Tables
- TABLE 1
Relative risk of venous thromboembolism diagnosis in hospitalised cancer patients
Cancers Odds ratio Haematological cancer 26.2 Lung 24.8 Gastrointestinal (bowel, pancreas, stomach, oesophagus) 18.9 Brain 8.0 Kidney 5.8 Skin (melanoma, squamous cell) 3.6 Breast 3.5 Prostate 3.4 Uterine cervix 3.3 Ovarium 2.3 Ear, nose and throat 1.5 Other 6.6 Data from [19].
- TABLE 2
Risk factors for cancer-associated thrombosis
Patient-related factors Advanced age
Female sex
Prior venous thromboembolism
Patient comorbidities
Infection, obesity, anaemia, pulmonary or renal disease
Prolonged immobilisation
Inherited thrombophilic factors Cancer-related factors Site: haematological malignancies, lung, pancreas, stomach, brain, kidney
Stage: advanced stage and initial period after diagnosis
Hospitalisation
Surgery
Chemotherapy and hormonal therapy
Anti-angiogenic therapy
Erythropoiesis-stimulating agents
Blood transfusions
Candidate biomarkers Platelet count (>35 0000 per µL)
Leukocyte count (>11 000 per µL)
D-dimer
Tissue factor expression by tumour cells
Circulating tissue factor
Soluble P-selectin
C-reactive protein
Reproduced from [22] with permission from the publisher.
- TABLE 3
Predictive model for chemotherapy-associated venous thromboembolism
Patient characteristics Risk score Site of cancer Very high risk (stomach, pancreas) 2 High risk (lung, lymphoma, gynaecologic, bladder, testicular) 1 Prechemotherapy platelet count ≥350 000 per mm3 1 Haemoglobin level <10 g·dL−1 or use of red cell growth factors 1 Prechemotherapy leukocyte count >11 000 per mm3 1 Body mass index ≥35 kg·m−2 1 A risk score ≥3 is a high-risk score, 1–2 is an intermediate score, and 0 is a low-risk score.
- TABLE 4
Major randomised trials in cancer-associated thrombosis primary prophylaxis
Trial Year Patients n Drugs evaluated Major findings ENOXACAN II [32] 2002 332 (submitted for abdominal or pelvic surgery) Enoxaparin (31 days) versus placebo (after 10 days of surgery) Enoxaparin patients presented less VTE events than placebo after 1 (p=0.02) and 3 months (p=0.01). No difference in major bleeding. PROTECHT [27] 2009 1150 Nadroparin (4 months) versus placebo Nadroparin patients presented less thrombotic events (venous and arterial) than placebo (p=0.02). No statistical difference in major bleeding. SAVE-ONCO [28] 2012 3212 Semuloparin (3.5 months) versus placebo Semuloparin patients presented less VTE events than placebo (p<0.001). No difference in major bleeding. AVERT [30] 2018 563 Apixaban (180 days) versus placebo Apixaban patients presented less VTE events than placebo (p<0.001) and more major bleeding (p=0.046) than placebo. CASSINI [31] 2018 841 Rivaroxaban (180 days) versus placebo Statistical trend of less VTE events and VTE-related death in rivaroxaban patients (p=0.10). No difference in major bleeding. VTE: venous thromboembolism.
- TABLE 5
Major randomised trials in cancer-associated thrombosis treatment
Trial Year Patients n Drugs evaluated Major findings CANTHANOX [35] 2002 146 Enoxaparin versus warfarin Statistical tendency of warfarin to be more associated with major bleeding (p=0.09) and death (p=0.07) than enoxaparin. CLOT [36] 2003 672 Dalteparin versus warfarin Dalteparin was superior to warfarin in VTE recurrence (p=0.002). No difference in major bleeding or mortality. CATCH [37] 2015 900 Tinzaparin versus warfarin Statistical tendency of VTE recurrence reduction with tinzaparin (p=07). No difference in major bleeding or mortality. HOKUSAI-CANCER [45] 2018 1046 Edoxaban versus dalteparin Edoxaban was non-inferior to dalteparin. Statistical tendency of superiority of edoxaban in VTE recurrence reduction (p=0.09), statistically significant more major bleeding with edoxaban (p=0.04). SELECT-D [47] 2018 406 Rivaroxaban versus dalteparin Statistically significant less VTE recurrence (HR 0.43, 95% CI 0.19–0.99) and statistical tendency of more bleeding (HR 1.83, 95% CI 0.68–4.96) with rivaroxaban (oesophagus and gastro-oesophageal junction cancer patients excluded after inclusion of the first 220 patients) CARAVAGGIO [48] 2019 (expected) 1168 (expected) Apixaban versus dalteparin ? VTE: venous thromboembolism.