Anticoagulant Therapy for Venous Thromboembolism in Cancer

This editorial discusses the evolving role of direct oral anticoagulants (DOACs) for treating venous thromboembolism (VTE) in cancer patients, focusing on recent trials (Hokusai VTE Cancer, SELECT-D, ADAM VTE, and Caravaggio). Apixaban demonstrated noninferiority to dalteparin (low-molecular-weight heparin) in reducing recurrent VTE (5.6% vs. 7.9%) without increased major bleeding (3.8% vs. 4.0%). While DOACs offer convenience over warfarin and dalteparin, bleeding risks persist, particularly in gastrointestinal cancers. The author emphasizes individualized therapy based on cancer type, bleeding risk, drug interactions, and patient preferences, noting that low-molecular-weight heparin remains preferred for high-risk subgroups (e.g., brain metastases, severe renal impairment)

This editorial discusses the evolving role of direct oral anticoagulants (DOACs) for treating venous thromboembolism (VTE) in cancer patients, focusing on recent trials (Hokusai VTE Cancer, SELECT-D, ADAM VTE, and Caravaggio). Apixaban demonstrated noninferiority to dalteparin (low-molecular-weight heparin) in reducing recurrent VTE (5.6% vs. 7.9%) without increased major bleeding (3.8% vs. 4.0%). While DOACs offer convenience over warfarin and dalteparin, bleeding risks persist, particularly in gastrointestinal cancers. The author emphasizes individualized therapy based on cancer type, bleeding risk, drug interactions, and patient preferences, noting that low-molecular-weight heparin remains preferred for high-risk subgroups (e.g., brain metastases, severe renal impairment)