Mahé Isabelle, Benarroch Samuel, Djennaoui Sadji, Hakem Rabiaa, Ghorbel Abdallah, Helfer Hélène, Chidiac Jean
Paris Cité University, Assistance-Publique-Hôpitaux de Paris (AP-HP), Service de Médecine Interne, Hôpital Louis-Mourier, Inserm, Paris Cardiovascular Research Center, Team « Endotheliopathy and Hemostasis Disorders », Paris, France.
Curr Opin Oncol. 2025 Mar 1;37(2):150-157. doi: 10.1097/CCO.0000000000001125. Epub 2025 Jan 16.
The life expectancy of patients suffering from thrombosis associated with cancer has improved significantly, making them a chronic disease. Patients with thrombosis and cancer are fragile. Treated with anticoagulants, they remain at risk of complications.
Consequently, news issues emerge for clinical practice: anticoagulation therapy personalization is required to optimize the benefit ratio, involving patient characteristics and cancer characteristics. During follow-up, prediction score are designed and investigated to help identify and discriminate patients at risk of venous thromboembolism recurrences and major bleedings. Considering the improved prognosis of patients with cancer and cancer-associated thrombosis, the question of extended treatment arises, representing a major unmet need to date. Finally, new strategies, in particular anti-XI agents that appear attractive options, are currently being evaluated in the treatment of thrombosis associated with cancer.
The improved prognosis of patients with cancer-associated thrombosis is accompanied by new therapeutic strategies to improve the benefit-risk ratio of anticoagulant treatment in these fragile patients, at risk of both venous thromboembolic recurrence and haemorrhagic complication.
与癌症相关的血栓形成患者的预期寿命显著提高，使其成为一种慢性疾病。患有血栓形成和癌症的患者较为脆弱。接受抗凝治疗后，他们仍有并发症风险。
因此，临床实践出现了新问题：需要对抗凝治疗进行个性化，以优化获益率，这涉及患者特征和癌症特征。在随访期间，设计并研究了预测评分，以帮助识别和区分有静脉血栓栓塞复发和大出血风险的患者。考虑到癌症和癌症相关血栓形成患者预后的改善，延长治疗的问题随之而来，这是迄今为止一个尚未满足的主要需求。最后，目前正在评估新的策略，特别是抗XI因子药物，它们似乎是有吸引力的选择，用于治疗与癌症相关的血栓形成。
癌症相关血栓形成患者预后的改善伴随着新的治疗策略，以提高这些脆弱患者抗凝治疗的获益风险比，他们有静脉血栓栓塞复发和出血并发症的风险。
