Summary
Venous thromboembolism (VTE) is associated with numerous complications and high mortality
rates. Patients with cancer are at high risk of developing cancer-associated thrombosis
(CAT), and VTE recurrence is common. Evidence supporting use of non-vitamin K antagonist
(VKA) oral anticoagulants (NOACs) in patients with cancer is lacking – direct comparisons
between NOACs and low-molecular-weight heparin (LMWH) are needed, along with patient-reported
outcomes. Cancer Associated thrombosis – expLoring soLutions for patients through
Treatment and Prevention with RivarOxaban (CALLISTO) is an international research
programme exploring the potential of the direct, oral factor Xa inhibitor rivaroxaban
for the prevention and treatment of CAT, supplementing existing data from EINSTEIN
DVT and EINSTEIN PE. Here, we focus on four CALLISTO studies: A Study to Evaluate
the Efficacy and Safety of Rivaroxaban Venous Thromboembolism Prophylaxis in Ambulatory
Cancer Participants receiving Chemotherapy (CASSINI), Antico-agulation Therapy in
SELECTeD Cancer Patients at Risk of Recurrence of Venous Thromboembolism (SELECT-D),
Rivaroxaban in the Treatment of Venous Thromboembolism in Cancer Patients – a Randomized
Phase III Study (CONKO-011) and a database analysis. Optimal anticoagulation duration
for VTE treatment has always been unclear. Following favourable results for rivaroxaban
20 mg once-daily (Q. D.) for secondary VTE prevention (EINSTEIN EXT), EINSTEIN CHOICE
is assessing rivaroxaban safety and (20 mg Q. D. or 10 mg Q. D.) vs acetylsalicylic
acid (ASA), and will investigate whether an alternative rivaroxaban dose (10 mg Q.
D.) could offer long-term VTE protection. It is anticipated that results from these
studies will provide important answers and expand upon current evidence for rivaroxaban
in VTE management.
Keywords
Cancer-associated thrombosis - venous thromboembolism - thromboprophylaxis - rivaroxaban