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

...T...

...ed patients who have active malignancy and acut...


...lized patients who have active malignancy wi...


...rmacologic thromboprophylaxis should...


...rmacologic thromboprophylaxis should...


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


...ultiple myeloma receiving thalidomi...


...patients with malignant disease undergoing major...


...h UFH or LMWH should be commenced preoperative...


...hanical methods may be added to pharmacologic t...


...ned regimen of pharmacologic and mechan...


...rmacologic thromboprophylaxis for patients...


...pharmacologic thromboprophylaxis for up...


...d) Patients who are candidates for...


...Alternatively, patients may be offered prophy...


...pdated) Initial anticoagulation may inv...


...ng-term anticoagulation, LMWH, edox...


...ulation with LMWH, direct factor Xa inhibi...


...n expert opinion in the absence of ra...


...nsertion of a vena cava filter may...


...ith primary or metastatic central ne...


...nd deep vein thrombosis should be treated in the...


...tment of isolated subsegmental PE o...


...ulant use is not recommended to improve surviva...


...re is substantial variation in risk of VTE bet...


...ogists and members of the oncology...


...ding off-label use in guideline recommendation...


...le 2. Predictive Model for Chemotherapy-associate...