Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer

Maraveyas, Anthony; Waters, Justin S.; Roy, Rajarshi; Fyfe, D.; Propper, David; Lofts, F.; Sgouros, Joseph; Gardiner, Eric; Wedgwood, K. R.; Ettelaie, Camille; Bozas, George

doi:10.1016/j.ejca.2011.10.017

Cited by 283 publications

(258 citation statements)

References 22 publications

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“…The updated search identifi ed eight meta-analyses (1669-9861 patients) [103][104][105][106][107][108][109][110] and six randomised clinical trials [111][112][113][114][115][116] comparing anticoagulant prophylaxis with no intervention or placebo in ambulatory patients receiving systemic anticancer therapy. Overall, a signifi cant 45·0% reduction in VTE occurrence was reported across the six meta-analyses assessing the safety and effi cacy of LMWH compared with no intervention or placebo.…”

Section: Ambulatory Patients Treated With Systemic Anticancer Therapymentioning

confidence: 99%

International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer

Farge

Bounameaux

Brenner

et al. 2016

The Lancet Oncology

388

434

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Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at an increased risk of developing VTE and are more likely to have a recurrence of VTE and bleeding while taking anticoagulants. Management of VTE in patients with cancer is a major therapeutic challenge and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME), established to reduce the global burden of VTE in patients with cancer, published international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis. The rapid global adoption of direct oral anticoagulants for management of VTE in patients with cancer is an emerging treatment trend that needs to be addressed based on the current level of evidence. In this Review, we provide an update of the ITAC-CME consensus recommendations based on a systematic review of the literature ranked according to the Grading of Recommendations Assessment, Development, and Evaluation scale. These guidelines aim to address in-hospital and outpatient cancer-associated VTE in specifi c subgroups of patients with cancer.

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Section: Ambulatory Patients Treated With Systemic Anticancer Therapymentioning

confidence: 99%

International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer

Farge

Bounameaux

Brenner

et al. 2016

The Lancet Oncology

388

434

View full text Add to dashboard Cite

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“…A pancreastumoros betegekkel a FRAGEM [35] és a CONKO-004 [36] vizsgálatok foglalkoztak. Mindkét vizsgálatban testsúlyra adaptált LMWH-t adtak a betegeknek VTE-profilaxisra.…”

Section: Az Ambuláns Kemoterápia Vte-profilaxisára Több Klinikai Vizsunclassified

A kórházi és az ambuláns kemoterápiában részesülő onkológiai betegek vénásthromboembolia-profilaxisának aktuális kérdései

Losonczy

Nagy

Tar³

2016

Orvosi Hetilap

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Daganatos betegekben a vénás thromboembolia kockázata 2-7-szer nagyobb a nem daganatos betegekhez viszonyít-va, ami 1990 óta folyamatosan nő és jelentős morbiditási és mortalitási tényező. A közleményben megbeszélésre kerülnek a vénás thromboemboliára hajlamosító kockázati tényezők. A vénás thromboembolia kockázata függ a daganat típusától és stádiumától, például a hasnyálmirigy-és az agydaganatok nagyobb kockázatot jelentenek vénás thromboemboliára, mint az emlő-vagy a prosztatadaganatok. A kockázat függ a daganat lokalizált vagy metasztatikus állapotától, az utóbbi lényegesen nagyobb kockázatot jelent. A tumoros sejtekből származó prokoaguláns faktorok, citokinek, növekedési faktorok direkt vagy indirekt módon fokozzák a vénás thromboembolia incidenciáját. A daganatellenes kemoterápia 6,5-szeresére emeli a vénás thromboembolia populációs gyakoriságát, amely a kemoterápiát kapó járóbetegek legjelentősebb kockázati faktora és a második leggyakoribb haláloka. A szerzők áttekintik a daganatellenes kemoterápia okozta vénásthromboembolia-profilaxis irányelveinek fejlődését a kórházi és a járóbeteg-ellátásban. A jelenlegi ajánlások profilaxis céljából elsősorban a kis molekulatömegű heparint ajánlják. A daganat okozta kis molekulatömegű heparin további kutatása célzott, hatékony profilaxishoz fog vezetni. Orv. Hetil., 2016, 157(6), 203-211. Kulcsszavak: tumorok és thrombosis, kemoterápia, vénásthromboembolia-profilaxis Actual questions about the prevention of venous thromboembolism in hospitalized and ambulatory cancer patients receiving chemotherapyCancer patients have a 2-7 fold increased risk of venous thromboembolism compared with the general population and, since 1990, this is associated with significant morbidity and mortality. This review summarizes the current knowledge on venous thromboembolism and cancer. Notably, the risk of venous thromboembolism varies depending on the type and stage of cancer. For instance, pancreatic and brain cancer patients have a higher risk of venous thromboembolism than breast and prostate cancer patients. Moreover, patients with metastatic disease have a higher risk than those with localized tumors. Tumor-derived procoagulant factors, cytokines and growth factors may directly and indirectly enhance venous thromboembolism. Chemotherapy produces ~6,5 fold increase in venous thromboembolism incidence in cancer patients compared to the general population. Prevention of this complication is challenging. The authors review the development of guidelines concerning venous thromboembolism prevention in hospitalized and also in ambulatory cancer patients treated with chemotherapy. Current guidelines recommend the use of low-molecular-weight heparin. Understanding the underlying mechanisms may allow the development of new therapies to safely prevent venous thromboembolism in cancer patients. Keywords: cancer and thrombosis, chemotherapy, venous thromboembolism preventionLosonczy, H., Nagy, Á., Tar, A., [Actual questions about the prevention of venous thromboembolism in cancer patients rece...

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“…A retrospective cohort study showed that venous thromboembolism occurs in over one-third of pancreatic cancer patients and, whether symptomatic or incidental, is strongly associated with worsened mortality [14]. Although the evidence is growing that prophylactic anticoagulation with low molecular weight heparins reduces the incidence of thrombosis in pancreatic cancer [15], its routine general use is not yet recommended. Further investigation is warranted, particularly in the era of new oral non-coumarin anticoagulants.…”

Section: Obtaining a Pathological Proofmentioning

confidence: 99%

The management of metastatic pancreatic cancer: expert discussion and recommendations from the 14th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2012

et al. 2013

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Gemcitabine versus gemcitabine plus dalteparin thromboprophylaxis in pancreatic cancer

Cited by 283 publications

References 22 publications

International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer

International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer

A kórházi és az ambuláns kemoterápiában részesülő onkológiai betegek vénásthromboembolia-profilaxisának aktuális kérdései

The management of metastatic pancreatic cancer: expert discussion and recommendations from the 14th ESMO/World Congress on Gastrointestinal Cancer, Barcelona, 2012

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