Abstract Number: PB2112
Meeting: ISTH 2020 Congress
Background: Both direct oral anticoagulants (DOAC) and low molecular weight heparins (LMWH) are recommended as first-line option for the treatment of cancer-associated thrombosis (CAT) by recent guidelines, mainly based on the results of 2 dedicated noninferiority trials demonstrating that DOAC are equally or more effective than LMWH for the prevention of recurrent venous thromboembolism (VTE) in this specific population. The definition of “cancer patient” appears to differ substantially among studies and one out of these two trials included 22% of patients having their cancer “cured” at the time of the index VTE event.
Aims: To investigate whether patients with an active cancer and those with a history of cancer carry the same risks of recurrent VTE and bleeding.
Methods: We reviewed all the literature available data reporting the rates of recurrent VTE and bleeding in patients with an active cancer and those with a history of cancer.
Results: Scarce studies reported separately the efficacy and safety of anticoagulants in these 2 groups of cancer patients. Data are summarized in this review. While cancer patient subgroup analyses of the EINSTEIN-PE, EINSTEIN–DVT and HOKUSAI trials reported no difference between patients with an active cancer and those with a history of cancer, results from COMMAND-VTE, HOKUSAI VTE Cancer and AMPLIFY studies at least suggest that the bleeding risk might be potentially lower in patients with a history of cancer compared to those with an active cancer.
Conclusions: Whether or not these 2 groups of cancer patients carry the same risk of recurrent VTE and bleeding remains an unanswered question. A strict definition of active cancer accurately reflecting the high risks of recurrent VTE and bleeding associated with active cancer should be used in further trials assessing the efficacy and safety of anticoagulants for the prevention of recurrent VTE in patients with malignancy.
To cite this abstract in AMA style:Frere C, Lejeune M, Janus N. Are Patients with an Active Cancer and those with a History of Cancer Carrying the Same Risks of Recurrent VTE and Bleeding while on Anticoagulants? [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/are-patients-with-an-active-cancer-and-those-with-a-history-of-cancer-carrying-the-same-risks-of-recurrent-vte-and-bleeding-while-on-anticoagulants/. Accessed February 21, 2024.
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