title: Guidance for the prevention and treatment of cancer-associated venous thromboembolism.
abstract: Venous thromboembolism (VTE) is a highly prevalent complication of malignancy with emerging changes in incidence, diagnosis and treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. We address a) the appropriate workup to search for occult malignancy in patients with idiopathic VTE, b) identification of high-risk cancer patients for primary thromboprophylaxis, c) the appropriate immediate and long-term treatment for people with cancer diagnosed with acute thromboembolism, d) the appropriate duration of anticoagulation and e) the appropriate treatment strategy in patients with recurrent VTE on anticoagulation. Areas of controversy and future directions in this field are highlighted.
authors.affiliation: Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland Clinic, 9500 Euclid Ave, R35, Cleveland, OH, 44195, USA. khorana@ccf.org.
authors.forename: Alok A
authors.initials: AA
authors.lastname: Khorana
authors.affiliation: Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Carrier
authors.affiliation: Division of Hematology, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Garcia
authors.affiliation: Department of Medicine, Thrombosis Program, University of British Columbia and Vancouver Coastal Health Authority, Vancouver, BC, Canada.
authors.forename: Agnes Y Y
authors.initials: AY
authors.lastname: Lee
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000627:therapeutic use*; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D054556:Venous Thromboembolism / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000925:Anticoagulants
keywords: Cancer; Direct oral anticoagulants (DOAC); New oral anticoagulants (NOAC); Prevention; Risk factors; Venous thromboembolism