Venous thromboembolism (VTE) is frequently encountered in patients with
cancer.
Cancer patients have an increased risk of VTE during the entire course of their disease, but this risk is particularly high during the first months after
cancer diagnosis and during the advanced stage of disease. VTE is a relevant cause of morbidity and mortality in patients with
cancer and has a significant impact on their quality of life. Since 50 years,
heparin and
vitamin K antagonists are the mainstay
anticoagulants for the prevention and treatment of VTE. At present, the treatment of VTE in patients with
cancer does not differ from that of other medical patients. However, patients with
cancer still have unmet clinical needs with the currently available
antithrombotic agents. These patients are known to be at two- to four-fold risk for both VTE recurrence and
anticoagulant-related
bleeding, despite adequate anticoagulation, in comparison to non
cancer patients Several new antithrombotic drugs targeting
activated factor X or activated
thrombin have been developed in the last decades for treatment of VTE. Some of them seems to have a potential therapeutic value for VTE treatment in patients with
cancer, but no randomized studies have been specifically conducted in
cancer patients. Until data with these novel agents in the specific oncology setting will be available, their efficacy and safety for both prevention and treatment of VTE in
cancer patients remains to be defined.