Bevacizumab Plus Direct Oral Anticoagulant Therapy in Ovarian Cancer Patients with Distal Deep Vein Thrombosis

Komiyama, Shinichi; Nagashima, Masaru; Taniguchi, Takeo; Rikitake, Takayuki; Morita, Mineto

doi:10.1007/s40261-019-00757-w

Cited by 9 publications

(8 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As VEGF has been implicated in the same signaling cascades with TF as EGFR, we sought to determine whether bevacizumab therapy would influence our results. Bevacizumab adjuvant treatment in particular has been linked with increased thrombotic risk [33,61,62]. Multivariate analysis demonstrated there was not a statistically significant difference in our results when controlling for bevacizumab therapy (Table 3).…”

Section: Discussionmentioning

confidence: 68%

The Role of EGFR Amplification in Deep Venous Thrombosis Occurrence in IDH Wild-Type Glioblastoma

Kaye,

Ali,

Correa Bastianon Santiago

et al. 2023

Current Oncology

View full text Add to dashboard Cite

Introduction: Glioblastoma (GBM) patients have a 20–30 incidence of venous thromboembolic events. EGFR is a widely used prognostic marker for many cancers. Recent lung cancer studies have described relationships between EGFR amplification and an increased incidence of thromboembolic complications. We aim to explore this relationship in glioblastoma patients. Methods: Two hundred ninety-three consecutive patients with IDH wild-type GBM were included in the analysis. The amplification status of EGFR was measured using fluorescence in situ hybridization (FISH). Centromere 7 (CEP7) expression was recorded to calculate the EGFR-to-CEP7 ratio. All data were collected retrospectively through chart review. Molecular data were obtained through the surgical pathology report at the time of biopsy. Results: There were 112 subjects who were EGFR-amplified (38.2%) and 181 who were non-amplified (61.8%). EGFR amplification status was not significantly correlated with VTE risk overall (p = 0.2001). There was no statistically significant association between VTE and EGFR status after controlling for Bevacizumab therapy (p = 0.1626). EGFR non-amplified status was associated with an increased VTE risk in subjects greater than 60 years of age (p = 0.048). Conclusions: There was no significant difference in occurrence of VTE in patients with glioblastoma, regardless of EGFR amplification status. Patients older than 60 years of age with EGFR amplification experienced a lower rate of VTE, contrary to some reports on non-small-cell lung cancer linking EGFR amplification to VTE risk.

show abstract

Section: Discussionmentioning

confidence: 68%

The Role of EGFR Amplification in Deep Venous Thrombosis Occurrence in IDH Wild-Type Glioblastoma

Kaye,

Ali,

Correa Bastianon Santiago

et al. 2023

Current Oncology

View full text Add to dashboard Cite

show abstract

“…Although the combination of Atezo/Bev‐based regimens and DOACs, both of which cause adverse bleeding events, may increase the risk of bleeding, this was not the case in the present study. A case series of ovarian cancer combining bevacizumab with DOAC showed similar findings 18 . On the other hand, for tyrosine kinase inhibitors (TKIs) targeting the VEGF pathway, such as cabozantinib and sunitinib, studies have addressed the caution that their concurrent treatment with anticoagulant agents, including DOACs, in renal cell carcinoma harbored a greater risk of bleeding than did anti‐VEGF TKIs alone 19,20 .…”

Section: Discussionmentioning

confidence: 81%

“…A case series of ovarian cancer combining bevacizumab with DOAC showed similar findings. 18 On the other hand, for tyrosine kinase inhibitors (TKIs) targeting the VEGF pathway, such as cabozantinib and sunitinib, studies have addressed the caution that their concurrent treatment with anticoagulant agents, including DOACs, in renal cell carcinoma harbored a greater risk of bleeding than did anti‐VEGF TKIs alone. 19 , 20 The bleeding risks concurrent with DOACs were different between recombinant monoclonal antibodies and TKIs, although both target the VEGF pathway.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of atezolizumab and bevacizumab combination regimens in patients with hepatocellular carcinoma and lung cancer taking direct oral anticoagulants

Nakabori,

Kunimasa,

Kawabata

et al. 2024

Cancer Medicine

View full text Add to dashboard Cite

AimAtezolizumab and bevacizumab (Atezo/Bev) combination immunotherapy regimens and direct oral anticoagulants (DOACs) are both associated with bleeding. Therefore, combining Atezo/Bev regimens with DOACs may exacerbate the bleeding risk. This study investigated the feasibility of the Atezo/Bev regimen in patients taking DOACs.MethodsThis retrospective study included 141 patients with unresectable hepatocellular carcinoma (HCC) or advanced lung cancer (LC) treated with Atezo/Bev regimens. Patients who used antithrombotic agents other than DOACs were excluded. Bleeding events during the Atezo/Bev regimen were analyzed.ResultsThe incidence rates of bleeding of any grade in the DOAC (n = 11) and no antithrombotic agent (NAA) (n = 130) groups were 9.1% and 10.8%, respectively, with no significant differences. Moreover, no significant difference was found in the frequency of bleeding of grade ≥3 between the DOAC and NAA groups. No patients in the DOAC group discontinued the Atezo/Bev regimen because of severe bleeding. Although serum albumin levels, with a hazard ratio (HR) of 0.298 (95% confidence interval [CI]: 0.105–0.847), independently contributed to bleeding events (p = 0.023), DOAC administration did not (HR: 1.357; 95% CI: 0.157–10.54; p = 0.770). Among only patients with HCC (n = 59), none of the five patients taking DOACs experienced bleeding events. A high albumin–bilirubin score (HR: 9.083, 95% CI: 1.118–73.76) was associated with bleeding events (p = 0.039).ConclusionsDOACs did not have a considerable effect on bleeding events in the Atezo/Bev regimens for HCC or LC. Under careful surveillance for bleeding, Atezo/Bev regimens may be feasible in patients receiving DOACs.

show abstract

“…In a retrospective analysis of patients with ovarian cancer, seven of 88 patients were identified who received concurrent bevacizumab, and DOACs for the treatment of deep vein thrombosis, and the investigators deemed the joint use safe in this patient population. 56 Another study retrospectively explored the concomitant use of VEGF TKIs and anticoagulation. 57 Of 258 patients with cancer, they identified 74 on concurrent therapy.…”

Section: Special Considerations: Antiangiogenic Agentsmentioning

confidence: 99%

Practical guidance for direct oral anticoagulant use in the treatment of venous thromboembolism in primary and metastatic brain tumor patients

Ranjan,

Leung,

Ghiaseddin

et al. 2024

Cancer

View full text Add to dashboard Cite

Management of venous thromboembolism (VTE) in patients with primary and metastatic brain tumors (BT) is challenging because of the risk of intracranial hemorrhage (ICH). There are no prospective clinical trials evaluating safety and efficacy of direct oral anticoagulants (DOACs), specifically in patients with BT, but they are widely used for VTE in this population. A group of neuro‐oncology experts convened to provide practical clinical guidance for the off‐label use of DOACs in treating VTE in patients with BT. We searched PubMed for the following terms: BTs, glioma, glioblastoma (GBM), brain metastasis, VTE, heparin, low‐molecular‐weight heparin (LWMH), DOACs, and ICH. Although prospective clinical trials are needed, the recommendations presented aim to assist clinicians in making informed decisions regarding DOACs for VTE in patients with BT.

show abstract

Bevacizumab Plus Direct Oral Anticoagulant Therapy in Ovarian Cancer Patients with Distal Deep Vein Thrombosis

Cited by 9 publications

References 23 publications

The Role of EGFR Amplification in Deep Venous Thrombosis Occurrence in IDH Wild-Type Glioblastoma

The Role of EGFR Amplification in Deep Venous Thrombosis Occurrence in IDH Wild-Type Glioblastoma

Feasibility of atezolizumab and bevacizumab combination regimens in patients with hepatocellular carcinoma and lung cancer taking direct oral anticoagulants

Practical guidance for direct oral anticoagulant use in the treatment of venous thromboembolism in primary and metastatic brain tumor patients

Contact Info

Product

Resources

About