Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer
Thromboembolism is a compelling challenge in cancer care because of its life-threatening nature as well as its impact on specific treatments. Current guidelines do not generally recommend antithrombotic prophylaxis, except in selected categories of patients at high risk of thrombosis. Accordingly, s...
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MDPI - Multidisciplinary Digital Publishing Institute
2022
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| Online Access: | ONIX_20220812_9783036547077_56 |
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| description | Thromboembolism is a compelling challenge in cancer care because of its life-threatening nature as well as its impact on specific treatments. Current guidelines do not generally recommend antithrombotic prophylaxis, except in selected categories of patients at high risk of thrombosis. Accordingly, several clinical decision models have been developed to guide the oncologist in thromboembolic risk assessment and targeted prophylaxis. Low-molecular-weight heparins (LMWH) are currently considered as the standard approach in clinical practice guidelines, but recent randomized controlled trials (RCT) indicate that direct oral anticoagulants (DOACs) are effective for the treatment/prophylaxis of cancer-associated thromboembolism. However, many unanswered questions remain on the efficacy and safety of anticoagulants in selected cancer subgroups, and in primary and secondary prevention settings, where anticoagulation needs to be balanced on the risk of bleeding complications. Presently, patient selection remains the main challenge. Improvement in existing VTE risk models or the construction of alternative risk assessment tools are needed in order to ameliorate the risk stratification of cancer patients. This reprint will cover the current clinical evidence supporting the standard of care and emerging treatment/prophylactic options for cancer-associated thromboembolism during both active treatment and simultaneous/palliative care. Tailored approaches based on the use of individualized factors to stratify the thrombotic/bleeding risk in each individual patient are discussed. |
| format | Online |
| id | doab-20.500.12854ir-91177 |
| institution | Directory of Open Access Books |
| language | eng |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | MDPI - Multidisciplinary Digital Publishing Institute |
| publisherStr | MDPI - Multidisciplinary Digital Publishing Institute |
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| spelling | doab-20.500.12854ir-911772024-03-31T13:10:36Z Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer Ferroni, Patrizia Roselli, Mario Guadagni, Fiorella multiple myeloma venous thromboembolism risk assessment models thromboprophylaxis direct oral anticoagulants cancer-associated venous thromboembolism thrombosis pulmonary embolism neoplasms anticoagulants coumarins low molecular weight heparins cancer endogenous heparin heparanase heparan sulfate hospice palliative care units low molecular weight heparin deep vein thrombosis cancer associated thrombosis VTE malignancy direct oral anticoagulant pancreatic cancer low-molecular weight heparin survival coagulation activation locally advanced breast cancer prognostic model pCR treatment prophylaxis DOAC simultaneous care integrated care lymphoma Non-Hodgkin lymphoma Hodgkin lymphoma risk factors molecular subtype arterial thrombosis ALK ROS1 KRAS chemotherapy low-molecular-weight heparin (LMWH) VKA UFH DOACs n/a thema EDItEUR::M Medicine and Nursing thema EDItEUR::M Medicine and Nursing::MJ Clinical and internal medicine::MJC Diseases and disorders::MJCL Oncology Thromboembolism is a compelling challenge in cancer care because of its life-threatening nature as well as its impact on specific treatments. Current guidelines do not generally recommend antithrombotic prophylaxis, except in selected categories of patients at high risk of thrombosis. Accordingly, several clinical decision models have been developed to guide the oncologist in thromboembolic risk assessment and targeted prophylaxis. Low-molecular-weight heparins (LMWH) are currently considered as the standard approach in clinical practice guidelines, but recent randomized controlled trials (RCT) indicate that direct oral anticoagulants (DOACs) are effective for the treatment/prophylaxis of cancer-associated thromboembolism. However, many unanswered questions remain on the efficacy and safety of anticoagulants in selected cancer subgroups, and in primary and secondary prevention settings, where anticoagulation needs to be balanced on the risk of bleeding complications. Presently, patient selection remains the main challenge. Improvement in existing VTE risk models or the construction of alternative risk assessment tools are needed in order to ameliorate the risk stratification of cancer patients. This reprint will cover the current clinical evidence supporting the standard of care and emerging treatment/prophylactic options for cancer-associated thromboembolism during both active treatment and simultaneous/palliative care. Tailored approaches based on the use of individualized factors to stratify the thrombotic/bleeding risk in each individual patient are discussed. 2022-08-12T12:48:02Z 2022-08-12T12:48:02Z 2022 book ONIX_20220812_9783036547077_56 9783036547077 9783036547084 https://directory.doabooks.org/handle/20.500.12854/91177 eng image/jpeg Attribution 4.0 International https://mdpi.com/books/pdfview/book/5822 MDPI - Multidisciplinary Digital Publishing Institute 10.3390/books978-3-0365-4708-4 10.3390/books978-3-0365-4708-4 46cabcaa-dd94-4bfe-87b4-55023c1b36d0 9783036547077 9783036547084 202 Basel open access |
| spellingShingle | multiple myeloma venous thromboembolism risk assessment models thromboprophylaxis direct oral anticoagulants cancer-associated venous thromboembolism thrombosis pulmonary embolism neoplasms anticoagulants coumarins low molecular weight heparins cancer endogenous heparin heparanase heparan sulfate hospice palliative care units low molecular weight heparin deep vein thrombosis cancer associated thrombosis VTE malignancy direct oral anticoagulant pancreatic cancer low-molecular weight heparin survival coagulation activation locally advanced breast cancer prognostic model pCR treatment prophylaxis DOAC simultaneous care integrated care lymphoma Non-Hodgkin lymphoma Hodgkin lymphoma risk factors molecular subtype arterial thrombosis ALK ROS1 KRAS chemotherapy low-molecular-weight heparin (LMWH) VKA UFH DOACs n/a thema EDItEUR::M Medicine and Nursing thema EDItEUR::M Medicine and Nursing::MJ Clinical and internal medicine::MJC Diseases and disorders::MJCL Oncology Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer |
| title | Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer |
| title_full | Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer |
| title_fullStr | Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer |
| title_full_unstemmed | Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer |
| title_short | Risk Prediction and New Prophylaxis Strategies for Thromboembolism in Cancer |
| title_sort | risk prediction and new prophylaxis strategies for thromboembolism in cancer |
| topic | multiple myeloma venous thromboembolism risk assessment models thromboprophylaxis direct oral anticoagulants cancer-associated venous thromboembolism thrombosis pulmonary embolism neoplasms anticoagulants coumarins low molecular weight heparins cancer endogenous heparin heparanase heparan sulfate hospice palliative care units low molecular weight heparin deep vein thrombosis cancer associated thrombosis VTE malignancy direct oral anticoagulant pancreatic cancer low-molecular weight heparin survival coagulation activation locally advanced breast cancer prognostic model pCR treatment prophylaxis DOAC simultaneous care integrated care lymphoma Non-Hodgkin lymphoma Hodgkin lymphoma risk factors molecular subtype arterial thrombosis ALK ROS1 KRAS chemotherapy low-molecular-weight heparin (LMWH) VKA UFH DOACs n/a thema EDItEUR::M Medicine and Nursing thema EDItEUR::M Medicine and Nursing::MJ Clinical and internal medicine::MJC Diseases and disorders::MJCL Oncology |
| topic_facet | multiple myeloma venous thromboembolism risk assessment models thromboprophylaxis direct oral anticoagulants cancer-associated venous thromboembolism thrombosis pulmonary embolism neoplasms anticoagulants coumarins low molecular weight heparins cancer endogenous heparin heparanase heparan sulfate hospice palliative care units low molecular weight heparin deep vein thrombosis cancer associated thrombosis VTE malignancy direct oral anticoagulant pancreatic cancer low-molecular weight heparin survival coagulation activation locally advanced breast cancer prognostic model pCR treatment prophylaxis DOAC simultaneous care integrated care lymphoma Non-Hodgkin lymphoma Hodgkin lymphoma risk factors molecular subtype arterial thrombosis ALK ROS1 KRAS chemotherapy low-molecular-weight heparin (LMWH) VKA UFH DOACs n/a thema EDItEUR::M Medicine and Nursing thema EDItEUR::M Medicine and Nursing::MJ Clinical and internal medicine::MJC Diseases and disorders::MJCL Oncology |
| url | ONIX_20220812_9783036547077_56 |