According to the American Cancer Society, 48,960 people will be diagnosed with pancreatic cancer in 2015 and 40,560 will die of the disease.2 Advanced pancreatic cancer accounts for the highest rates of VTEs in patients with cancer, which can result in impaired quality of life, delayed cancer treatment, longer hospitalizations, and higher costs.1

The National Comprehensive Cancer Network (NCCN) guidelines currently recommend enoxaparin or dalteparin, both of which are types of low molecular weight heparin (LMWH), as well as fondaparinux, unfractionated heparin, and warfarin, for the prevention of cancer-associated VTEs in the outpatient and inpatient settings.3

The findings of this study build upon existing data in that primary prophylaxis of VTEs with enoxaparin effectively prevents these major complications in ambulatory patients with advanced pancreatic cancer without decreasing the efficacy of chemotherapy.1

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Clinicians prescribing enoxaparin to patients should be aware that enoxaparin should be dose adjusted in patients with a creatinine clearance less than 30 mL/min and enoxparin should be dosed using total or actual body weight in obese patients depending on patient’s weight .4

Clinicians should obtain peak and trough anti-Factor Xa levels, as well as complete blood counts and stool occult blood tests periodically, and monitor patients for signs of bleedings.4

References

  1. Pelzer U, Opitz B, Deutschinoff G, et al. Efficacy of prophylactic low-molecular weight heparin for ambulatory patients with advanced pancreatic cancer: outcomes from the CONKO-004 trial. J Clin Oncol. 2015. [Epub ahead of print]. DOI: 10.1200/JCO.2014.55.1481.
  2. What are the key statistics about pancreatic cancer?. American Cancer Society website. http://www.cancer.org/cancer/pancreaticcancer/detailedguide/pancreatic-cancer-key-statistics. Updated January 9, 2015. Accessed May 21, 2015.
  3. NCCN Clinical Practice Guidelines in Oncology. Hodgkin Lymphoma. V2.2015. Available at: http://www.nccn.org/professionals/physician_gls/pdf/vte.pdf. Accessed May 21, 2015.
  4. Enoxaparin (Lovenox) [prescribing information]. Bridgewater, NJ: Sanofi-Aventis. http://products.sanofi.us/lovenox/lovenox.html.