Controversies in the management of cancer-associated thrombosis

Cancer associated thrombosis (CAT) is a frequent complication among cancer patients. It is associated with increased morbidity, mortality, and psychological burden. Areas covered: Low-molecular-weight heparin monotherapy for the initial 6 months is considered the standard of care for the acute and long-term management of CAT. For patients at high risk of recurrent CAT (e.g. active cancer or still undergoing anticancer therapy) beyond the initial 6 months of treatment, continuation of anticoagulation therapy for secondary prevention is usually recommended. The management of anticoagulation therapy is more challenging in patients with cancer. Cancer patients are more likely to have recurrent events despite anticoagulation, thrombocytopenia due to their chemotherapy regimens or have incidental pulmonary embolism diagnosed on their staging imaging. Expert commentary: We will review expert consensuses and opinions in order to guide clinicians on how to tailor the management of CAT in these special circumstances.