Low-molecular-weight heparin in oncology

Venous thromboembolism (VTE) is a wellknown complication of malignant disease and multiple risk factors contribute to the hypercoagulability that commonly accompanies malignancy. Thromboprophylaxis with antithrombotic drugs such as the low-molecular-weight heparins (LMWHs) can be used to control the hypercoagulable state and to reduce the incidence of VTE in patients with cancer. Clinical and biochemical data suggest that LMWHs may also inhibit tumour growth, leading to a survival benefit in these patients. This review addresses the efficacy and safety of LMWHs for prophylaxis and treatment of VTE in patients with cancer. Outstanding issues relating to thromboprophylaxis and treatment of VTE in patients with cancer and the clinical trials that may resolve these issues are also highlighted.