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An Update in Anticoagulant Therapy for Patients with Cancer-Associated Venous Thromboembolism
Murillo A Martins1, Taysa F Silva1,2, Caio J Fernandes3,4,5
1Cardiopulmonary Department - Heart Institute, University of Sao Paulo Medical School, 44, Av. Dr. Eneas de Carvalho Aguiar, São Paulo, SP, 05403-000, Brazil.
Purpose Of Review:
This review aims to assess the treatment options for cancer-associated venous thromboembolism (VTE) based on the most robust level of evidence recommendations and suggestions based on expert opinion.
Recent Findings:
Several classes of anticoagulants have been studied in the treatment of cancer-associated thrombosis (CAT). Since the CLOT trial, guidelines recommend the use of low-molecular-weight heparin (LMWH) for the treatment of this condition. However, since 2018, some direct oral anticoagulants became an alternative first-line treatment for CAT. Three Xa antagonists (rivaroxaban, apixaban, and edoxaban) proved to be at least as effective as the LMWH strategy for the short-term prevention of VTE recurrence. The right choice of treatment in the context of anticoagulation strategy, thrombo-hemorrhagic risk management, and a patient's comorbidities represents a challenge. The correct management of CAT and a more individualized approach are needed to identify risk factors and offer the best treatment for each patient.
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