Qureshi Muzammil R, Barsoum Marian, Salim Danyal, Mudika Sese Ekolle Mbonde, Barakat Aly, Reghu Nair Neeraja, Ahmed Tanzeela F, Nayyar Shirish, Dahleh Aya H, Ambreen Sidra, Noel Aamanda, Fayyaz Muteeba
Internal Medicine, Avalon University School of Medicine, Willemstad, CUW.
Graduate Medical Education, Faculty of Medicine, Assiut University, Assiut, EGY.
Cureus. 2025 May 12;17(5):e83956. doi: 10.7759/cureus.83956. eCollection 2025 May.
Venous thromboembolism (VTE) is a frequent and serious complication observed in patients with malignancy. The management of cancer-associated thrombosis (CAT) remains complex and multifactorial, influenced by cancer type, stage, comorbidities, and ongoing therapeutic regimens. Among anticoagulation strategies, direct oral anticoagulants (DOACs) have gained increasing attention as potential alternatives to low-molecular-weight heparins (LMWHs) in selected oncology populations. This narrative review evaluates the role of DOACs in the treatment of CAT, focusing on their clinical efficacy, safety considerations, and practical advantages, including oral administration and patient adherence. However, their use may be limited in certain cancer types and patients with renal or hepatic impairment. DOACs have also raised concerns regarding bleeding risks, drug interactions, and individualized dosing strategies. This review also highlights ongoing challenges such as optimal treatment duration, real-world applicability, and patient-specific considerations. The discussion aims to assess current data and clinical guidance while identifying future directions for integrating DOACs into standard oncology practice.
静脉血栓栓塞症（VTE）是恶性肿瘤患者中常见且严重的并发症。癌症相关血栓形成（CAT）的管理仍然复杂且涉及多方面因素，受到癌症类型、分期、合并症以及正在进行的治疗方案的影响。在抗凝策略中，直接口服抗凝剂（DOACs）作为低分子量肝素（LMWHs）在特定肿瘤人群中的潜在替代药物，受到越来越多的关注。这篇叙述性综述评估了DOACs在CAT治疗中的作用，重点关注其临床疗效、安全性考量以及实际优势，包括口服给药和患者依从性。然而，它们在某些癌症类型以及有肾或肝功能损害的患者中的使用可能受到限制。DOACs还引发了关于出血风险、药物相互作用和个体化给药策略的担忧。本综述还强调了持续存在的挑战，如最佳治疗持续时间、实际应用情况以及针对患者的具体考量。讨论旨在评估当前数据和临床指南，同时确定将DOACs纳入标准肿瘤学实践的未来方向。
