Abstract
Patients with cancer-associated thrombosis (CAT) are at high risk of recurrent venous thromboembolism (VTE) and major bleeding complications. Risks vary significantly between individuals based on cancer status, treatment, and other characteristics. To facilitate the evidence-based management of anticoagulant therapy in this patient population, a committee of 11 Canadian clinical experts updated a consensus-based algorithm for the acute and extended treatment of symptomatic and incidental CAT that was developed in 2018. Following a systematic review of the literature, updates to the algorithm were discussed during an online teleconference, and the algorithm was subsequently refined based on feedback from committee members. Clinicians using this treatment algorithm should consider bleeding risk, type of cancer, and drug–drug interactions, as well as patient and clinician preferences, in tailoring anticoagulation for patients with CAT. Anticoagulant therapy should be adapted as the patient’s cancer status and management change over time.
Highlights
The search of the PubMed database identified 420 articles, 22 of which were selected for review according to pre-specified criteria, while the search of the American Society of Hematology abstract database identified 27 abstracts, one of which was selected for review
LMWH for the acute treatment of cancer-associated thrombosis (CAT) (Table 1), clinical practice guidelines recommended the use of LMWH over DOACs or VKA for the acute and secondary prevention of venous thromboembolism (VTE)
On the other hand, have suggested that either a DOAC or LMWH can be used for the acute treatment of CAT [19,20,21,22,23], with recommendations that treatment be individualized based on patient characteristics
Summary
The management of venous thromboembolism (VTE) is a frequent and important clinical issue in patients with cancer. The 6-month VTE risk for patients with cancer is. 12-fold higher compared to the general population, and as much as 23-fold higher in patients receiving chemotherapy or targeted therapy [1]. 12-month cumulative incidence for VTE has increased three-fold in cancer patients [1]. Thromboembolism has been reported to be the second leading cause of death in patients with cancer, highlighting the importance of urgently initiating therapeutic dosing of anticoagulation [2,3]. The management of anticoagulant therapy for cancer-associated thrombosis (CAT) is complex due to an increased risk of both recurrent
Sign-in/Register to view highlights & summary 
Published Version (
Free)
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 call