{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T13:48:31Z","timestamp":1788961711234,"version":"build-2803163510"},"reference-count":33,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T00:00:00Z","timestamp":1726704000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>About 7% of patients with cancer-associated venous thromboembolism (CAT) develop a recurrence during anticoagulant treatment. Identification of high-risk patients may help guide treatment decisions.<\/jats:p><jats:p>To identify clinical predictors and develop a prediction model for on-treatment recurrent CAT.<\/jats:p><jats:p>For this individual patient data meta-analysis, we used data from four randomized controlled trials evaluating low-molecular-weight heparin or direct oral anticoagulants (DOACs) for CAT (Hokusai VTE Cancer, SELECT-D, CLOT, and CATCH). The primary outcome was adjudicated on-treatment recurrent CAT during a 6-month follow-up. A clinical prediction model was developed using multivariable logistic regression analysis with backward selection. This model was validated using internal\u2013external cross-validation. Performance was assessed by the c-statistic and a calibration plot.<\/jats:p><jats:p>After excluding patients using vitamin K antagonists, the combined dataset comprised 2,245 patients with cancer and acute CAT who were treated with edoxaban (23%), rivaroxaban (9%), dalteparin (47%), or tinzaparin (20%). Recurrent on-treatment CAT during the 6-month follow-up occurred in 150 (6.7%) patients. Predictors included in the final model were age (restricted cubic spline), breast cancer (odds ratio [OR]: 0.42; 95% confidence interval [CI]: 0.20\u20130.87), metastatic disease (OR: 1.44; 95% CI: 1.01\u20132.05), treatment with DOAC (OR: 0.66; 95% CI: 0.44\u20130.98), and deep vein thrombosis only as an index event (OR: 1.72; 95% CI: 1.31\u20132.27). The c-statistic of the model was 0.63 (95% CI: 0.54\u20130.72) after internal\u2013external cross-validation. Calibration varied across studies.<\/jats:p><jats:p>The prediction model for recurrent CAT included five clinical predictors and has only modest discrimination. Prediction of recurrent CAT at the initiation of anticoagulation remains challenging.<\/jats:p>","DOI":"10.1055\/a-2418-3960","type":"journal-article","created":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T23:00:13Z","timestamp":1726786813000},"page":"589-596","source":"Crossref","is-referenced-by-count":10,"title":["Risk of Recurrent Venous Thromboembolism in Patients with Cancer: An Individual Patient Data Meta-analysis and Development of a Prediction Model"],"prefix":"10.1055","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8269-9473","authenticated-orcid":false,"given":"Vincent R.","family":"Lanting","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands"},{"name":"Department of Internal Medicine, Tergooi Hospital, Hilversum, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Takada","sequence":"additional","affiliation":[{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands"},{"name":"Department of General Medicine, Shirakawa Satellite for Teaching and Research (STAR), Fukushima Medical University, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floris T. M.","family":"Bosch","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands"},{"name":"Department of Internal Medicine, Tergooi Hospital, Hilversum, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Marshall","sequence":"additional","affiliation":[{"name":"Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Grosso","sequence":"additional","affiliation":[{"name":"Clinical Development, Daiichi Sankyo, Basking Ridge, New Jersey, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie M.","family":"Young","sequence":"additional","affiliation":[{"name":"Warwick Clinical Trials Unit, University of Warwick, Coventry, United Kingdom"},{"name":"Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnes Y. Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Hematology, University of British Columbia, British Columbia Cancer Agency, Vancouver BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5930-7304","authenticated-orcid":false,"given":"Marcello","family":"Di Nisio","sequence":"additional","affiliation":[{"name":"Department of Medicine and Ageing Sciences, Gabriele D\u2032Annunzio University, Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary E.","family":"Raskob","sequence":"additional","affiliation":[{"name":"University of Oklahoma Health Sciences Center and OU Health, Oklahoma City, Oklahoma, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter W.","family":"Kamphuisen","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands"},{"name":"Department of Internal Medicine, Tergooi Hospital, Hilversum, The Netherlands"},{"name":"Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry R.","family":"B\u00fcller","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"van Es","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam, Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2024,10,16]]},"reference":[{"issue":"10","key":"ref1","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1182\/blood-2013-04-460121","article-title":"Epidemiology of cancer-associated venous thrombosis","volume":"122","author":"J F Timp","year":"2013","journal-title":"Blood"},{"issue":"07","key":"ref2","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1056\/NEJMoa1711948","article-title":"Edoxaban for the treatment of cancer-associated venous thromboembolism","volume":"378","author":"G E Raskob","year":"2018","journal-title":"N Engl J Med"},{"issue":"20","key":"ref3","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1200\/JCO.2018.78.8034","article-title":"Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism: results of a randomized trial (SELECT-D)","volume":"36","author":"A M Young","year":"2018","journal-title":"J Clin Oncol"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1111\/jth.14662","article-title":"Apixaban and dalteparin in active malignancy-associated venous thromboembolism: the ADAM VTE trial","volume":"18","author":"R D McBane II","year":"2020","journal-title":"J Thromb Haemost"},{"issue":"17","key":"ref5","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1056\/NEJMoa1915103","article-title":"Apixaban for the treatment of venous thromboembolism associated with cancer","volume":"382","author":"G Agnelli","year":"2020","journal-title":"N Engl J Med"},{"issue":"22","key":"ref6","doi-asserted-by":"crossref","first-page":"1924","DOI":"10.1001\/jama.2023.7843","article-title":"Direct oral anticoagulants vs low-molecular-weight heparin and recurrent VTE in patients with cancer: a randomized clinical trial","volume":"329","author":"D 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a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer","volume":"349","author":"A YY Lee","year":"2003","journal-title":"N Engl J Med"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/j.chest.2021.09.037","article-title":"Rivaroxaban vs dalteparin in cancer-associated thromboembolism: a randomized trial","volume":"161","author":"B Planquette","year":"2022","journal-title":"Chest"},{"issue":"07","key":"ref17","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1016\/S1470-2045(22)00160-7","article-title":"2022 International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer, including patients with COVID-19","volume":"23","author":"D Farge","year":"2022","journal-title":"Lancet Oncol"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1182\/bloodadvances.2020003442","article-title":"American Society of 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