CANCER patients can be protected from further recurrence of venous thromboembolism (VTE) with an oral drug, suggests results of a study from the University of Warwick, Coventry, UK. The researchers found that cancer patients receiving the oral drug rivaroxaban had lower recurrence rates of VTE compared with those treated with an anticoagulant (a low molecular weight heparin).
Cancer patients have a high risk of experiencing VTE due to a combination of factors such as immobility, chemotherapy, and pancreatic and gastric tumours: around one in five have either had deep vein thrombosis (DVT) or pulmonary embolism (PE). Currently, international guidelines recommend injection with a low weight molecular heparin in cancer patients to treat and prevent recurrence of VTE.
In this study, named the ‘select-d’ trial, 406 cancer patients who also had VTE were randomised to either receive rivaroxaban or dalteparin, a low-molecular-weight heparin. Of the participants, 69% were receiving cancer treatment (typically chemotherapy) at the time of their VTE. The recurrence rate of VTE was shown to be 4% and 11% amongst those receiving the oral drug and the low molecular weight heparin, respectively, following 6 months of treatment.
Major bleeding events occurred at a similar rate in both patient groups (6% with rivaroxaban and 11% with dalteparin). However, there was a significantly higher number of clinically relevant non-major bleeds in those treated with rivaroxaban compared with dalteparin (13% versus 4%, respectively). The authors suggested that the greater potency of rivaroxaban may explain this increased bleeding.
The results suggest this oral drug, taken daily, provides an alternative treatment option for VTE in cancer patients in select cases. Prof Annie Young, University of Warwick, commented: “Clinicians were already adopting the oral drug into practice for non-cancer patients and now they have data from this study to indicate that this form of treatment is an alternative option for many cancer patients who have a clot.”
It is hoped the option of rivaroxaban will help physicians better optimise VTE treatment for each individual patient.
James Coker, Reporter
For the source and further information about the study, click here.