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Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism

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TLDR
Oral edoxaban was noninferior to subcutaneous dalteparin with respect to the composite outcome of recurrent venous thromboembolism or major bleeding during the 12 months after randomization, regardless of treatment duration.
Abstract
Background Low-molecular-weight heparin is the standard treatment for cancer-associated venous thromboembolism. The role of treatment with direct oral anticoagulant agents is unclear. Methods In this open-label, noninferiority trial, we randomly assigned patients with cancer who had acute symptomatic or incidental venous thromboembolism to receive either low-molecular-weight heparin for at least 5 days followed by oral edoxaban at a dose of 60 mg once daily (edoxaban group) or subcutaneous dalteparin at a dose of 200 IU per kilogram of body weight once daily for 1 month followed by dalteparin at a dose of 150 IU per kilogram once daily (dalteparin group). Treatment was given for at least 6 months and up to 12 months. The primary outcome was a composite of recurrent venous thromboembolism or major bleeding during the 12 months after randomization, regardless of treatment duration. Results Of the 1050 patients who underwent randomization, 1046 were included in the modified intention-to-treat analys...

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2019 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer.

Dominique Farge, +98 more
- 01 Oct 2019 - 
TL;DR: The 2019 International Initiative on Thrombosis and Cancer clinical practice guidelines, which are based on a systematic review of the literature published up to December, 2018, are presented along with a Grading of Recommendations Assessment Development and Evaluation scale methods.
Journal ArticleDOI

Glioblastoma in adults: a Society for Neuro-Oncology (SNO) and European Society of Neuro-Oncology (EANO) consensus review on current management and future directions

TL;DR: Novel therapies such as targeted molecular therapies, agents targeting DNA damage response and metabolism, immunotherapies and viral therapies will be reviewed, as well as the current challenges and future directions for research.
References
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Journal ArticleDOI

Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients: Definitions of major bleeding in clinical studies

TL;DR: A definition of major bleeding in non‐surgical patients was developed that should be applicable to studies with all agents that interfere with hemostasis, including anticoagulants, platelet function inhibitors and fibrinolytic drugs.
Journal ArticleDOI

Low-Molecular-Weight Heparin versus a Coumarin for the Prevention of Recurrent Venous Thromboembolism in Patients with Cancer

TL;DR: In patients with cancer and acute venous thromboembolism, dalteparin was more effective than an oral anticoagulant in reducing the risk of recurrent thrombosis without increasing therisk of bleeding.
Journal ArticleDOI

Recurrent venous thromboembolism and bleeding complications during anticoagulant treatment in patients with cancer and venous thrombosis.

TL;DR: Possibility for improvement using the current paradigms of anticoagulation seem limited and new treatment strategies should be developed, as cancer patients with venous thrombosis are more likely to develop recurrent thromboembolic complications and major bleeding during anticoaggerant treatment than those without malignancy.
Journal ArticleDOI

Epidemiology of cancer-associated venous thrombosis

TL;DR: This review describes the literature on incidence of and risk factors for cancer-associated venous thrombosis to provide a basis for identification of high-risk patients and for further development and refinement of prediction models.
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