Department of Medicine and Surgery, University of Insubria, Varese, Italy (L.G., W.A.).
Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada (T.-F.W., M.C.).
Arterioscler Thromb Vasc Biol. 2023 Jun;43(6):824-831. doi: 10.1161/ATVBAHA.123.318779. Epub 2023 May 4.
Patients with cancer are at higher risk of developing venous thromboembolism (VTE) compared with the general population. This elevated risk is due to several risk factors and multiple, overlapping thrombotic and hemostatic pathophysiological pathways that are specific to this patient population. Hence, the management of cancer-associated VTE can be challenging for clinicians. Patients with cancer-associated VTE are at higher risk of both recurrent events despite anticoagulation and bleeding complications due to the anticoagulant regimens. Direct oral anticoagulants have recently been shown to be effective, safe, and more convenient than parenteral low-molecular-weight heparin for the management of cancer-associated VTE. Despite these recent advances in anticoagulant therapy, many unmet needs remain in these patients (increased risk of bleeding with specific cancer types, drug-drug interactions, liver dysfunction). Factor XI inhibitors are currently being assessed for the management of cancer-associated VTE and may help clinicians address these important knowledge gaps.
与普通人群相比，癌症患者发生静脉血栓栓塞症（VTE）的风险更高。这种风险增加是由于多种风险因素以及特定于该患者群体的多个重叠的血栓形成和止血病理生理途径所致。因此，癌症相关 VTE 的管理对临床医生来说具有挑战性。尽管接受抗凝治疗，但癌症相关 VTE 患者仍有较高的复发风险和出血并发症风险，这与抗凝方案有关。最近的研究表明，直接口服抗凝剂在管理癌症相关 VTE 方面比普通低分子肝素更有效、更安全、更方便。尽管抗凝治疗有了这些最新进展，但这些患者仍存在许多未满足的需求（某些特定癌症类型出血风险增加、药物相互作用、肝功能障碍）。因子 XI 抑制剂目前正在评估用于癌症相关 VTE 的管理，可能有助于临床医生解决这些重要的知识空白。
