Cancer and thrombosis

Cancer and incident thrombosis are very much associated. One the one hand are patients with cancer at higher risk of developing venous thromboembolism due to procoagulant proteins produced by cancer cells, high frequency of surgical procedures and period of immobility, pro-thrombotic chemotherapy and local compression of veins by tumour mass. On the other hand, coagulation proteins play a role in tumour biology and may help further progression and metastasizing of the tumour. Treatment of patients with cancer-associated thrombosis is challenging since this patient category is at higher risk of recurrent venous thromboembolism as well as bleeding from anticoagulant therapy. By performing clinical studies in this research theme, we target several of the many reaming challenges of the management of patients with cancer and thrombosis, such as the relevance of incidental venous thromboembolism, optimal choice of anticoagulant drug class and duration of anticoagulant therapy.

Three relevant publications of our group (with collaborators) within this theme are:

1. den Exter PL, Hooijer J, van der Hulle T, van Oosten JP, Dekkers OM, Klok FA, Huisman MV. Vitamin K Antagonists Compared to Low-Molecular-Weight Heparins for Treatment of Cancer-Associated Venous Thromboembolism: An Observational Study in Routine Clinical Practice. An Observational Study in Routine Clinical Practice. Thromb Haemost 2017;117:2163-2167
2. van der Hulle T, den Exter PL, van den Hoven P, van der Hoeven JJ, van der Meer FJ, Eikenboom J, Huisman MV, Klok FA. Cohort Study on the Management of Cancer-Associated Venous Thromboembolism Aimed at the Safety of Stopping Anticoagulant Therapy in Patients Cured of Cancer. Chest 2016;149:1245-1251
3. van der Hulle T, den Exter PL, Planquette B, Meyer G, Soler S, Monreal M, JimĂ©nez D, Portillo AK, O’Connell C, Liebman HA, Shteinberg M, Adir Y, Tiseo M, Bersanelli M, Abdel-Razeq HN, Mansour AH, Donnelly OG, Radhakrishna G, Ramasamy S, Bozas G, Maraveyas A, Shinagare AB, Hatabu H, Nishino M, Huisman MV, Klok FA. Risk of recurrent venous thromboembolism and major hemorrhage in cancer-associated incidental pulmonary embolism among treated and untreated patients: a pooled analysis of 926 patients. J Thromb Haemost 2016;14:105-13.