Treatment Algorithm in Cancer-Associated Thrombosis: Updated Canadian Expert Consensus

Marc Carrier; Normand Blais; Mark Crowther; Petr Kavan; Grégoire Le Gal; Otto Moodley; Sudeep Shivakumar; Deepa Suryanarayan; Vicky Tagalakis; Cynthia Wu; Agnes Y.Y. Lee

doi:10.3390/curroncol28060453

Treatment Algorithm in Cancer-Associated Thrombosis: Updated Canadian Expert Consensus

Marc Carrier, Normand Blais, Mark Crowther, Petr Kavan, Grégoire Le Gal, Otto Moodley, Sudeep Shivakumar, Deepa Suryanarayan, Vicky Tagalakis, Cynthia Wu, Agnes Y.Y. Lee

Medicine

Research output: Contribution to journal › Review article › peer-review

39 Citations (Scopus)

Abstract

Patients with cancer-associated thrombosis (CAT) are at high risk of recurrent venous thromboembolism (VTE) and major bleeding complications. Risks vary significantly between indi-viduals based on cancer status, treatment, and other characteristics. To facilitate the evidence-based management of anticoagulant therapy in this patient population, a committee of 11 Canadian clinical experts updated a consensus-based algorithm for the acute and extended treatment of symptomatic and incidental CAT that was developed in 2018. Following a systematic review of the literature, updates to the algorithm were discussed during an online teleconference, and the algorithm was subsequently refined based on feedback from committee members. Clinicians using this treatment algorithm should consider bleeding risk, type of cancer, and drug–drug interactions, as well as patient and clinician preferences, in tailoring anticoagulation for patients with CAT. Anticoagulant therapy should be adapted as the patient’s cancer status and management change over time.

Original language	English
Pages (from-to)	5434-5451
Number of pages	18
Journal	Current Oncology
Volume	28
Issue number	6
DOIs	https://doi.org/10.3390/curroncol28060453
Publication status	Published - Dec 2021

Bibliographical note

Funding Information:
Conflicts of Interest: M. Carrier has received research funding from Bristol-Myers Squibb, LEO Pharma, and Pfizer and honoraria from Bayer, Bristol-Myers Squibb, Sanofi, LEO Pharma, Pfizer, and Servier. In the last 24 months, M. Crowther has received honoraria from CSL Behring, Hemostasis Reference Laboratory, Precision Biologicals, and Syneos Health. G. Le Gal has received honoraria from Aspen, Bayer, Bristol-Myers Squibb, LEO Pharma, Pfizer, and Sanofi. P. Kavan has received educational grants from Bristol-Myers Squibb, Pfizer, and Servier and honoraria from LEO Pharma. A. Lee has received research funding from Bristol-Myers Squibb and honoraria from Bayer, Bristol-Myers Squibb, LEO Pharma, Pfizer, and Servier. O. Moodley has received honoraria and educational grants from Boehringer Ingelheim, LEO Pharma, Pfizer, and Sanofi. S. Shivakumar has received honoraria from Bayer, LEO Pharma, and Pfizer. V Tagalakis has received research funding from Sanofi and honoraria from Bristol-Myers Squibb, Pfizer, and Servier. C. Wu has received honoraria from Bristol-Myers Squibb-Pfizer, LEO Pharma, Pfizer, and Servier. M Suryanarayan did not report any conflicts.

Funding Information:
The revision of the algorithm was funded by unrestricted grants from Pfizer Canada, Hospital Business Unit (Kirkland, QC, Canada), Bayer Canada Inc (Montreal, QC, Canada), LEO Pharma Inc (Thornhill, ON, Canada) and Servier Canada (Ottawa, ON, Canada) to Thrombosis Canada. The authors administered all aspects of revising the treatment algorithm, and the funding sources had no role in drafting, editing, or approving the treatment algorithm.

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

ASJC Scopus Subject Areas

Oncology

PubMed: MeSH publication types

Journal Article
Research Support, Non-U.S. Gov't
Review
Systematic Review

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/curroncol28060453

Cite this

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title = "Treatment Algorithm in Cancer-Associated Thrombosis: Updated Canadian Expert Consensus",

abstract = "Patients with cancer-associated thrombosis (CAT) are at high risk of recurrent venous thromboembolism (VTE) and major bleeding complications. Risks vary significantly between indi-viduals based on cancer status, treatment, and other characteristics. To facilitate the evidence-based management of anticoagulant therapy in this patient population, a committee of 11 Canadian clinical experts updated a consensus-based algorithm for the acute and extended treatment of symptomatic and incidental CAT that was developed in 2018. Following a systematic review of the literature, updates to the algorithm were discussed during an online teleconference, and the algorithm was subsequently refined based on feedback from committee members. Clinicians using this treatment algorithm should consider bleeding risk, type of cancer, and drug–drug interactions, as well as patient and clinician preferences, in tailoring anticoagulation for patients with CAT. Anticoagulant therapy should be adapted as the patient{\textquoteright}s cancer status and management change over time.",

author = "Marc Carrier and Normand Blais and Mark Crowther and Petr Kavan and Gal, {Gr{\'e}goire Le} and Otto Moodley and Sudeep Shivakumar and Deepa Suryanarayan and Vicky Tagalakis and Cynthia Wu and Lee, {Agnes Y.Y.}",

note = "Funding Information: Conflicts of Interest: M. Carrier has received research funding from Bristol-Myers Squibb, LEO Pharma, and Pfizer and honoraria from Bayer, Bristol-Myers Squibb, Sanofi, LEO Pharma, Pfizer, and Servier. In the last 24 months, M. Crowther has received honoraria from CSL Behring, Hemostasis Reference Laboratory, Precision Biologicals, and Syneos Health. G. Le Gal has received honoraria from Aspen, Bayer, Bristol-Myers Squibb, LEO Pharma, Pfizer, and Sanofi. P. Kavan has received educational grants from Bristol-Myers Squibb, Pfizer, and Servier and honoraria from LEO Pharma. A. Lee has received research funding from Bristol-Myers Squibb and honoraria from Bayer, Bristol-Myers Squibb, LEO Pharma, Pfizer, and Servier. O. Moodley has received honoraria and educational grants from Boehringer Ingelheim, LEO Pharma, Pfizer, and Sanofi. S. Shivakumar has received honoraria from Bayer, LEO Pharma, and Pfizer. V Tagalakis has received research funding from Sanofi and honoraria from Bristol-Myers Squibb, Pfizer, and Servier. C. Wu has received honoraria from Bristol-Myers Squibb-Pfizer, LEO Pharma, Pfizer, and Servier. M Suryanarayan did not report any conflicts. Funding Information: The revision of the algorithm was funded by unrestricted grants from Pfizer Canada, Hospital Business Unit (Kirkland, QC, Canada), Bayer Canada Inc (Montreal, QC, Canada), LEO Pharma Inc (Thornhill, ON, Canada) and Servier Canada (Ottawa, ON, Canada) to Thrombosis Canada. The authors administered all aspects of revising the treatment algorithm, and the funding sources had no role in drafting, editing, or approving the treatment algorithm. Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2021",

month = dec,

doi = "10.3390/curroncol28060453",

language = "English",

volume = "28",

pages = "5434--5451",

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AU - Carrier, Marc

AU - Blais, Normand

AU - Crowther, Mark

AU - Kavan, Petr

AU - Gal, Grégoire Le

AU - Moodley, Otto

AU - Shivakumar, Sudeep

AU - Suryanarayan, Deepa

AU - Tagalakis, Vicky

AU - Wu, Cynthia

AU - Lee, Agnes Y.Y.

N1 - Funding Information: Conflicts of Interest: M. Carrier has received research funding from Bristol-Myers Squibb, LEO Pharma, and Pfizer and honoraria from Bayer, Bristol-Myers Squibb, Sanofi, LEO Pharma, Pfizer, and Servier. In the last 24 months, M. Crowther has received honoraria from CSL Behring, Hemostasis Reference Laboratory, Precision Biologicals, and Syneos Health. G. Le Gal has received honoraria from Aspen, Bayer, Bristol-Myers Squibb, LEO Pharma, Pfizer, and Sanofi. P. Kavan has received educational grants from Bristol-Myers Squibb, Pfizer, and Servier and honoraria from LEO Pharma. A. Lee has received research funding from Bristol-Myers Squibb and honoraria from Bayer, Bristol-Myers Squibb, LEO Pharma, Pfizer, and Servier. O. Moodley has received honoraria and educational grants from Boehringer Ingelheim, LEO Pharma, Pfizer, and Sanofi. S. Shivakumar has received honoraria from Bayer, LEO Pharma, and Pfizer. V Tagalakis has received research funding from Sanofi and honoraria from Bristol-Myers Squibb, Pfizer, and Servier. C. Wu has received honoraria from Bristol-Myers Squibb-Pfizer, LEO Pharma, Pfizer, and Servier. M Suryanarayan did not report any conflicts. Funding Information: The revision of the algorithm was funded by unrestricted grants from Pfizer Canada, Hospital Business Unit (Kirkland, QC, Canada), Bayer Canada Inc (Montreal, QC, Canada), LEO Pharma Inc (Thornhill, ON, Canada) and Servier Canada (Ottawa, ON, Canada) to Thrombosis Canada. The authors administered all aspects of revising the treatment algorithm, and the funding sources had no role in drafting, editing, or approving the treatment algorithm. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021/12

Y1 - 2021/12

N2 - Patients with cancer-associated thrombosis (CAT) are at high risk of recurrent venous thromboembolism (VTE) and major bleeding complications. Risks vary significantly between indi-viduals based on cancer status, treatment, and other characteristics. To facilitate the evidence-based management of anticoagulant therapy in this patient population, a committee of 11 Canadian clinical experts updated a consensus-based algorithm for the acute and extended treatment of symptomatic and incidental CAT that was developed in 2018. Following a systematic review of the literature, updates to the algorithm were discussed during an online teleconference, and the algorithm was subsequently refined based on feedback from committee members. Clinicians using this treatment algorithm should consider bleeding risk, type of cancer, and drug–drug interactions, as well as patient and clinician preferences, in tailoring anticoagulation for patients with CAT. Anticoagulant therapy should be adapted as the patient’s cancer status and management change over time.

AB - Patients with cancer-associated thrombosis (CAT) are at high risk of recurrent venous thromboembolism (VTE) and major bleeding complications. Risks vary significantly between indi-viduals based on cancer status, treatment, and other characteristics. To facilitate the evidence-based management of anticoagulant therapy in this patient population, a committee of 11 Canadian clinical experts updated a consensus-based algorithm for the acute and extended treatment of symptomatic and incidental CAT that was developed in 2018. Following a systematic review of the literature, updates to the algorithm were discussed during an online teleconference, and the algorithm was subsequently refined based on feedback from committee members. Clinicians using this treatment algorithm should consider bleeding risk, type of cancer, and drug–drug interactions, as well as patient and clinician preferences, in tailoring anticoagulation for patients with CAT. Anticoagulant therapy should be adapted as the patient’s cancer status and management change over time.

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Treatment Algorithm in Cancer-Associated Thrombosis: Updated Canadian Expert Consensus

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

UN SDGs

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