Venous thromboembolism (VTE) is a prevalent complication in patients with active cancer. Direct oral anticoagulants (DOACs) have been approved for the treatment of VTE in general populations. However, for cancer patients, most guidelines continue to recommend low molecular weight heparin (LMWH) monotherapy for at least 3–6 months, owing to the lack of cancer-speciﬁc data regarding the use of these agents. Both recent emerging data from clinical practice experience and new randomized clinical trials (RCTs) speciﬁcally for cancer patients may alter this approach. This statement incorporates these new data, and provides guidance on the current role of DOACs in the treatment of cancer-associated thrombosis.
This guidance outlines factors that may inﬂuence decision-making in individual patients.
Dr. Marc Carrier, M.D., MSc, FRCPC, is an Associate Professor in the Faculty of Medicine, Department of Medicine and Scientist in the Clinical Epidemiology Program of The Ottawa Hospital Research Institute. Holds a Tier 2 Research Chair in Venous Thromboembolism and Cancer from the University of Ottawa and New Investigator Award from the Heart and Stroke Foundation of Canada.