Cancer-associated thrombosis - treatment and prevention with direct oral factor Xa inhibitors

Klin Onkol. 2021 Summer;34(4):283-290. doi: 10.48095/ccko2021283.

Abstract

Background: Venous thromboembolism (VTE) is a frequent cause of morbidity and mortality in patients with cancer. Moreover, management of VTE is frequently connected with complications, namely risk of recurrent VTE and bleeding. Low molecular weight heparins (LMWH) therapy administrated for 3-6 months is currently considered a standard for the treatment of cancer-associated VTE (CA-VTE). Direct oral factor Xa inhibitors (FXaI) apixaban, edoxaban and rivaroxaban have emerged as a new possibility for long-term antithrombotic therapy for VTE. These agents expose several advantages in individuals with cancer, and might overcome several disadvantages connected with LMWH therapy.

Purpose: First clinical studies with oral FXaI for the treatment of CA-VTE with very promising results were recently published. The article summarizes current data regarding the use of oral FXaI in the treatment of CA-VTE.

Keywords: Deep vein thrombosis; Pulmonary embolism; cancer-associated venous thromboembolic disease; deep vein thrombosis; direct oral factor Xa inhibitors; pulmonary embolism.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Factor Xa Inhibitors / administration & dosage
  • Factor Xa Inhibitors / therapeutic use*
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / therapeutic use
  • Heparin, Low-Molecular-Weight / therapeutic use
  • Humans
  • Neoplasms / complications*
  • Pyrazoles / administration & dosage
  • Pyrazoles / therapeutic use
  • Pyridines / administration & dosage
  • Pyridines / therapeutic use
  • Pyridones / administration & dosage
  • Pyridones / therapeutic use
  • Rivaroxaban / administration & dosage
  • Rivaroxaban / therapeutic use
  • Thiazoles / administration & dosage
  • Thiazoles / therapeutic use
  • Thrombosis / drug therapy*
  • Thrombosis / etiology
  • Thrombosis / prevention & control*
  • Venous Thromboembolism / drug therapy
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control

Substances

  • Factor Xa Inhibitors
  • Fibrinolytic Agents
  • Heparin, Low-Molecular-Weight
  • Pyrazoles
  • Pyridines
  • Pyridones
  • Thiazoles
  • apixaban
  • Rivaroxaban
  • edoxaban