Novel oral anticoagulants in the treatment of cancer patients
Journal Title: OncoReview - Year 2014, Vol 4, Issue 1
Abstract
Cancer and its treatment are well-recognized risk factors for venous thromboembolism. The risk of thrombotic complications increases 4–7-fold in cancer patients and coexistence of both pathologies is associated with shorter survival. Incidence of thrombosis depends on the tumour type, antineoplastic and supportive therapy, and patient-related factors such as age, physical activity and comorbidities.Current recommendations of scientific societies indicate a dominant role of low molecular weight heparins in the treatment and prevention of venous thromboembolism in cancer patients. Long duration of the anticoagulant effect, and the subcutaneous administration route of heparins call for a safer therapeutic option, and one that would be more convenient for the patient. New oral anticoagulants:dabigatran, rivaroxaban, and apixaban, are indicated as prevention of venous thromboembolism following an orthopaedic surgery, and as stroke prevention in nonvalvular atrial fibrillation, with rivaroxaban also applied in the treatment of acute deep vein thrombosis and pulmonary embolism. In the trials evaluating the efficacy of novel oral anticoagulants, they have been compared with enoxaparinor vitamin K antagonists. Cancer patients accounted for a small percentage of the trial population, and they were rarely analysed in subgroup analysis. It was only in the phase II ADVOCATE study that the target group were patients receiving chemotherapy. Direct comparison between test drug and low molecular weight heparins was not performed. The currently available study results do not allowus to recommend the new oral anticoagulants for the treatment and prevention of venous thromboembolism associated with cancer.
Authors and Affiliations
Renata Biernacka, Tomasz Lewandowski, Jolanta Andrzejuk, Marek Szmyd
Keywords
Related Articles
- EP ID EP67747
- DOI -
- Views 230
- Downloads 0
Krwioplucie – rak czy zatorowość płucna?
Pacjenci onkologiczni to grupa o zwiększonym ryzyku wystąpienia zatorowości płucnej. Zarówno w obrazie klinicznym zatorowości płucnej, jak i w przebiegu choroby rozrostowej może wystąpić krwioplucie. Jest ono zawsze obja...
Papillary renal cell carcinoma – case report of a patient with disseminated disease treated with pazopanib with several years of survival against reviewing current literature
Papillary renal cell carcinoma is the second most common histological type of renal cell carcinoma with distinct cytogenetics, histology and prognosis. It exhibits significantly poorer response to molecular targeted ther...
Kontrolowane placebo, z podwójnie ślepą próbą, prospektywne, randomizowane badanie skuteczności oktreotudu LAR w kontroli guza u chorych na guzy neuroendokrynne środkowej części prajelita z przerzutami: raport grupy badawczej PROMID
Wstęp: Analogi somatostatyny są wskazane w opanowywaniu objawów u chorych na żołądkowo-jelitowo-trzustkowe guzy neuroendokrynne (NETs). Zdolność analogów somatostatyny do kontrolowania wzrostu wysoko zróżnicowanych NETs...
Płyn w worku osierdziowym zagrażający tamponadą serca u chorych onkologicznie – standardy diagnostyki i leczenia
Obecność płynu w worku osierdziowym zagrażająca tamponadą serca jest stanem bezpośredniego zagrożenia życia. Najważniejsze w takim przypadku są: rozpoznanie, ustalenie wskazań do perikardiocentezy i drenaż jamy osierdzia...
Application of echocardiography in oncology – practical remarks
The paper presents the contemporary use of echocardiography in diagnosis of primary and metastatic tumors of the heart as well as in assessment of cardiovascular risk related to medical and interventional oncological the...