Abstract
Thromboembolism is life-threating condition which is reported to be the second-leading cause of death in cancer patients after cancer itself. Cancer-associated thromboembolism (CAT) is classified as arterial thromboembolism and venous thromboembolism (VTE), but multiple pathologies are considered depending on the onset mechanism. A recent nationwide prospective cohort study revealed that the prevalence of VTE among treatment naïve Japanese cancer patients was 5.9% overall, and that VTE prevalence appeared to increase as the cancer stage increased, reaching a level of 11.2% at stage IV. Moreover, as cancer patients in Japan progressively age, comorbid VTE is expected to increase in prevalence in the next decade. CA-VTE is not rare at all. Although anticoagulant treatment is the recommended standard of care for acute CA-VTE, this treatment is complicated by both a high risk of recurrent VTE and bleeding events. Direct oral anticoagulants (DOACs) are recommended as new standard care for CA-VTE. The most updated meta-analysis demonstrated that the incidence of VTE recurrence was significantly lower with DOACs compared with low molecular weight heparin (LMWH), and that the risk of major bleeding was non-significantly higher with DOACs compared with LMWH. Unfortunately, no formal bleeding assessment scores are currently available to predict the risk of bleeding in cancer patients receiving DOACs. Clinicians should use them with caution, especially when patients have a high risk of bleeding such as luminal gastrointestinal cancers with an intact primary. In addition, recent trials showed that thromboprophylaxis with DOACs in ambulatory cancer patients at intermediate or high risk of VTE (Khorana score ≥2) was effective and safe. Taken together, DOACs will be more common all over the world. It should be noted that Japanese patients were rarely included in the pivotal international phase III trials mentioned above. Further complementary Japanese studies are warranted.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
