The Role of Direct Oral Anticoagulants in Cancer-Associated Thrombosis According to the Current Literature
Petroula Nana,
Konstantinos Dakis,
Michail Peroulis,
Nikos Rousas,
Konstantinos Spanos,
George Kouvelos,
Eleni Arnaoutoglou,
Miltos Matsagkas
Affiliations
Petroula Nana
Vascular Surgery Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
Konstantinos Dakis
Vascular Surgery Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
Michail Peroulis
Unit of Minimally Invasive Vascular Surgery, Mediterraneο Hospital, 16675 Athens, Greece
Nikos Rousas
Vascular Surgery Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
Konstantinos Spanos
Vascular Surgery Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
George Kouvelos
Vascular Surgery Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
Eleni Arnaoutoglou
Anesthesiology Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
Miltos Matsagkas
Vascular Surgery Department, Larissa University Hospital, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41110 Larissa, Greece
Venous thromboembolism (VTE) is a common complication among patients suffering from malignancies, leading to an increased mortality rate. Novel randomized trials have added valuable information regarding cancer-associated thrombosis (CAT) management using direct oral anticoagulants (DOACs). The aim of this study is to present an overview of the current literature and recommendations in CAT treatment. A few randomized control trials (RCTs) have been integrated suggesting that DOACs may be effectively applied in CAT patients compared to low molecular weight heparins (LMWHs) with a decreased mortality and VTE recurrence rate. However, the risk of bleeding is higher, especially in patients with gastrointestinal malignancies. Real-world data are in accordance with these RCT findings, while in the currently available recommendations, DOACs are suggested as a reliable alternative to LMWH during the initial, long-term, and extended phase of treatment. Data retrieved from the current literature, including RCTs and “real-world” studies, aim to clarify the role of DOACs in CAT management, by highlighting their benefits and remarking upon the potential adverse outcomes. Current recommendations suggest the use of DOACs in well-selected patients with an increasing level of evidence through years.
