{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T19:46:30Z","timestamp":1782935190921,"version":"3.54.5"},"reference-count":46,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,12,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Data on specific studies in cancer patients using direct oral anticoagulants (DOACs) for the prevention and treatment of venous thromboembolism (VTE) are still scarce. For preventing VTE with DOACs, current experience is still very limited, so definite conclusions cannot yet be drawn. However, DOACs have so far been compared with vitamin K antagonists (VKAs) in patients with acute VTE in 5 studies, and several hundreds of patients included in these studies had either active cancer, a history of cancer, or a new occurrence of cancer during the course of disease. Meta-analyses have revealed an at least similar efficacy and safety profile of DOACs compared with VKAs. A number of studies of cancer patients investigating primary prevention and treatment are underway, and some will be finalized soon. Nevertheless, we might need further trials, specifically on the prevention of VTE in patients who are at particularly high risk. This article also includes a personal opinion on the use of DOACs in cancer patients. In conclusion, the currently available data show that DOACs might be safe and efficacious in the treatment of VTE, however, this has yet to be proven in specifically designed trials in patients with cancer. With regard to prevention, thus far, even less data exist, and the outcomes of the ongoing studies have to be evaluated before DOACs may be used for primary prevention.<\/jats:p>","DOI":"10.1182\/asheducation-2017.1.136","type":"journal-article","created":{"date-parts":[[2019,4,16]],"date-time":"2019-04-16T22:13:11Z","timestamp":1555452791000},"page":"136-143","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":5,"title":["Direct oral anticoagulants: now also for prevention and treatment of cancer-associated venous thromboembolism?"],"prefix":"10.1182","volume":"2017","author":[{"given":"Ingrid","family":"Pabinger","sequence":"first","affiliation":[{"name":"Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Riedl","sequence":"additional","affiliation":[{"name":"Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"234","reference":[{"issue":"1","key":"2019111703553129600_B1","first-page":"61","article-title":"Causes of death in cancer patients","volume":"6","author":"Ambrus","year":"1975","journal-title":"J Med"},{"issue":"2","key":"2019111703553129600_B2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1053\/clon.1999.9023","article-title":"The prevalence and associated variables of deep venous thrombosis in patients with advanced cancer","volume":"11","author":"Johnson","year":"1999","journal-title":"Clin Oncol (R Coll Radiol)"},{"issue":"2","key":"2019111703553129600_B3","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1634\/theoncologist.2016-0214","article-title":"Cancer and venous thromboembolic disease: a review","volume":"22","author":"Donnellan","year":"2017","journal-title":"Oncologist"},{"issue":"6","key":"2019111703553129600_B4","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1016\/j.ejca.2012.10.021","article-title":"Incidence of venous thromboembolism in patients with cancer - a cohort study using linked United Kingdom databases","volume":"49","author":"Walker","year":"2013","journal-title":"Eur J Cancer"},{"issue":"6","key":"2019111703553129600_B5","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1001\/archinte.160.6.809","article-title":"Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study","volume":"160","author":"Heit","year":"2000","journal-title":"Arch Intern Med"},{"issue":"3","key":"2019111703553129600_B6","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/eci.12042","article-title":"Microparticle-associated tissue factor activity in patients with pancreatic cancer: correlation with clinicopathological features","volume":"43","author":"Thaler","year":"2013","journal-title":"Eur J Clin Invest"},{"issue":"2","key":"2019111703553129600_B7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1160\/TH16-08-0615","article-title":"Cancer-associated venous thromboembolism: Burden, mechanisms, and management","volume":"117","author":"Ay","year":"2017","journal-title":"Thromb Haemost"},{"key":"2019111703553129600_B8","article-title":"Lectures on clinical medicine: delivered at the Hotel-Dieu","author":"Trousseau","year":"1867"},{"issue":"10","key":"2019111703553129600_B9","doi-asserted-by":"crossref","first-page":"3484","DOI":"10.1182\/blood-2002-01-0108","article-title":"Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis","volume":"100","author":"Prandoni","year":"2002","journal-title":"Blood"},{"issue":"6","key":"2019111703553129600_B10","first-page":"1136","article-title":"Independent predictors of poor vitamin K antagonist control in venous thromboembolism patients. Data from the EINSTEIN-DVT and PE studies","volume":"114","author":"Kooistra","year":"2015","journal-title":"Thromb Haemost"},{"issue":"7","key":"2019111703553129600_B11","doi-asserted-by":"crossref","first-page":"1230","DOI":"10.1160\/TH16-11-0876","article-title":"Stroke prevention in atrial fibrillation: past, present and future. Comparing the guidelines and practical decision-making","volume":"117","author":"Lip","year":"2017","journal-title":"Thromb Haemost"},{"issue":"2","key":"2019111703553129600_B12","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.chest.2015.11.026","article-title":"Antithrombotic therapy for VTE disease: CHEST Guideline and Expert Panel Report [published correction appears in Chest. 2016;150(4):988]","volume":"149","author":"Kearon","year":"2016","journal-title":"Chest"},{"issue":"10","key":"2019111703553129600_B13","doi-asserted-by":"crossref","first-page":"e452","DOI":"10.1016\/S1470-2045(16)30369-2","article-title":"International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer","volume":"17","author":"Farge","year":"2016","journal-title":"Lancet Oncol"},{"issue":"9","key":"2019111703553129600_B14","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1056\/NEJMoa1302507","article-title":"Oral apixaban for the treatment of acute venous thromboembolism","volume":"369","author":"Agnelli","year":"2013","journal-title":"N Engl J Med"},{"issue":"24","key":"2019111703553129600_B15","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1056\/NEJMoa0906598","article-title":"Dabigatran versus warfarin in the treatment of acute venous thromboembolism","volume":"361","author":"Schulman","year":"2009","journal-title":"N Engl J Med"},{"issue":"7","key":"2019111703553129600_B16","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1161\/CIRCULATIONAHA.113.004450","article-title":"Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis","volume":"129","author":"Schulman","year":"2014","journal-title":"Circulation"},{"issue":"1","key":"2019111703553129600_B17","first-page":"150","article-title":"Treatment with dabigatran or warfarin in patients with venous thromboembolism and cancer","volume":"114","author":"Schulman","year":"2015","journal-title":"Thromb Haemost"},{"issue":"15","key":"2019111703553129600_B18","first-page":"1406","article-title":"Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism [published correction appears in N Engl J Med. 2014;370(4):390]","volume":"369","author":"B\u00fcller","year":"2013","journal-title":"N Engl J Med"},{"issue":"8","key":"2019111703553129600_B19","doi-asserted-by":"crossref","first-page":"e379","DOI":"10.1016\/S2352-3026(16)30057-6","article-title":"Edoxaban for venous thromboembolism in patients with cancer: results from a non-inferiority subgroup analysis of the Hokusai-VTE randomised, double-blind, double-dummy trial","volume":"3","author":"Raskob","year":"2016","journal-title":"Lancet Haematol"},{"issue":"26","key":"2019111703553129600_B20","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1056\/NEJMoa1007903","article-title":"Oral rivaroxaban for symptomatic venous thromboembolism","volume":"363","author":"Bauersachs","year":"2010","journal-title":"N Engl J Med"},{"issue":"14","key":"2019111703553129600_B21","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1056\/NEJMoa1113572","article-title":"Oral rivaroxaban for the treatment of symptomatic pulmonary embolism","volume":"366","author":"B\u00fcller","year":"2012","journal-title":"N Engl J Med"},{"issue":"1","key":"2019111703553129600_B22","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/S2352-3026(14)70018-3","article-title":"Oral rivaroxaban versus enoxaparin with vitamin K antagonist for the treatment of symptomatic venous thromboembolism in patients with cancer (EINSTEIN-DVT and EINSTEIN-PE): a pooled subgroup analysis of two randomised controlled trials","volume":"1","author":"Prins","year":"2014","journal-title":"Lancet Haematol"},{"issue":"5","key":"2019111703553129600_B23","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1111\/j.1538-7836.2012.04693.x","article-title":"A randomized phase II trial of apixaban for the prevention of thromboembolism in patients with metastatic cancer","volume":"10","author":"Levine","year":"2012","journal-title":"J Thromb Haemost"},{"issue":"6","key":"2019111703553129600_B24","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1056\/NEJMoa1111096","article-title":"Rivaroxaban for thromboprophylaxis in acutely ill medical patients","volume":"368","author":"Cohen","year":"2013","journal-title":"N Engl J Med"},{"issue":"2 suppl","key":"2019111703553129600_B25","doi-asserted-by":"crossref","first-page":"e195S","DOI":"10.1378\/chest.11-2296","article-title":"Prevention of VTE in nonsurgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines","volume":"141","author":"Kahn","year":"2012","journal-title":"Chest"},{"issue":"7","key":"2019111703553129600_B26","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1056\/NEJMoa1108898","article-title":"Semuloparin for thromboprophylaxis in patients receiving chemotherapy for cancer","volume":"366","author":"Agnelli","year":"2012","journal-title":"N Engl J Med"},{"issue":"10","key":"2019111703553129600_B27","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/S1470-2045(09)70232-3","article-title":"Nadroparin for the prevention of thromboembolic events in ambulatory patients with metastatic or locally advanced solid cancer receiving chemotherapy: a randomised, placebo-controlled, double-blind study","volume":"10","author":"Agnelli","year":"2009","journal-title":"Lancet Oncol"},{"issue":"18","key":"2019111703553129600_B28","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1200\/JCO.2014.55.1481","article-title":"Efficacy of prophylactic low-molecular weight heparin for ambulatory patients with advanced pancreatic cancer: outcomes from the CONKO-004 trial","volume":"33","author":"Pelzer","year":"2015","journal-title":"J Clin Oncol"},{"issue":"4","key":"2019111703553129600_B29","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/s11239-011-0549-x","article-title":"Extended-duration rivaroxaban thromboprophylaxis in acutely ill medical patients: MAGELLAN study protocol","volume":"31","author":"Cohen","year":"2011","journal-title":"J Thromb Thrombolysis"},{"issue":"3","key":"2019111703553129600_B30","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.ahj.2013.11.006","article-title":"The design and rationale for the Acute Medically Ill Venous Thromboembolism Prevention with Extended Duration Betrixaban (APEX) study","volume":"167","author":"Cohen","year":"2014","journal-title":"Am Heart J"},{"issue":"6","key":"2019111703553129600_B31","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1056\/NEJMoa1601747","article-title":"Extended Thromboprophylaxis with Betrixaban in Acutely Ill Medical Patients","volume":"375","author":"Cohen","year":"2016","journal-title":"N Engl J Med"},{"issue":"10","key":"2019111703553129600_B32","doi-asserted-by":"crossref","first-page":"4902","DOI":"10.1182\/blood-2007-10-116327","article-title":"Development and validation of a predictive model for chemotherapy-associated thrombosis","volume":"111","author":"Khorana","year":"2008","journal-title":"Blood"},{"issue":"2","key":"2019111703553129600_B33","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1056\/NEJMoa025313","article-title":"Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer","volume":"349","author":"Lee","year":"2003","journal-title":"N Engl J Med"},{"key":"2019111703553129600_B34","article-title":"Direct oral anticoagulants for the treatment of cancer-associated venous thromboembolism. What do we know so far [published online ahead of print 16 May 2017]?","author":"Voigtlaender","journal-title":"Hamostaseologie"},{"issue":"12","key":"2019111703553129600_B35","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1182\/blood-2014-04-571232","article-title":"Direct oral anticoagulants compared with vitamin K antagonists for acute venous thromboembolism: evidence from phase 3 trials","volume":"124","author":"van Es","year":"2014","journal-title":"Blood"},{"issue":"12","key":"2019111703553129600_B36","doi-asserted-by":"crossref","first-page":"e114445","DOI":"10.1371\/journal.pone.0114445","article-title":"Non-vitamin K antagonist oral anticoagulants and the treatment of venous thromboembolism in cancer patients: a semi systematic review and meta-analysis of safety and efficacy outcomes","volume":"9","author":"Larsen","year":"2014","journal-title":"PLoS One"},{"issue":"3","key":"2019111703553129600_B37","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1016\/j.thromres.2015.07.011","article-title":"Treatment of venous thromboembolism in patients with cancer: A network meta-analysis comparing efficacy and safety of anticoagulants","volume":"136","author":"Posch","year":"2015","journal-title":"Thromb Res"},{"issue":"7","key":"2019111703553129600_B38","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1111\/jth.12605","article-title":"Meta-analysis of the efficacy and safety of new oral anticoagulants in patients with cancer-associated acute venous thromboembolism","volume":"12","author":"van der Hulle","year":"2014","journal-title":"J Thromb Haemost"},{"key":"2019111703553129600_B39","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.ijcard.2016.12.168","article-title":"Direct oral anti-coagulants compared with vitamin-K inhibitors and low-molecular-weight-heparin for the prevention of venous thromboembolism in patients with cancer: A meta-analysis study","volume":"230","author":"Brunetti","year":"2017","journal-title":"Int J Cardiol"},{"issue":"3","key":"2019111703553129600_B40","doi-asserted-by":"crossref","first-page":"e442","DOI":"10.1200\/JOP.2015.004473","article-title":"Venous thromboembolism prophylaxis and treatment in patients with cancer: American Society of Clinical Oncology clinical practice guideline update","volume":"11","author":"Lyman","year":"2015","journal-title":"J Oncol Pract"},{"issue":"5","key":"2019111703553129600_B41","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1111\/bjh.13556","article-title":"Guideline on aspects of cancer-related venous thrombosis","volume":"170","author":"Watson","year":"2015","journal-title":"Br J Haematol"},{"issue":"10","key":"2019111703553129600_B42","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.3324\/haematol.2014.117176","article-title":"European Myeloma Network guidelines for the management of multiple myeloma-related complications","volume":"100","author":"Terpos","year":"2015","journal-title":"Haematologica"},{"issue":"suppl 2","key":"2019111703553129600_B43","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/S0049-3848(10)70028-1","article-title":"Venous thromboembolism (VTE) in cancer patients. ESMO clinical recommendations for prevention and management","volume":"125","author":"Mandal\u00e0","year":"2010","journal-title":"Thromb Res"},{"issue":"11","key":"2019111703553129600_B44","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1111\/jth.12725","article-title":"Prevention of venous thromboembolism in cancer outpatients: guidance from the SSC of the ISTH","volume":"12","author":"Khorana","year":"2014","journal-title":"J Thromb Haemost"},{"issue":"9","key":"2019111703553129600_B45","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.6004\/jnccn.2015.0133","article-title":"Cancer-Associated Venous Thromboembolic Disease, Version 1.2015","volume":"13","author":"Streiff","year":"2015","journal-title":"J Natl Compr Canc Netw"},{"issue":"6","key":"2019111703553129600_B46","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/jth.12923","article-title":"Treatment of venous thromboembolism in cancer patients with dalteparin for up to 12 months: the DALTECAN Study","volume":"13","author":"Francis","year":"2015","journal-title":"J Thromb Haemost"}],"container-title":["Hematology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ashpublications.org\/hematology\/article-pdf\/2017\/1\/136\/1249466\/hem00019.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/ashpublications.org\/hematology\/article-pdf\/2017\/1\/136\/1249466\/hem00019.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,17]],"date-time":"2019-11-17T08:56:16Z","timestamp":1573980976000},"score":1,"resource":{"primary":{"URL":"https:\/\/ashpublications.org\/hematology\/article\/2017\/1\/136\/21047\/Direct-oral-anticoagulants-now-also-for-prevention"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,8]]},"references-count":46,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,12,8]]}},"URL":"https:\/\/doi.org\/10.1182\/asheducation-2017.1.136","relation":{},"ISSN":["1520-4391","1520-4383"],"issn-type":[{"value":"1520-4391","type":"print"},{"value":"1520-4383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,8]]}}}