) based on the most robust level of evidence recommendations and suggestions based on expert opinion.

Recent Findings

Several classes of anticoagulants have been studied in the treatment of cancer-associated thrombosis (CAT). Since the CLOT trial, guidelines recommend the use of low-molecular-weight heparin (LMWH) for the treatment of this condition. However, since 2018, some direct oral anticoagulants became an alternative first-line treatment for CAT. Three Xa antagonists (rivaroxaban, apixaban, and edoxaban) proved to be at least as effective as the LMWH strategy for the short-term prevention of VTE recurrence.

Summary

The right choice of treatment in the context of anticoagulation strategy, thrombo-hemorrhagic risk management, and a patient’s comorbidities represents a challenge. The correct management of CAT and a more individualized approach are needed to identify risk factors and offer the best treatment for each patient.

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Data Availability

The authors declare that the data supporting the findings of this study are available within the article.

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Authors and Affiliations

  1. Cardiopulmonary Department – Heart Institute, University of Sao Paulo Medical School, 44, Av. Dr. Eneas de Carvalho Aguiar, São Paulo, SP, 05403-000, Brazil

    Murillo A. Martins, Taysa F. Silva & Caio J. Fernandes

  2. Sirio Libanes Hospital, 115, Adma Jafet St, Sao Paulo, SP, Brazil

    Taysa F. Silva & Caio J. Fernandes

  3. Cancer Institute, University of Sao Paulo Medical School, 251, Dr. Arnaldo Avenue, Sao Paulo, SP, Brazil

    Caio J. Fernandes

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Martins, M.A., Silva, T.F. & Fernandes, C.J. An Update in Anticoagulant Therapy for Patients with Cancer-Associated Venous Thromboembolism. Curr Oncol Rep 25, 425–432 (2023). https://doi.org/10.1007/s11912-023-01384-7

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