Antithrombotic therapy and cancer.
OBJECTIVE
To assess the current evidence from recent clinical trials investigating antithrombotic agents for the prophylaxis and treatment of venous thromboembolism in cancer patients and for the effects of these agents on cancer progression.


RESULTS
A growing body of evidence supports the preventive use of antithrombotic strategies in subgroups of cancer patients. Moreover, in the long-term management of deep venous thrombosis in cancer patients, low-molecular-weight heparin seems to represent a valid alternative to vitamin K antagonists. Finally, several studies have claimed a direct anticancer activity and a positive impact on prognosis of some antithrombotic agents, eg, aspirin and low-molecular-weight heparin.


CONCLUSIONS
Although recent evidence suggests low-molecular-weight heparin as a possible option in the management and prevention of venous thromboembolism in cancer patients, more evidence from large randomized, prospective, controlled trials is needed to determine the exact the magnitude of the risk-benefit ratio associated with its use. The promising results on the effects of antithrombotic agents in the prognosis of cancer patients deserve further evaluation to estimate the potential and the feasibility of this approach.
Di Nisio
Marcello
M
Department of Vascular Medicine and of Oncology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. marcellodinisio@hotmail.com
Squizzato
Alessandro
A
Klerk
Clara P W
CP
Richel
Dick J
DJ
Büller
Harry R
HR
D000925:Anticoagulants / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D009369:Neoplasms / Q000150:complications*; D013923:Thromboembolism / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D020246:Venous Thrombosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants