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20.03.2019 | special report | Ausgabe 2/2019 Open Access

memo - Magazine of European Medical Oncology 2/2019

Direct oral anticoagulants: a treatment option in oncological patients

Zeitschrift:
memo - Magazine of European Medical Oncology > Ausgabe 2/2019
Autoren:
Johannes B. Jaeger, Thomas Jaeger, Ass. Prof. Priv. Doz. Dr. Clemens Feistritzer
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Summary

Venous thrombosis and pulmonary embolism are common complications in patients with active cancer. For many years low molecular weight heparins (LMWH) have been the preferred treatment option for cancer patients, because of their superiority over vitamin K antagonists, which bear high risk of interaction and unsatisfactory anticoagulation. With the introduction of direct oral anticoagulants (DOAC) a second oral treatment option appeared. However, recommendations for the use of DOACs in the treatment of cancer-associated venous thromboembolic events were only given recently. DOAC possess a different side effect profile regarding drug/drug interactions. Recent publications revealed a slightly increased risk for non major bleedings compared to LMWH, and caution is advised when used in patients with gastrointestinal tract malignancies, especially upper gastro-intestinal tract malignancies. This review depicts actual considerations for anticoagulation in cancer patients to provide a rational for clinicians before treatment initiation.
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