Venous thromboembolism in cancer patients: an underestimated major health problem

Khalil, J.; Bensaid, B.; Elkacemi, H.; Afif, M.; Bensaïd, Y.; Kebdani, Tayeb; Benjaafar, Noureddine

doi:10.1186/s12957-015-0592-8

Cited by 105 publications

(94 citation statements)

References 154 publications

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“…Others have reported synergistic effects of germline polymorphisms and chemotherapy-an anticancer strategy that increases the risk of VTE six-fold-on the incidence of VTE in cancer patients. 8 Specifically, patients with a polymorphism in the promoter region of vascular endothelial growth factor, at location -1154, appear to have a four-fold reduced risk of VTE (OR = 0.26) while treated with standard chemotherapies, like fluorouracil, irinotecan, or platinumbased drugs. 41 Gastrointestinal cancer patients carrying the tumor necrosis factor alpha -857 C/T polymorphism or a five-loci CTGGG haplotype (-863C/-857T/-376G/-308G/-238G) are at increased risk of VTE during fluorouracil-based chemotherapy.…”

Section: Host-specific Geneticsmentioning

confidence: 99%

“…Cancer types may be classified into those that confer a high risk (pancreas, brain), moderate risk (lung, colon) and low risk (prostate, breast) of VTE 6, 7. In addition, cancer treatment such as surgery and chemotherapy further increases the risk of VTE 8, 9…”

Section: Introductionmentioning

confidence: 99%

“…6,7 In addition, cancer treatment such as surgery and chemotherapy further increases the risk of VTE. 8,9 In order to select those patients that are at (high) risk for VTE and those who might benefit from thromboprophylaxis, development of an accurate prediction models is key. These models will undoubtedly become more accurate as we learn more on the mechanisms underlying CAT.…”

mentioning

confidence: 99%

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Cancer‐associated thrombosis: The search for the holy grail continues

Ünlü

Versteeg

2018

Research and Practice in Thrombosis and Haemostasis

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Cancer patients have an increased risk of developing venous thromboembolism (VTE), a condition that is associated with increased morbidity and mortality. Although risk assessment tools have been developed, it is still very challenging to predict which cancer patients will suffer from VTE. The scope of this review is to summarize and discuss studies focusing on the link between genetic alterations and risk of cancer‐associated thrombosis (CAT). Thus far, classical risk factors that contribute to VTE have been tried as risk factors of CAT, with low success. In support, hypercoagulant plasma profiles in patients with CAT differ from those with only VTE, indicating other risk factors that contribute to VTE in cancer. As germline mutations do not significantly contribute to elevated risk of VTE, somatic mutations in tumors may significantly associate with and contribute to CAT. As it is very time‐consuming to investigate each and every mutation, an unbiased approach is warranted. In this light we discuss our own recent unbiased proof‐of‐principle study using RNA sequencing in isolated colorectal cancer cells. Our work has uncovered candidate genes that associate with VTE in colorectal cancer, and these gene profiles associated with VTE more significantly than classical parameters such as platelet counts, D‐dimer, and P‐selectin levels. Genes associated with VTE could be linked to pathways being involved in coagulation, inflammation and methionine degradation. We conclude that tumor cell‐specific gene expression profiles and/or mutational status has superior potential as predictors of VTE in cancer patients.

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Section: Host-specific Geneticsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Cancer‐associated thrombosis: The search for the holy grail continues

Ünlü

Versteeg

2018

Research and Practice in Thrombosis and Haemostasis

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“…CAT makes a significant contribution to the burden of VTE, accounting for approximately 20% of all cases . Anticoagulants are the cornerstone for the primary prevention and treatment of VTE but may be underused for CAT because of complications in management specific to patients with cancer …”

Section: Introductionmentioning

confidence: 99%

Cancer‐associated venous thromboembolism: Treatment and prevention with rivaroxaban

Bauersachs¹,

Khorana

Lee

et al. 2020

Research and Practice in Thrombosis and Haemostasis

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Cancer‐associated venous thromboembolism (VTE) is a frequent, potentially life‐threatening event that complicates cancer management. Anticoagulants are the cornerstone of therapy for the treatment and prevention of cancer‐associated thrombosis (CAT); factor Xa–inhibiting direct oral anticoagulants (DOACs; apixaban, edoxaban, and rivaroxaban), which have long been recommended for the treatment of VTE in patients without cancer, have been investigated in this setting. The first randomized comparisons of DOACs against low‐molecular‐weight heparin for the treatment of CAT indicated that DOACs are efficacious in this setting, with findings reflected in recent updates to published guidance on CAT treatment. However, the higher risk of bleeding events (particularly in the gastrointestinal tract) with DOACs highlights the need for appropriate patient selection. Further insights will be gained from additional studies that are ongoing or awaiting publication. The efficacy and safety of DOAC thromboprophylaxis in ambulatory patients with cancer at a high risk of VTE have also been assessed in placebo‐controlled randomized controlled trials of apixaban and rivaroxaban. Both studies showed efficacy benefits with DOACs, but both studies also showed a nonsignificant increase in major bleeding events while on treatment. This review summarizes the evidence base for rivaroxaban use in CAT, the patient profile potentially most suited to DOAC use, and ongoing controversies under investigation. We also describe ongoing studies from the CALLISTO (Cancer Associated thrombosis—expLoring soLutions for patients through Treatment and Prevention with RivarOxaban) program, which comprises several randomized clinical trials and real‐world evidence studies, including investigator‐initiated research.

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“…The risk factors, such as: previous episodes of deep vein thrombosis, immobilization, trauma, neoplastic disease, markedly increase the probability of VTE [3][4][5]. According to recent publications, incidence of VTE is also increased in the patients with chronic lung disorders, such as: chronic obstructive pulmonary disease (COPD) [6], severe asthma [7], idiopathic pulmonary fibrosis [8] and sarcoidosis [9,10].…”

Section: Introductionmentioning

confidence: 99%

Non-High Risk PE in the Patients with Acute or Exacerbated Respiratory Disease: The Value of the Algorithm Based on D-Dimer Evaluation and Revised Geneva Score

Szturmowicz¹,

Kacprzak²,

Wyrostkiewicz³

et al. 2015

Advances in Respiratory Medicine

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Introduction: The diagnostic algorithm of non-high risk pulmonary embolism (PE) is based on probability scoring systems and plasma D-dimer (DD) assessment. The aim of the present study was to investigate the efficacy of Revised Geneva Scoring (RGS) and DD testing for the excluding of non-high risk PE, in the patients admitted to the hospital due to acute respiratory diseases. Material and methods:The consecutive patients, above 18 years of age, referred to the department of lung diseases, entered the study. The exclusion criteria were: the pregnancy and the suspicion of high risk PE. Plasma DD was measured with quick ELISA test, VIDAS D-dimer New, bioMerieux, France. Multislice computed tomography angiography was performed in all of the patients. Results: 153 patients, median age 65 (19−88) years entered the study. The probability of PE was: low -in 58 patients (38%), intermediate -in 90 (59%), high -in 5 (3%). DD < 500 ng/ml was found in 12% of patients with low and intermediate probability of PE. PE was recognized in 10 out of 153 patients (7%). None of the patients with DD < 500 ng/ml was diagnosed with PE (NPV 100%). Median DD value was significantly higher in PE patients comparing to non-PE (4500 ng/ml and 1356 ng/ml respectively, p = 0.006). Conclusion: In the group of the patients with acute respiratory symptoms, low or intermediate clinical probability scoring combined with normal DD had a high NPV in excluding PE. Nevertheless, such approach was not very effective, as the increased DD was noted in 88% of the examined population.

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Venous thromboembolism in cancer patients: an underestimated major health problem

Cited by 105 publications

References 154 publications

Cancer‐associated thrombosis: The search for the holy grail continues

Cancer‐associated thrombosis: The search for the holy grail continues

Cancer‐associated venous thromboembolism: Treatment and prevention with rivaroxaban

Non-High Risk PE in the Patients with Acute or Exacerbated Respiratory Disease: The Value of the Algorithm Based on D-Dimer Evaluation and Revised Geneva Score

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