Abstract
Recently, cancer-related venous thromboembolism (VTE) has been termed “cancer-associated thrombosis (CAT)” and is the focus of current research. We retrospectively investigated the efficacy of a single-drug approach with edoxaban for the treatment of non-acute CAT. Thirty-two non-acute CAT patients who received edoxaban were analyzed. The primary endpoint of this analysis was the thrombus disappearance rate at the first evaluation. Secondary endpoints included progression/recurrence of VTE, major bleeding, and D-dimer levels. The thrombus disappearance rate was 62.5%. Therefore, the null hypothesis for the primary endpoint (thrombus disappearance rate of ≤32.0%) was rejected (p = 0.00038) based on the rate of the previous study as the historical control. Recurrent VTE and major bleeding occurred in two patients each. After the start of treatment with edoxaban, a significant difference in D-dimer levels was observed (p = 0.00655). We demonstrated that a single-drug approach with edoxaban is a potential treatment option for non-acute CAT.
Highlights
The Japan VTE Treatment Registry, a multicenter cohort study of patients with venous thromboembolism (VTE) in Japan, has shown that cancer is the biggest risk factor for VTE [1].The incidence of VTE among patients with cancer is increasing annually [2] and is four to eight times higher than in patients without cancer [3,4,5]
Surgery for cancer increases the risk of fatal pulmonary embolism (PE) and chemotherapy can cause VTE [6,7,8]
We focused on VTE and referred to cancer-associated venous thrombosis as cancer-associated thrombosis (CAT)
Summary
The Japan VTE Treatment Registry, a multicenter cohort study of patients with venous thromboembolism (VTE) in Japan, has shown that cancer is the biggest risk factor for VTE [1]. The incidence of VTE among patients with cancer is increasing annually [2] and is four to eight times higher than in patients without cancer [3,4,5]. The increased risk of VTE is thought to be related to cancer treatment. Surgery for cancer increases the risk of fatal pulmonary embolism (PE) and chemotherapy can cause VTE [6,7,8]. VTE is the leading cause of non-cancer-related death in patients with cancer [9]; caution should be exercised concerning VTE.
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