1. Real-World Data on Thromboprophylaxis in Active Cancer Patients: Where Are We? Are We Getting There?
- Author
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Evangelos Bournakis, Athanasios Athanasiadis, Epameinondas Samantas, Gerasimos Aravantinos, Christos N. Papandreou, Georgios Samelis, Charalambos Andreadis, Maria Souggleri, Anastasios Grivas, Elli-Sofia Tripodaki, Georgios Koumakis, Nikolaos Ziras, Helen Stergiou, Eleni Timotheadou, Nikolaos Tsoukalas, Georgios Papatsimpas, Ioannis Varthalitis, Paris Makrantonakis, Alexandros Bokas, C. Kalofonos, Ioannis Boukovinas, Alexandros Ardavanis, Pavlos Papakostas, P. Papakotoulas, Athina Christopoulou, and Georgios Pentheroudakis
- Subjects
Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,030204 cardiovascular system & hematology ,active cancer ,low molecular weight heparins (LMWHs) ,lcsh:RC254-282 ,Article ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,cancer ,thrombosis ,Cause of death ,Chemotherapy ,business.industry ,Stomach ,cancer associated thrombosis (CAT) ,Cancer ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Thrombosis ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Observational study ,thromboprophylaxis ,business ,Real world data - Abstract
Background: Cancer patients are at high risk for cancer-associated thrombosis (CAT). CAT is the second leading cause of death in these patients but it can be preventable with thromboprophylaxis. Patients and Methods: An observational, prospective, multicenter study aiming to record CAT management in clinical practice was conducted by the Hellenic Society of Medical Oncology (HeSMO). Results: A total of 426 active cancer patients (mean age 65.3 years, mean BMI: 26.1 kg/m2) who received thromboprophylaxis, were included from 18 oncology units. Tumor types were lung 25.1%, pancreas 13.9%, breast 8.7%, stomach 8.5%, ovarian 7.8%, and others 36%, while 69% had metastases. A total of 71% had a Khorana score &le, 2 and 61% received High Thrombotic Risk Chemotherapy Agents (HTRCAs, e.g., platinum). For thromboprophylaxis patients received mainly Low Molecular Weight Heparins (LMWHs), on higher than prophylactic doses in 50% of cases. Overall, 16 (3.8%) thrombotic events and 6 (1.4%) bleeding events were recorded. Notably, patients on higher doses of LMWHs compared to patients who received standard prophylactic doses had 70% lower odds to develop thrombotic events (OR: 0.3, 95% CI: 0.10&ndash, 1.0, p = 0.04). Conclusion: CAT is an important issue in oncology. Along with the Khorana score, factors as metastasis and use of HTRCAs should also be taken into consideration. Thromboprophylaxis for active cancer patients with LMWHs, even on higher doses is safe and efficient.
- Published
- 2020