Enoxaparin Efficacious, Feasible for Prevention of VTE in Advanced Pancreatic Cancer

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Recent research shows that enoxaparin effectively prevents VTE complications in advanced pancreatic cancer without decreasing efficacy of chemotherapy.
Recent research shows that enoxaparin effectively prevents VTE complications in advanced pancreatic cancer without decreasing efficacy of chemotherapy.

Primary pharmacologic prevention of symptomatic venous thromboembolic events (VTEs) in outpatients with advanced pancreatic cancer is highly efficacious and feasible, a recent study published in the Journal of Clinical Oncology has shown.1

Uwe Pelzer, MD, PhD, from Charité - Universitätsmedizin Berlin in Germany, and colleagues enrolled 312 patients with histologically proven advanced pancreatic cancer and randomly assigned them 1:1 to receive ambulant first-line chemotherapy and prophylactic use of enoxaparin 1 mg/kg subcutaneously daily or chemotherapy alone.1

Chemotherapy either consisted of gemcitabine monotherapy 1 g/m2 intravenously on days 1, 8, and 15 in 28-day cycles, or gemcitabine 1 g/m2 intravenously plus fluorouracil 750 mg/m2 continuous intravenous infusion, folinic acid 200 mg/m2 intravenously, and cisplatin 30 mg/m2 intravenously on days 1 and 8 in 21-day cycles.1

After 3 months, all patients received gemcitabine alone with or without enoxaparin 40 mg daily. Enoxaparin was dose-adjusted based on patients' platelet count and kidney function.1

Results of the study showed that within the first 3 months, 15 of 152 patients randomly assigned to the observation group experienced symptomatic VTEs compared with two of the 160 patients in the enoxaparin group (HR 0.12; 95% CI: 0.03, 0.52; P = 0.001).1

RELATED: Stereotactic Body Radiotherapy Using Fiducial Implants for Pancreatic Cancer

In addition, five of the 152 patients in the observation are experienced major bleeding events versus seven of 160 patients in the enoxaparin arm (HR 1.4; 95% CI: 0.35,3.72; P = 1.0).1

The overall cumulative incidence rates of symptomatic VTEs were 15.1% and 6.4% in the observation and enoxaparin groups, respectively (HR 0.40; 95% CI: 0.19, 0.83; P = 0.01). Researchers found no difference in progression-free survival (P = 0.64) and overall survival (P = 0.44) between the two treatment arms.1

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