It is estimated that the annual incidence of venous thromboembolism (VTE) in patients with cancer is five times greater than in the general population (0.5% versus 0.1%, respectively)1. Active cancer accounts for 20% of the overall incidence of the disease2. Traditionally, anticoagulants used to treat signs and symptoms of VTE have included low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs). Recently, a newer class of direct oral anticoagulant therapy, the direct oral anticoagulants (DOACs), has emerged as a potential option for pharmacologic thromboprophylaxis and for treatment of patients with cancer at high risk or at risk of VTE3. Emerging evidence, such as that from the recent CARAVAGGIO trial, suggests DOACs are promising new treatments for CAT, which may be more appropriate for certain subsets of cancer patients4.
Short on time? Here’s a quick overview of the assessment, diagnosis and treatment of patients with CAT.
Giancarlo Agnelli, MD, is Professor of Internal Medicine at the University of Perugia, Italy, and Director of the Department of Internal and Cardiovascular Medicine and Stroke-Unit at the University Hospital in Perugia, Italy.
- Elyamany G, Alzahrani AM, Bukhary E. Cancer-associated thrombosis: An overview. Clinical Medicine Insights: Oncology. 2014;8:129–137.
- Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016;41(1):3–14.
- Iorga R, Bratu O, Marcu R, Constantin T, Mischianu D, Socea B, et al. Venous thromboembolism in cancer patients: Still looking for answers (Review). Exp Ther Med. 2019;18(6):5026–5032.
- Agnelli G, Becattini C, Meyer G, Muñoz A, Huisman M V., Connors JM, et al. Apixaban for the treatment of venous thromboembolism associated with cancer. N Engl J Med. 2020;382(17):1599–1607.
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