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1. 2022 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer, including patients with COVID-19

Author

Dominique Farge, Corinne Frere, Jean M Connors, Alok A Khorana, Ajay Kakkar, Cihan Ay, Andres Muñoz, Benjamin Brenner, Pedro H Prata, Dialina Brilhante, Darko Antic, Patricia Casais, María Cecilia Guillermo Esposito, Takayuki Ikezoe, Syed A Abutalib, Luis A Meillon-García, Henri Bounameaux, Ingrid Pabinger, James Douketis, Walter Ageno, Fernando Ajauro, Thierry Alcindor, Pantep Angchaisuksiri, Juan I. Arcelus, Raquel Barba, Ali Bazarbachii, Audrey Bellesoeur, Okba Bensaoula, Ilham Benzidia, Darius Bita, Viktoria Bitsadze, Dorit Blickstein, Mark Blostein, Isabel Bogalho, Antonio Brandao, Rodrigo Calado, Antoine Carpentier, Jose Manuel Ceresetto, Rufaro Chitsike, Jérôme Connault, Catarina Jacinto Correia, Benjamin Crichi, Erich V. De Paula, Ahmet M. Demir, Laure Deville, Ludovic Doucet, Vera Dounaevskaia, Cécile Durant, Martin Ellis, Joseph Emmerich, Anna Falanga, Carme Font, Enrique Gallardo, Thomas Gary, Filipe Gonçalves, Jean-Christophe Gris, Hiromi Hayashi, Adrian Hij, Luis Jara-Palomares, David Jiménez, Jamilya Khizroeva, Michel N'Guessan, Florian Langer, Claire Le Hello, Christine Le Maignan, Ramón Lecumberri, Lai Heng Lee, Zachary Liederman, Luisa Lopes dos Santos, Duarte Henrique Machado, Alexander Makatsariya, Alberto Maneyro, Zora Marjanovic, Serban Milhaileanu, Manuel Monreal, Sara Morais, Antonio Moreira, Mikio Mukai, Arlette Ndour, Luciana Correa Oliveira, Remedios Otero-Candelara, Maria Carolina Tostes Pintao, Florian Posch, Pascal Prilollet, Hanadi Rafii, Daniel Dias Ribeiro, Hanno Riess, Marc Righini, Helia Robert-Ebadi, Cynthia Rothschild, Andre Roussin, José Antonio Rueda Camino, Pedro Ruiz-Artacho, Gleb Saharov, Joana Santos, Maxime Sebuhyan, Ali Shamseddine, Galia Spectre Spectre, Ali Taher, Javier Trujillo-Santos, Inna Tzoran, Stéphane Villiers, Raymond Wong, Yugo Yamashita, Alexandra Yannoutsos, and Chikao Yasuda

Subjects
Oncology, Neoplasms, Practice Guidelines as Topic, Anticoagulants, COVID-19, Humans, Hemorrhage, Thrombosis, Venous Thromboembolism, Heparin, Low-Molecular-Weight
Abstract

The International Initiative on Thrombosis and Cancer is an independent academic working group of experts aimed at establishing global consensus for the treatment and prophylaxis of cancer-associated thrombosis. The 2013, 2016, and 2019 International Initiative on Thrombosis and Cancer clinical practice guidelines have been made available through a free, web-based mobile phone application. The 2022 clinical practice guidelines, which are based on a literature review up to Jan 1, 2022, include guidance for patients with cancer and with COVID-19. Key recommendations (grade 1A or 1B) include: (1) low-molecular-weight heparins (LMWHs) for the initial (first 10 days) treatment and maintenance treatment of cancer-associated thrombosis; (2) direct oral anticoagulants for the initial treatment and maintenance treatment of cancer-associated thrombosis in patients who are not at high risk of gastrointestinal or genitourinary bleeding, in the absence of strong drug-drug interactions or of gastrointestinal absorption impairment; (3) LMWHs or direct oral anticoagulants for a minimum of 6 months to treat cancer-associated thrombosis; (4) extended prophylaxis (4 weeks) with LMWHs to prevent postoperative venous thromboembolism after major abdominopelvic surgery in patients not at high risk of bleeding; and (5) primary prophylaxis of venous thromboembolism with LMWHs or direct oral anticoagulants (rivaroxaban or apixaban) in ambulatory patients with locally advanced or metastatic pancreatic cancer who are treated with anticancer therapy and have a low risk of bleeding.

Published
2022

2. 2019 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer

Author

Ali Shamseddine, Juan I. Arcelus, Isabel Bogalho, Jérôme Connault, Hans Stricker, Maral Koolian, Ali Bazarbachii, Susan Solymoss, Andre Roussin, Thierry André, Gerald A. Soff, Stéphane Villiers, Enrique Gallardo, Ingrid Pabinger, Michel Nguessan, Marc Philip Righini, Hanno Riess, Joseph Emmerich, Pantep Angchaisuksiri, Dorit Blickstein, Ajay K. Kakkar, Dialina Brilhante, Pedro Ruiz-Artacho, Kenneth A. Bauer, Hugo A. Clemente, Emmanuel Messas, Walter Ageno, Anthony Marayevas, Anna Falanga, Vanessa Pachon Olmos, José Antonio Rueda-Camino, Sanjith Saseedharan, Javier Trujillo-Santos, Alexander Makatsariya, Arlette Ndour, Toutou Toussaint, Vicky Tagalakis, Hanadi Rafii, Raymond S.M. Wong, Fernando Ajauro, Antonio Moreira, Henri Bounameaux, Russel D. Hull, Ellis Martin, Florian Posch, Isabelle Madelaine, Joydeep Chakbrabartty, Mark Blostein, Kamal R. Al-Aboudi, Patricia Casais, Thierry Alcindor, Mario Mandalà, Corinne Frere, Lai Heng Lee, Eric Assenat, Ahmet M. Demir, Christine Marosi, Carme Font, Cecilia Guillermo, Luis Meillon, Viktoria Bitsadze, Ana Pais, Luisa Lopes Dos Santos, Ludovic Doucet, Thomas Gary, Andrés Muñoz, Ali T. Taher, Luis Jara-Palomares, Norizaku Yamada, Takayuki Ikezoe, Matthias Preusser, Cécile Durant, Jamilya Khrizroeva, Zora Marjanovic, Barbara Bournet, James D. Douketis, Clemens Feistritzer, Remedios Otero-Candelera, Alok A. Khorana, Jean-Christophe Gris, I. Benzidia, Nigel S. Key, A. Hij, Ramón Lecumberri, Cynthia Rothschild, Duarte Henrique Machado, Manuel Monreal, Jan Beyer-Westendorf, Jean M. Connors, Florian Langer, Darko Antic, Gabriela Cesarman-Maus, Dominique Farge, Benjamin Brenner, Antoine F. Carpentier, Charles W. Francis, Howard A. Liebman, Cihan Ay, Service de Médecine Interne [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), McGill University = Université McGill [Montréal, Canada], Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Hématologie clinique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Brigham & Women’s Hospital [Boston] (BWH), Harvard Medical School [Boston] (HMS), Medizinische Universität Wien = Medical University of Vienna, Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), University College of London [London] (UCL), Hôpital Saint-Louis, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, McMaster University [Hamilton, Ontario], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), McGill University, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]-Sorbonne Université (SU), Service d'Hématologie Clinique [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Medical University of Vienna, Universidad Complutense de Madrid [Madrid] (UCM), and Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)

Subjects
medicine.medical_specialty, Vitamin K, Vena Cava Filters, [SDV]Life Sciences [q-bio], education, MEDLINE, 030204 cardiovascular system & hematology, Anticoagulants/administration & dosage/therapeutic use, Venous Thromboembolism/drug therapy/etiology/prevention & control, 03 medical and health sciences, 0302 clinical medicine, Neoplasms, Neoplasms/complications/surgery, Central Venous Catheters, Humans, Medicine, In patient, Vitamin K/antagonists & inhibitors, Factor Xa Inhibitors/therapeutic use, Intensive care medicine, Grading (tumors), Heparin, Low-Molecular-Weight/administration & dosage/therapeutic use, Cause of death, ddc:616, Central Venous Catheters/adverse effects, business.industry, Anticoagulants, Venous Thromboembolism, Heparin, Low-Molecular-Weight, medicine.disease, Thrombosis, 3. Good health, Clinical trial, Clinical Practice, Fondaparinux, Oncology, Fondaparinux/therapeutic use, 030220 oncology & carcinogenesis, business, Venous thromboembolism, Factor Xa Inhibitors
Abstract

International audience; Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at a high risk of VTE recurrence and bleeding during anticoagulant therapy. The International Initiative on Thrombosis and Cancer is an independent academic working group aimed at establishing a global consensus for the treatment and prophylaxis of VTE in patients with cancer. The International Initiative on Thrombosis and Cancer last updated its evidence-based clinical practice guidelines in 2016 with a free, web-based mobile phone application, which was subsequently endorsed by the International Society on Thrombosis and Haemostasis. The 2019 International Initiative on Thrombosis and Cancer clinical practice guidelines, which are based on a systematic review of the literature published up to December, 2018, are presented along with a Grading of Recommendations Assessment Development and Evaluation scale methods, with the support of the French National Cancer Institute. These guidelines were reviewed by an expanded international advisory committee and endorsed by the International Society on Thrombosis and Haemostasis. Results from head-to-head clinical trials that compared direct oral anticoagulant with low-molecular-weight heparin are also summarised, along with new evidence for the treatment and prophylaxis of VTE in patients with cancer.

Published
2019

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