Anticoagulation for the initial treatment of venous thromboembolism in patients with cancer

Abstract

LMWH is possibly superior to UFH in the initial treatment of VTE in patients with cancer. Additional trials focusing on patient important outcomes will further inform the questions addressed in this review.

Antithrombotic Therapy in Patients With Thrombocytopenic Cancer

“…These rates are also comparable to findings in patients with nonthrombocytopenic cancer enrolled in randomized controlled trials. 19,20,22 In our series, all patients who experienced recurrent VTE, despite treatment had prominent risk factors for clots. In terms of likelihood of treatment failure, a review of these patients suggests that the importance of individual differences in clot risk may outweigh the influence of most differences in clinical characteristics between treatment groups (Table 1).…”

Antithrombotic Therapy in Patients With Thrombocytopenic Cancer

“…These rates are also comparable to findings in patients with nonthrombocytopenic cancer enrolled in randomized controlled trials. 19,20,22 In our series, all patients who experienced recurrent VTE, despite treatment had prominent risk factors for clots. In terms of likelihood of treatment failure, a review of these patients suggests that the importance of individual differences in clot risk may outweigh the influence of most differences in clinical characteristics between treatment groups (Table 1).…”

Anticoagulation for prevention and treatment of cancer‐related venous thromboembolism

“…However, a recent Cochrane meta-analysis included seven randomised clinical trials comparing LMWH to oral vitamin K antagonists for the long-term secondary prophylaxis of cancer-related VTE. This did not demonstrate a statistically significant survival benefit with LMWH (HR 0Á96; 95% CI, 0Á81-1Á14) (Akl et al, 2011).…”

International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer

“…In two meta-analyses specifically performed in cancer patients, the rates of recurrence did not differ statistically between LMWH and UFH [50,51]; the relative effect regarding bleeding was not reported. Interestingly, a beneficial effect of LMWH vs. UFH was observed on the risk of death [50,51]: in the most recent meta-analysis in 801 cancer patients, the death rate was reduced from 18.9% with UFH to 13.1% with…”

Antithrombotic Therapy in Patients With Thrombocytopenic Cancer

“…These rates are also comparable to findings in patients with nonthrombocytopenic cancer enrolled in randomized controlled trials. 19,20,22 In our series, all patients who experienced recurrent VTE, despite treatment had prominent risk factors for clots. In terms of likelihood of treatment failure, a review of these patients suggests that the importance of individual differences in clot risk may outweigh the influence of most differences in clinical characteristics between treatment groups (Table 1).…”

Anticoagulation for prevention and treatment of cancer‐related venous thromboembolism

“…However, a recent Cochrane meta-analysis included seven randomised clinical trials comparing LMWH to oral vitamin K antagonists for the long-term secondary prophylaxis of cancer-related VTE. This did not demonstrate a statistically significant survival benefit with LMWH (HR 0Á96; 95% CI, 0Á81-1Á14) (Akl et al, 2011).…”

International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer

“…In two meta-analyses specifically performed in cancer patients, the rates of recurrence did not differ statistically between LMWH and UFH [50,51]; the relative effect regarding bleeding was not reported. Interestingly, a beneficial effect of LMWH vs. UFH was observed on the risk of death [50,51]: in the most recent meta-analysis in 801 cancer patients, the death rate was reduced from 18.9% with UFH to 13.1% with…”

Antithrombotic Therapy in Patients With Thrombocytopenic Cancer

“…These rates are also comparable to findings in patients with nonthrombocytopenic cancer enrolled in randomized controlled trials. 19,20,22 In our series, all patients who experienced recurrent VTE, despite treatment had prominent risk factors for clots. In terms of likelihood of treatment failure, a review of these patients suggests that the importance of individual differences in clot risk may outweigh the influence of most differences in clinical characteristics between treatment groups (Table 1).…”

Anticoagulation for prevention and treatment of cancer‐related venous thromboembolism

“…However, a recent Cochrane meta-analysis included seven randomised clinical trials comparing LMWH to oral vitamin K antagonists for the long-term secondary prophylaxis of cancer-related VTE. This did not demonstrate a statistically significant survival benefit with LMWH (HR 0Á96; 95% CI, 0Á81-1Á14) (Akl et al, 2011).…”

International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer

“…In two meta-analyses specifically performed in cancer patients, the rates of recurrence did not differ statistically between LMWH and UFH [50,51]; the relative effect regarding bleeding was not reported. Interestingly, a beneficial effect of LMWH vs. UFH was observed on the risk of death [50,51]: in the most recent meta-analysis in 801 cancer patients, the death rate was reduced from 18.9% with UFH to 13.1% with…”