The role of direct oral anticoagulants in the treatment of cancer associated venous thromboembolism Review article

Article Sidebar

PDF


Published: Sep 12, 2018
DOI: https://doi.org/10.24292/01.OR.121918
Keywords:
cancer-associated thromboembolism, direct oral anticoagulants

Main Article Content

Elizaveta Panchenko
Department of Clinical Problem of Atherothrombosis, A.L. Myasnikov Institute Cardiology National Medical Research Center of Cardiology of Ministry of Health of the Russian Federation
Julia Fedotkina
Department of Clinical Problem of Atherothrombosis, A.L. Myasnikov Institute Cardiology National Medical Research Center of Cardiology of Ministry of Health of the Russian Federation
Anatoly Dobrovolsky
Department of Clinical Problem of Atherothrombosis, A.L. Myasnikov Institute Cardiology National Medical Research Center of Cardiology of Ministry of Health of the Russian Federation

Abstract

Cancer disease is one of the most significant risk factors for venous thromboembolic complications. In this review features of treatment and unsolved questions of alternative anticoagulant therapy of cancer- associated thromboembolism (CAT) are considered. The modern guidelines advocate the use of low-molecular-weight heparin (LMWH) over a vitamin K antagonist (VKA) for the first 3–6 months after diagnosis of VTE in cancer patients. Few years ago direct oral anticoagulants (DOACs) have been approved for the treatment of venous thromboembolism (VTE). DOACs have demonstrated comparable efficacy and safety with VKA in general population. But efficacy and safety of DOACs as compared with long-term LMWH for the treatment of CAT have not been definitely established. The review focuses on the results of the first two prospective randomized studies (HOKUSAI VTE Cancer and SELECT-D) in which the efficacy and safety of edoxaban and rivaroxaban was compared with low-molecular-weight heparin dalteparin for the treatment of VTE in cancer patients and the latest recommendations from SSC of the ISTH on the feasibility of using DOACs in the treatment of CAT.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Article Details

How to Cite
1.
Panchenko E, Fedotkina J, Dobrovolsky A. The role of direct oral anticoagulants in the treatment of cancer associated venous thromboembolism. OncoReview [Internet]. 2018Sep.12 [cited 2024May6];8(3(31):70-5. Available from: https://journalsmededu.pl/index.php/OncoReview/article/view/425
Issue
Vol 8 No 3(31) (2018)
Section
CARDIO-ONCOLOGY
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)

References

1. Ay C, Kamphuisen P, Agnelli G et al. Antithrombotic therapy for prophylaxis and treatment of venous thromboembolism in patients with cancer: review of the literature on current practice and emerging options. ESMO Open 2017; 2(2): e000188. https://doi.org/10.1136/esmoopen-2017-000188. eCollection 2017.
2. Elyamany G, Alzahrani A, Bukhary E et al. Cancer-associated thrombosis: an overview. Clin Med Insights Oncol 2014; 8: 129-137.
3. Caine GJ, Stonelake PS, Lip GY et al. The hypercoagulable state of malignancy: pathogenesis and current debate. Neoplasia 2002; 4(6): 465-473.
4. Heit JA, O’Fallon WM, Petterson TM et al. Relative impact of risk factor for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med 2002; 162(11): 1245-1248.
5. Khorana AA, Francis CW, Culakova E et al. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost 2007; 5: 632-634.
6. Prandoni P, Lensing AW, Piccioli A et al. Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis. Blood 2002; 100: 3484-3488.
7. Lee AY, Levine MN, Baker RI et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 2003; 349: 146-153.
8. Meyer G, Marjanovic Z, Valcke J et al. Comparison of low-molecular-weight heparin and warfarin for the secondary prevention of venous thromboembolism in patients with cancer: a randomized controlled study. Arch Intern Med 2002; 162: 1729-1735.
9. Hull RD, Pineo GF, Brant RF et al. Long-term low-molecular-weight heparin versus usual care in proximal-vein thrombosis patients with cancer. Am J Med 2006; 119: 1062-1072.
10. Kearon C, Akl EA, Ornelas J et al. Antithrombotic Therapy for VTE Disease. Chest Guidelines and Expert Panel Report. Chest 2016; 149(2): 315-352.
11. Watson HG, Keeling DM, Laffan M et al. Guideline on aspects of cancer-related venous thrombosis. Br J Haematol 2015; 170: 640-648.
12. Zamorano JL, Lancellotti P, Rodriguez Muñoz D et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. EHJ. https://doi.org/10.1093/eurheat/ehw 211.
13. Farge D, Bounameaux H, Brenner B et al. International clinical practice guidelines in the treatment and prophylaxis VTE in patients with cancer. Lancet Oncol 2016; 17: e452-466.
14. Khorana A, Yannicelli D, McCrae KR et al. Еvaluation of US prescription patterns: are treatment guidelines for cancer-associated venous thromboembolism being followed? Thromb Res 2016; 145: 51-53.
15. Schulman S, Kearon C, Kakkar AK et al. Dabigatran versus warfarin in the treatment of acute venous thromboembolism. N Engl J Med 2009; 361: 2342-2352.
16. Bauersachs R, Berkowitz SD, Brenner B et al. Oral rivaroxaban for symptomatic venous thromboembolism. N Engl J Med 2010; 363: 2499-2510.
17. Buller HR, Prins MH, Lensin AW et al. Oral rivaroxaban for the treatment of symptomatic pulmonary embolism. N Engl J Med 2012; 366: 1287-1297.
18. Prins MH, Lensing WAA, Bauersachs R et al. Oral rivaroxaban versus standard therapy for the treatment of symptomatic venous thromboembolism: a pooled analysis of the EINSTEIN-DVT and PE randomized studies. Thromb J 2013; 11: 21.
19. Agnelli G, Buller HR, Cohen A et al. Oral apixaban for the treatment of acute venous thromboembolism. N Engl J Med 2013; 369: 799-808.
20. Buller HR, Décousus H, Grosso MA et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med 2013; 369: 1406-1415.
21. Raskob GE, van Es N, Verhamme P et al. Edoxaban for the treatment of cancer-associated venous thromboembolism. NEJM 2017, Dec 12.
22. Young AM, Marshall A, Thirlwall J et al. Comparison of an Oral Factor Xa Inhibitor with Low Molecular Weight Heparin in Patients with Cancer with Venous Thromboembolism: Results of Randomized Trial (SELECT-D). J Clin Oncol 2018; 36: 2017-2023.
23. Li A, Garsia DA, Lyman GH, Carrier M. Direct oral anticoagulant (DOAC) versus low-molecular-weight heparin (LMWH) for treatment of cancer associated thrombosis (CAT): a systematic review and meta-analysis. Thromb Res 2018; https://doi.org/10.1016/j.thromres.2018.02.144.
24. Khorana AA, Noble S, Lee AYY et al. Role of direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism: guidance from SSC of the ISTH. J Thromb Haemost 2018; https://doi.org/10.1111/jth.14219.