VTE in Malignancy

Question 1

VTE in malignancy

Answer 1

• significantly higher risk
• stomach or pancreatic cancer - increased risk of VTE
• radiation, chemo, metastatic disease increased risk
• associated with lower survival rate

Question 2

VTE prophylaxis

Answer 2

• prophylaxis not routinely recommended in cancer patients
• largest published study shows edoxaban NONINFERIOR to dalteparin for outcome of VTE and major bleeding but had higher risk of major bleeding

Question 3

SOME trial

Answer 3

• routine screening for cancer in patients with unprovoked VTE did NOT result in significant increase in detection of cancer

Question 4

CLOT and CATCH trials

Answer 4

show LWMH has lower recurrence rates than warfarin

• CATCH - not more effective than warfarin, but did reduce non major bleeding events
• CLOT - established LWMH superior to warfarin