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01-03-2018 | Review Article

The role of direct oral anticoagulants in cancer-related venous thromboembolism: a perspective beyond the guidelines

Author: Cristhiam M. Rojas-Hernandez

Published in: Supportive Care in Cancer | Issue 3/2018

Abstract

Cancer-related venous thromboembolism (Wickham et al., Intern Med J 42(6):698–708, 2012) is an important source of morbidity and mortality in that population. The standard of care for the treatment of cancer-related venous thromboembolism (VTE) is a low molecular weight heparin (LMWH) for long periods of time. The favorable clinical trial results for efficacy and safety and availability of direct oral anticoagulants (DOAC) have remodeled the care and options for treatment of venous thromboembolism in the adult population. The data of cancer population-subgroup analysis of those studies have shown that DOAC are as effective and safe as conventional long-term oral anticoagulation with vitamin K antagonists (VKA). Additionally, non-controlled retrospective and prospective cohort data have been published describing efficacy and safety outcomes for the use of DOAC in cancer-related VTE. Altogether, the results from clinical studies have shown that direct oral anticoagulants may represent a treatment option for cancer-related VTE and an alternative to anticoagulation with VKA. Little is known about the patient-centered and system-based variables that determine the use of DOAC outside consensus guidelines, neither is known the impact of different anticoagulant modalities in adherence and quality of life in cancer patients. The objectives of this manuscript are to summarize the clinical trial-based and cohort data of cancer patients treated with DOAC for VTE and to highlight the aspects that may influence adherent to therapy, effectiveness, and safety outcomes in the treatment of cancer-related VTE.

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Title: The role of direct oral anticoagulants in cancer-related venous thromboembolism: a perspective beyond the guidelines
Author: Cristhiam M. Rojas-Hernandez
Publication date: 01-03-2018
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 3/2018
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3990-3

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