Can Cancer Patients with Venous Thromboembolism Be Treated with Direct-Acting Oral Anticoagulants?

Current care standards dictate treating cancer patients who have venous thromboembolism (VTE; either deep venous thrombosis [DVT] or pulmonary embolism [PE]) with subcutaneous low-molecular-weight heparin (NEJM JW Emerg Med Feb 2016 and Chest 2016; 149:315). Although direct-acting oral anticoagulants (DOACs) have proven efficacy and safety for treating patients with VTE, they have not been compared directly to low-molecular-weight heparin in patients with active cancer. Investigators randomized more than 1000 active-cancer patients who had acute symptomatic VTE (two thirds of patients) or incidentally discovered VTE (including DVT or segmental or larger PE) to receive either oral edoxaban (Savaysa) or subcutaneous dalteparin (Fragmin) injec…