New oral drug can protect cancer patients from venous thromboembolism

New oral drug can protect cancer patients from venous thromboembolism

Taking one tablet a day could be the key to helping treat cancer patients and protect them from venous thromboembolism (VTE), according to research from the University of Warwick, UK.

People with cancer have an increased risk of developing blood clots, with one in five experiencing either deep vein thrombosis (DVT) or pulmonary embolism (PE), also known as venous thromboembolism – a dangerous and potentially deadly condition that affects ten million people worldwide.

The ‘select-d’ trial

Current international guidelines recommend cancer patients are injected with an anticoagulant to treat and prevent recurrence of VTE.

However, results from a large pilot trial called select-d that took place at the university’s medical school suggest that a daily tablet could be a beneficial alternative for treating VTE in selected patients.

Research found that prescribing the oral drug rivaroxaban (Xarelto) significantly reduced the occurrence of venous thromboembolism among patients with cancer and VTE.

Professor Annie Young, of Warwick Medical School and lead on the study, said: “Clinicians were already adopting the oral drug into practice for non-cancer patients, and now they have data from this study to indicate that this form of treatment is an alternative option for many cancer patients who have a clot.”

Cancer patients at biggest risk

VTE has many causes and risk factors, but cancer patients are particularly at risk due to a combination of factors, such as:

  • Immobility (if in bed unwell);
  • Pancreatic and gastric tumours; and
  • Chemotherapy.

Because VTE is life-threatening, blood thinners are used to shrink the existing clots and prevent others from forming.

The ‘select-d’ trial enrolled 406 patients who had cancer and VTE; 69% were receiving cancer treatment (typically chemotherapy) at the time of their VTE.

The results

After six months of treatment, the VTE recurrence rate was 4% among those taking the tablet and 11% in those receiving dalteparin.

Results for the secondary outcomes were mixed. Patients receiving rivaroxaban had the same percentage of major bleeding events (6%) as those receiving dalteparin (4%) but a marked and significant increase in clinically relevant non-major bleeds (13%) with rivaroxaban compared to those having dalteparin (4%).

Young added: “We now need to be sitting down with each one of our cancer patients with VTE, discussing their preference alongside looking at all their clinical details including whether the cancer lesion is still there, what other medications are being taken and what other conditions the patient has so that we can choose the optimal VTE treatment for each patient.”

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