ArticleCardio-oncology (London, England)2025
Real-world management and outcomes of venous thromboembolism in patients with cancer and limited life expectancy in the direct oral anticoagulant era: insights from the COMMAND VTE Registry-2.
Article in Cardio-oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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40 authors.
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Abstract
backgroundOptimal management strategies for venous thromboembolism (VTE) in patients with cancer and limited life expectancy (LLE) could still be challenging in the current era of widespread use of direct oral anticoagulants (DOACs). Real-world treatment patterns and outcomes in patients with LLE were investigated using a nationwide registry in Japan.
methodsThe COMMAND VTE Registry-2 is a multicenter registry that enrolled 5,197 consecutive acute symptomatic VTE patients from 31 centers in Japan between January 2015 and August 2020. In this cohort, baseline characteristics, anticoagulation strategies, and long-term clinical outcomes were compared between cancer patients with and without LLE. The main outcomes were the one-year cumulative incidences of VTE recurrence, major bleeding, and all-cause death. Incidences of VTE recurrence and major bleeding were estimated using a competing risk analysis, with death as the competing event.
resultsThe study population consisted of 222 cancer patients with LLE (14.7%) and 1,285 patients without LLE (85.3%). Patients with LLE were older (mean age 69.9 vs. 67.8 years, P = 0.03) and received oral anticoagulants less frequently (80.6% vs. 92.1%, P < 0.001) than patients without LLE. Accounting for the competing risk of death, the one-year cumulative incidence of major bleeding was not significantly different between the two groups (11.0% vs. 10.5%, Gray’s test P = 0.91), whereas the incidence of VTE recurrence showed a trend to be lower in the LLE group (2.9% vs. 4.3%; P = 0.059). The cumulative one-year incidence of all-cause death was higher in the LLE group (94.1% vs. 35.4%, P < 0.001).
conclusionCancer patients with LLE were less likely to receive oral anticoagulants. Patients with LLE had a significantly higher one-year mortality rate than those without LLE. Accounting for the competing risk of death, there were no significant differences in the cumulative incidence of VTE recurrence or major bleeding between the two groups.
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