Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2022 Aug;30(8):6973-6984.
doi: 10.1007/s00520-022-07096-1. Epub 2022 May 12.

Can thromboprophylaxis build a link for cancer patients undergoing surgical and/or chemotherapy treatment? The MeTHOS cohort study

Spyridon Xynogalos  1 , David Simeonidis  2 , George Papageorgiou  2 , Abraham Pouliakis  3 , Nikolaos Charalambakis  2 , Evangelos Lianos  2 , Evridiki Mazlimoglou  2 , Alexandros-Nikolaos Liatsos  2 , Christos Kosmas  2 , Nicolaos Ziras  2
Affiliations
Clinical Trial

Can thromboprophylaxis build a link for cancer patients undergoing surgical and/or chemotherapy treatment? The MeTHOS cohort study

Spyridon Xynogalos et al. Support Care Cancer. 2022 Aug.

Abstract

Background: Patients with active cancer have a 4-sevenfold increased risk for venous thromboembolism (VTE) especially during systematic anticancer treatment. Simultaneously, surgery is an additional risk factor.

Methods: The Metaxas's Hospital THromboprophylaxis program in Oncological & Surgical Patients (MeTHOS) is a prospective, phase IV, observational, non-interventional cohort study, aiming to record the thromboprophylaxis practice patterns in high-risk active cancer patients undergoing surgical and/or chemotherapy treatment.

Results: We are reporting results from 291 ambulatory patients (median age: 67 years, Q1-Q3: 59-73 years, 54.6% males) who received anti-neoplastic treatment and administered thromboprophylaxis. 59.8% had cardiovascular disease (mostly hypertension), 76.6% were reported as having at least one comorbidity, while 27.5% and 15.8% accumulated two and three comorbidities, respectively. 94.9% of the patients were receiving highly thrombogenic agents such as platinum-based agents, 5-FU, immunotherapy, antiangiogenics/anti-VEGF, or erythropoietin. 26.5% of the patients were initially surgically treated. In terms of anticoagulation, all patients were treated with tinzaparin (fixed dose, 10,000 Anti-Xa IU, OD). The median anticoagulation duration was 6.2 months. Six thrombotic events were observed (2.06%, 95% CI: 0.76-4.43%): 5 were DVT, and one PE. With respect to safety, 7 bleeding events occurred (2.6%, 95% CI: 1.0-5.3%); 6 of them were minor.

Conclusions: Thromboprophylaxis with LMWH in patients with active cancer and high thrombotic burden was safe and effective. Intermediate dose of tinzaparin seems to be an appropriate agent for cancer-associated thromboprophylaxis management.

Clinical trial registration: ClinicalTrials.gov: NCT04248348.

Keywords: Bleeding; Cancer-associated thrombosis; Conformance; Heparin; LMWH; Low molecular weight heparin; Pulmonary embolism; Thrombosis; Tinzaparin; Venous thromboembolism.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study
Fig. 2
Fig. 2
Cancer primary sites and metastatic disease. Metastasis bar (red) length is proportional to the percentage of metastasis within the primary site
See this image and copyright information in PMC

References

    1. Heit JA, Spencer FA, White RH. The epidemiology of venous thromboembolism. J Thromb Thrombolysis. 2016;41(1):3–14. doi: 10.1007/s11239-015-1311-6. - DOI - PMC - PubMed
    1. Kuderer NM, Culakova E, Lyman GH, Francis C, Falanga A, Khorana AA. A validated risk score for venous thromboembolism is predictive of cancer progression and mortality. Oncologist. 2016;21(7):861–867. doi: 10.1634/theoncologist.2015-0361. - DOI - PMC - PubMed
    1. Khorana AA, Francis CW, Culakova E, Fisher RI, Kuderer NM, Lyman GH. Thromboembolism in hospitalized neutropenic cancer patients. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2006;24(3):484–490. doi: 10.1200/JCO.2005.03.8877. - DOI - PubMed
    1. Mulder FI, Horvath-Puho E, van Es N, van Laarhoven HWM, Pedersen L, Moik F, et al. Venous thromboembolism in cancer patients: a population-based cohort study. Blood. 2021;137(14):1959–1969. doi: 10.1182/blood.2020007338. - DOI - PubMed
    1. Ay C, Pabinger I, Cohen AT. Cancer-associated venous thromboembolism: burden, mechanisms, and management. Thromb Haemost. 2017;117(2):219–230. doi: 10.1160/TH16-08-0615. - DOI - PubMed

Publication types

Associated data