Section of Thrombosis and Benign Hematology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1464, Houston, TX, 77030, USA.
Drugs. 2019 Apr;79(6):621-631. doi: 10.1007/s40265-019-01084-2.
Cancer accounts for 20% of all venous thromboembolism (VTE) worldwide and cancer patients are at four- to sevenfold increased risk of thrombosis compared to non-cancer patients. VTE is also a morbid complication of cancer and its incidence is rising. Thrombosis is also a second leading cause of death in cancer patients. The standard of care management for the prevention and treatment of cancer-associated thrombosis (CAT) remains the administration of low-molecular-weight heparins (LMWHs). In the last decade, five direct oral anticoagulants (DOACs), dabigatran, rivaroxaban, apixaban, edoxaban and betrixaban, have been approved for the treatment and prevention of VTE in the general patient population. In this review, we discuss the results of the already published clinical trials with DOACs in the treatment of CAT and the ongoing clinical trials with DOACs in the prevention and treatment of CAT.
癌症占全球所有静脉血栓栓塞症(VTE)的 20%,与非癌症患者相比,癌症患者的血栓形成风险增加了 4 至 7 倍。VTE 也是癌症的一种严重并发症,其发病率正在上升。血栓形成也是癌症患者死亡的第二大主要原因。预防和治疗癌症相关血栓形成(CAT)的标准治疗管理仍然是低分子量肝素(LMWHs)的给药。在过去十年中,五种直接口服抗凝剂(DOACs),即达比加群、利伐沙班、阿哌沙班、依度沙班和贝曲沙班,已被批准用于一般患者群体的 VTE 治疗和预防。在这篇综述中,我们讨论了已经发表的关于 DOACs 在 CAT 治疗中的临床试验结果,以及正在进行的关于 DOACs 在 CAT 的预防和治疗中的临床试验结果。