Results of a randomized trial support the role of residual vein thrombosis (RVT) as a factor in determining the optimal duration of anticoagulant therapy in cancer patients with deep vein thrombosis (DVT) of the lower limbs. These findings were published in the Journal of Clinical Oncology.
Mariasanta Napolitano, M.D., of the Universita degli Studi di Palermo in Italy, and colleagues enrolled 347 cancer patients, who were receiving six months of low molecular weight heparin (LMWH) therapy for a first episode of DVT, in the Residual Vein Thrombosis and the Optimal Duration of LMWH in Cancer Patients With DVT (Cancer-DACUS) study. Those with RVT (242 patients) were randomly assigned to an additional six months of LMWH therapy (119 patients; group A1) or no additional LMWH therapy (123 patients; group A2). LMWH therapy was stopped at six months for those without RVT (group B).
The researchers found that recurrent venous thromboembolism (VTE) occurred in 27 patients in group A2 versus 22 patients in group A1 (adjusted hazard ratio [aHR], 1.37; 95 percent confidence interval [CI], 0.7 to 2.5; P = 0.311). Recurrent VTE occurred in three of the patients in group B (aHR for group A1 versus group B, 6.0; 95 percent CI, 1.7 to 21.2; P = 0.005).
“Further research is required to define the utility of RVT for guiding the optimal duration of anticoagulant therapy in a patient with cancer with VTE,” write the authors of an accompanying editorial.
- Napolitano, Mariasanta, et al. “Optimal Duration of Low Molecular Weight Heparin for the Treatment of Cancer-Related Deep Vein Thrombosis: The Cancer-DACUS Study.” Journal of Clinical Oncology. doi: 10.1200/JCO.2013.51.7433. September 29, 2014.