Updates in anticoagulant therapy for cancer-associated venous thromboembolism

Dana Pop ^{1, 2}, Diana Andrada Irimie ^{1, 2 *}, Alexandra Dădârlat-Pop ^{1, 3}

¹ Department of Internal Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
² Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania
³ Department of Cardiology, N. Stancioiu Heart Institute, Cluj-Napoca, Romania
* Correspondence to: Diana Andrada Irimie, Department of Cardiology, Clinical Rehabilitation Hospital, 46-50 Viilor Str., Cluj-Napoca, 400066, Romania. E-mail: gurzaudiana@yahoo.com

Abstract

Venous thromboembolism (VTE) is a frequent complication in patients with cancer and a major cause of morbidity and mortality in this population. The risk of developing VTE in cancer patients varies according to the stage and type of cancer and increases during cancer treatment. Even with traditional anticoagulant therapy, patients with cancer and venous thromboembolism are more likely to experience recurrences and major bleeding compared with patients without malignant disease. Traditional treatment with low–molecular-weight heparins is associated with a lower recurrence rate of venous thromboembolism compared with vitamin K antagonists, but with a similar rate of major bleeding and extremely low adherence. In this context, studies on direct oral anticoagulants have emerged, leading to the development of guidelines that include them as a treatment option for managing cancer-associated venous thromboembolism.