Safety of anticoagulant treatment in cancer patients

Abstract

Introduction: Patients with cancer are at increased risk of (recurrent) venous thromboembolism. They are also at increased risk of bleeding. This makes treatment of venous thromboembolisms (VTE) in cancer patients challenging.

Areas covered: In this review, we will focus on the safety of anticoagulant treatment of VTE in cancer patients. We will discuss the absolute and relative bleeding risks associated with the various types of anticoagulants, specifically focusing on low-molecular-weight heparins (LMWH), vitamin K antagonist (VKA) and the new oral anticoagulants (NOACs).

Expert opinion: Monotherapy with LMWH is recommended for treatment of acute VTE in cancer patients. The bleeding risk associated with LMWH is comparable to VKAs, but LMWH are more effective in preventing recurrent VTE. More evidence on the efficacy and safety of NOACs in cancer patients is needed.

Keywords:

• anticoagulant treatment
• bleeding
• cancer
• low-molecular-weight heparins,
• new oral anticoagulants,
• venous thromboembolism
• vitamin k antagonists

Declaration of interest

M Di Nisio is a consultant for Bayer and Grifols. PW Kamphuisen is a consultant for Leopharma and Daiichi Sankyo. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed

Notes

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