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Clinical practice guidelines recommend low-molecular-weight heparin (LMWH) over warfarin for treating cancer patients with acute venous thromboembolism (VTE), based mostly on a single trial. In this industry-supported, multinational, open-label study, 900 adults with active cancer (cancer diagnosis or treatment within the previous 6 months) and proximal deep venous thrombosis (DVT) with or without pulmonary embolism (PE) were randomized to receive the low-molecular-weight heparin tinzaparin (175 IU per kg daily by subcutaneous injection) or warfarin for 6 months. Warfarin patients also received tinzaparin for the first 5 to 10 days; the warfarin dose was adjusted to maintain international normalized ratios (INRs) of 2.0 to 3.0.
Assessment at…