Prevention and treatment of cancer-associated venous thromboembolism

Abstract

Cancer and its treatment are well-recognized risk factors for venous thromboembolism (VTE). Cancer-associated venous thromboembolism (CAT) is associated with significant mortality and healthcare utilization.Pooled analysis demonstrated a decrease of VTE events in cancer patients receiving heparin-based primary prophylaxis, but an increase of bleeding events.This article reviews the latest literature on risk assessment for CAT, risk assessment for anticoagulant related bleeding, and prevention and treatment of CAT.Through a comprehensive analysis of literature, it has been found that these VTE risk assessment models have limited predictive value on CAT and need to be further investigated.And no anticoagulantrelated bleeding risk model has been validated in cancer patients.The primary preventions of CAT include mechanical prevention and drug therapy.Patients with high risk for CAT should receive appropriate primary prevention based on the patient′s clinical condition and preferences.The currently available anticoagulants for CAT include unfractionated heparin, low molecular weight heparin, fondaparin sodium, direct oral anticoagulant, vitamin K receptor antagonist.Patients with CAT should be aware of the advantages and disadvantages of each anticoagulant, and be appropriately treated according to the patient′s clinical condition and preferences. Key words: Venous thromboemlism; Neoplasms; Therapeutics