Arterial events in cancer patients treated with apixaban for venous thrombosis

Cancer and arterial thrombosis: therapeutic options

“…In support of a theoretical role of antiplatelet therapy, some studies on clots in cancer-associated stroke show that these are platelet rich [ 64 , 78 ]. Finally, there is evidence that cancer-associated stroke occurs despite therapeutic dose oral anticoagulation given for other indications [ 61 , 79 ]. To summarize, once NBTE and other specific causes have been ruled out, there is still equipoise regarding the use of anticoagulation or antiplatelet therapy in cancer-associated ESUS, but decisions on management must be taken on a case-by-case basis.…”

“…The optimal antithrombotic therapies in the context of cancer-associated ATE remains uncertain, including the choice between anticoagulation or antiplatelet therapy. The role of adjunctive therapies in ATE prophylaxis is also unclear [ 79 , 106 ]. In summary, substantial research is needed to advance our understanding of the relationship between ATE and cancer, ultimately enhancing the support and outcomes of oncological care for patient.…”

Arterial Thrombosis in Patients with Cancer

“…Finally, a role of biomarkers in risk stratification of ATE is emerging. In a prospective multi-center Norwegian cohort of patients with pancreatic-cancer-associated VTEs, Larsen et al reported a 36% cumulative incidence of breakthrough ATEs within the first six months of therapeutic apixaban treatment, primarily manifesting as ischemic strokes [ 21 ]. Leukocyte count was higher among patients with breakthrough ATEs compared to those without such events (10.7 vs. 6.8, p = 0.007).…”