Therapeutic anticoagulation is safe for treating venous thromboembolism in patients with cancer that has metastasized to the brain, according to new research. The study was published in Blood.

The study included 293 patients with brain metastases and venous thromboembolism. The patients were randomly selected to receive enoxaparin (Lovenox) or no anticoagulation medication.

After 12 months, the incidence of intracranial hemorrhage was 44 percent for people taking enoxaparin. In those who didn’t take the medication, 37 percent experienced intracranial hemorrhage; however, this was not a statistically significant difference (P = 0.13). Overall survival was similar for both groups.

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“While it is a very common clinical scenario to treat a patient with a metastatic brain tumor who also develops a blood clot, before this study there was very little data to inform the difficult decision of whether or not to anticoagulate these patients,” senior author Jeffrey Zwicker, M.D., of Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, said in a news release from the American Society of Hematology.

“Our findings, which demonstrate that current practice is safe, should reassure physicians that anticoagulants can be safely administered to patients with brain metastases and a history of blood clots.”


  1. Donato, Jessica, et al. “Intracranial hemorrhage in patients with brain metastases treated with therapeutic enoxaparin: a matched cohort study.” Blood. DOI: May 18, 2015.