Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer

Publication Date: April 19, 2023

Key Points

Key Points

Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is an important cause of morbidity and mortality among patients with cancer.

Patients with cancer are significantly more likely to develop VTE than people without cancer and experience higher rates of VTE recurrence and bleeding complications during VTE treatment.

Comprehensive management of VTE in patients with cancer includes both the identification of patients who are most likely to benefit from pharmacologic prophylaxis, as well as effective treatment to reduce the risk of VTE recurrence and mortality.

The current update adds apixaban as an option for the treatment of VTE in patients with cancer, and addresses recent evidence regarding direct factor Xa inhibitors for extended postoperative thromboprophylaxis.

Treatment

...atment...

...spitalized patients who have active malignancy...


...ients who have active malignancy without addit...


...macologic thromboprophylaxis should not be offe...


...pharmacologic thromboprophylaxis should no...


...gh-risk outpatients with cancer (Khorana...


...multiple myeloma receiving thalidom...


...ients with malignant disease undergoing major su...


...xis with UFH or LMWH should be commenced preo...


...chanical methods may be added to pharmacologic thr...


...d regimen of pharmacologic and mechanical...


...ologic thromboprophylaxis for patients undergoi...


...ed pharmacologic thromboprophylaxis...


...ients who are candidates for extended...


...rnatively, patients may be offered...


...) Initial anticoagulation may involve LMWH, UF...


...For long-term anticoagulation, LMWH, edoxab...


...with LMWH, direct factor Xa inhibitors,...


...d on expert opinion in the absence of randomize...


...of a vena cava filter may be offered as an adjun...


...ents with primary or metastatic central ne...


...PE and deep vein thrombosis should be treat...


...isolated subsegmental PE or splanch...


...icoagulant use is not recommended to imp...


...bstantial variation in risk of VTE...


...logists and members of the oncology team should...


...s regarding off-label use in guideline recomme...


...2. Predictive Model for Chemotherapy...