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Prevention and Treatment of Cancer-Associated Venous Thromboembolism: a Review

  • Cardio-oncology (M Fradley, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Patients with cancer have an increased risk of venous thromboembolism (VTE). Cancer-associated VTE is associated with an increased risk of morbidity and mortality. Treatment of VTE in cancer is associated with higher rates of recurrent thrombosis as well as major bleeding compared with the general population. The goal of this review is to provide a summary of current evidence for the prevention and treatment of cancer-associated VTE.

Recent findings

Validated risk prediction models are available to aide clinicians in identifying patients with cancer with the highest risk of VTE. Those patients with intermediate to high risk of VTE may benefit from primary prophylaxis with apixaban or rivaroxaban. Low-molecular-weight heparin is superior to vitamin K antagonists for the treatment of cancer-associated VTE. There is mounting evidence to support use of the direct oral anticoagulants for VTE in patients with cancer.

Summary

Decisions on type and duration of anticoagulation in patients with cancer, either for primary or secondary prevention, should be made on a case-by-case basis with taking into account the individual patient bleeding and thrombotic risk.

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Authors and Affiliations

  1. Division of Hematology, Washington University School of Medicine, 660 S. Euclid Avenue, CB 8125, Saint Louis, MO, 63110, USA

    Kristen M. Sanfilippo MD, MPHS

  2. Division of Hematology, The Ohio State University Comprehensive Cancer Center, A340 Starling Loving Hall, 320 W. 10th Avenue, Columbus, OH, 43210, USA

    Tzu-Fei Wang MD

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Correspondence to Kristen M. Sanfilippo MD, MPHS.

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Conflict of Interest

Kristen Sanfilippo was on the Bristol-Myers Squibb speaker bureau, served on an advisory board for Pfizer and Bayer, received travel expenses from AstraZeneca, and received research funding from NHLBI.

Tzu-Fei Wang received consulting fees and travel expenses from Daiichi Sankyo and Pfizer.

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Sanfilippo, K.M., Wang, TF. Prevention and Treatment of Cancer-Associated Venous Thromboembolism: a Review. Curr Treat Options Cardio Med 21, 70 (2019). https://doi.org/10.1007/s11936-019-0764-x

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