ABSTRACT
Venous thromboembolism (VTE) in patients with cancer follows an aggressive course,
and it is often resistant to traditional regimens of pharmacological prophylaxis and
treatment. Anticoagulant-related bleeding is also common and can complicate VTE treatment
as well as cancer therapy. Consequently, the most effective approach to reducing the
burden of VTE and its associated morbidity and mortality is to provide appropriate
prophylaxis. Few clinical trials have focused on the prevention of VTE in this high-risk
patient population, and they consistently demonstrate the efficacy and safety of anticoagulant
prophylaxis in reducing thrombotic complications. Currently, low-molecular-weight
heparins and oral vitamin K antagonists are the most commonly used anticoagulants
for primary prevention in patients with cancer, but compliance with consensus guidelines
is poor. Novel anticoagulants with a convenient and favorable risk/benefit profile
may help to improve prophylaxis utilization and treatment. This review will provide
a summary of the evidence on the primary prevention of VTE in patients with cancer.
KEYWORDS
Neoplasm - deep vein thrombosis - thromboembolism - prophylaxis - low-molecular-weight
heparin - heparin - warfarin
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Dr. Agnes Y.Y Lee
Hamilton Health Sciences Henderson Hospital
711 Concession Street, Hamilton, ON L8V 1C3, Canada
Email: alee@mcmaster.ca