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Review
. 2021 Jun;23(6):1034-1046.
doi: 10.1007/s12094-020-02506-4. Epub 2020 Nov 18.

Direct oral anticoagulants for the treatment and prevention of venous thromboembolism in patients with cancer: current evidence

I García-Escobar  1 , E Brozos-Vázquez  2 , D Gutierrez Abad  3 , V Martínez-Marín  4 , V Pachón  5 , A J Muñoz Martín  6 ; Cancer and Thrombosis Section of the Spanish Society of Medical Oncology (SEOM)
Affiliations
Review

Direct oral anticoagulants for the treatment and prevention of venous thromboembolism in patients with cancer: current evidence

I García-Escobar et al. Clin Transl Oncol. 2021 Jun.

Abstract

Venous thromboembolic disease (VTED) is a common and clinically important complication in patients with cancer, contributing to its mortality and morbidity. Direct oral anticoagulant agents (DOACs), including direct thrombin inhibitors and direct factor Xa inhibitors, are as effective as vitamin K antagonists for the treatment of VTED and are associated with less frequent and severe bleeding. They have advantages over low-molecular-weight heparin, but comparative long-term efficacy and safety data are lacking for these compounds. Recent randomized clinical trials suggest a role for DOACs in the treatment of VTED in patients with cancer. This review will discuss the existing evidence and future perspectives on the role of DOACs in the treatment of VTE based on the current evidence about their overall efficacy and safety and the limited information in patients with cancer; in addition, we will briefly review their pharmacokinetic properties with special reference to potential interactions.

Keywords: Cancer; Direct oral anticoagulant agents; Efficacy; Safety; Venous thromboembolic disease.

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Conflict of interest statement

IG-E has been an advisory board member for Leo Pharma and has received speaker honoraria from Leo Pharma. EB-V has received speaker honoraria from Leo Pharma and Rovi. VP has been an advisory board member for DAICHI and has received speaker honoraria from Sanofi and Leo Pharma. AJMM declares the following conflicts of interest: Advisory boards: Celgene, Astra-Zeneca, Roche, Servier, Sanofi, Pfizer, Bristol-Myers Squibb, Leo Pharma, Daiichi Sankyo, Bayer and Halozyme; Speaker’s bureau: Rovi, Lilly, Merck Sharp & Dohme; Research funding: Sanofi and Leo Pharma; Travel, Accommodations, Expenses: Celgene, Roche, Merck Serono, Amgen, Sanofi; Patents, royalties, other intellectual property: Risk assessment model in venous thromboembolism in patients with cancer. DGA and VM-M declare no conflicts of interest.

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