“THE RESULTS of these two trials are more similar than different. I think the best conclusion would be that we now have two trials with consistent results and can probably, in most cases, replace low–molecular-weight heparin with direct oral anticoagulants,” said Dr. Raskob, lead investigator of the Hokusai VTE–Cancer trial.
Robert Brodsky, MD
“These results are important because they show direct oral anticoagulants are safe and appropriate in patients with cancer. The good news is there is a better way to administer anticoagulation. We can say these results are potentially practice-changing,” said Robert Brodsky, MD, Director of Hematology and Professor at Johns Hopkins Medicine in Baltimore and moderator of a press conference where these data were presented.
“I think these studies will usher in a new standard of care for a common situation that oncologists face,” Dr. Brodsky continued. “Many patients can’t inject themselves [with low–molecular-weight heparin]; for example, those with fewer resources and older age may need someone else to inject them. The injections hurt. Direct oral anticoagulants have the potential to have a big impact, but the issues around bleeding in gastrointestinal cancers need to be addressed. As far as cost goes, I have no information on that.” ■
DISCLOSURE: Dr. Brodsky reported no conflicts of interest.
THE FIRST TWO randomized trials to directly compare direct oral anticoagulants vs low–molecular-weight heparin for management of venous thromboembolism (VTE) in patients with cancer suggest that direct oral anticoagulants may become the new standard of care.1,2 Direct oral anticoagulants appear to...