Tanaka Yoshihiro, Sato Yuta, Suetsugu Tomonari, Mase Junichi, Takaha Ritsuki, Okumura Naoki, Matsuhashi Nobuhisa, Takahashi Takao, Yoshida Kazuhiro
Department of Surgical Oncology, Graduate School of Medicine, Gifu University, Gifu, Japan.
Cancer Diagn Progn. 2021 Nov 3;1(5):417-422. doi: 10.21873/cdp.10055. eCollection 2021 Nov-Dec.
BACKGROUND/AIM: The frequency of detecting cancer-associated venous thromboembolism (CAT) during chemotherapy is increasing. It is not desirable to discontinue chemotherapy for CAT. In this study, we investigated the feasibility of simultaneous progression of anticoagulant and anticancer therapy, focusing on drug interactions.
We retrospectively evaluated patients with gastroenterological CAT from February 2017 to December 2020 at the Gifu University Hospital. When both chemotherapy and CAT treatments using edoxaban were performed in parallel and the thrombus disappeared, patients were defined as being Keep-ACT (keeping anticancer therapy and anticoagulant therapy) successful. The effect and safety of treatment strategy focusing on cytochrome P450 (CYP) metabolism using edoxaban were evaluated.
A total of 114 patients with CAT during chemotherapy were treated with edoxaban. Keep-ACT was successful in 101 (88.6%) cases. Clinically relevant non-major bleeding was observed in 5 cases (4.4%). All 114 patients were using some drug affected by CYP metabolism, and the median number of affected cases was 5.
Combined use of edoxaban for CAT may lead to sustainable therapy for gastroenterological cancer patients who are administered several drugs.
背景/目的：化疗期间癌症相关静脉血栓栓塞（CAT）的检出率在上升。因CAT而中断化疗并非理想之举。在本研究中，我们聚焦于药物相互作用，调查了抗凝治疗与抗癌治疗同步推进的可行性。
我们回顾性评估了2017年2月至2020年12月在岐阜大学医院就诊的患有胃肠道CAT的患者。当同时进行化疗和使用依度沙班的CAT治疗且血栓消失时，患者被定义为抗凝与抗癌治疗并行（Keep-ACT）成功。评估了以依度沙班为基础、针对细胞色素P450（CYP）代谢的治疗策略的效果和安全性。
共有114例化疗期间发生CAT的患者接受了依度沙班治疗。101例（88.6%）患者Keep-ACT成功。5例（4.4%）患者出现临床相关非大出血。所有114例患者均使用了一些受CYP代谢影响的药物，受影响药物的中位数为5种。
对于接受多种药物治疗的胃肠道癌症患者，联合使用依度沙班治疗CAT可能会实现持续治疗。
