Oral drug treatment helps protect cancer patients from potentially deadly blood clots

May 11, 2018

Oral drug treatment helps protect cancer patients from potentially deadly DVT and pulmonary embolism

Research from the University of Warwick indicates that taking a tablet a day can help treat cancer patients of a potentially deadly condition.

People with cancer have an increased risk of developing blood clots, with roughly one in five experiencing venous thromboembolism (VTE) - either deep vein thrombosis (DVT) or pulmonary embolism (PE). Blood clots in the deep veins of the leg may travel to the lungs causing a pulmonary embolism. These two conditions are referred to as VTE - a dangerous and potentially deadly medical condition of which there are 10 million cases worldwide.

Current international guidelines recommend cancer patients are injected with an anticoagulant (a low molecular weight heparin) to treat and prevent recurrence of VTE. However, new results from a large pilot trial run at the University's Warwick Medical School called 'select-d' suggest that a daily tablet could be a beneficial alternative for treating VTE in selected patients.

Research led by Professor Annie Young of Warwick Medical School found that prescribing the oral drug rivaroxaban (Xarelto) significantly reduced venous thromboembolism recurrence among patients with cancer and VTE. She said: "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."

Although there are many causes and risk factors for VTE, cancer patients are particularly at risk due to a combination of factors such as immobility (if in bed poorly), pancreatic and gastric tumours, and chemotherapy. Because VTE can be life-threatening, blood thinners are used to shrink existing clots and prevent others from forming.

The 'select-d' trial enrolled 406 patients who had cancer and VTE; most (69 percent) were receiving cancer treatment (typically chemotherapy) at the time of their VTE. Half were randomly assigned to receive low-molecular-weight heparin (dalteparin) and half were given the oral drug rivaroxaban. After six months of treatment, the VTE recurrence rate was four percent among those taking the tablet and 11 percent in those receiving dalteparin.

The results for secondary outcomes were mixed. In patients receiving rivaroxaban, there were around the same percentage of major bleeding events (6%) as those receiving dalteparin (4%) but a marked and significant increase in clinically relevant non-major bleeds (13%) with rivaroxaban compared to those having low molecular weight heparin (4%). The reason for increased bleeding is not known, it may be because rivaroxaban is more 'potent'.

Professor Young added: "We now need to be sitting down with each one of our cancer patients with VTE, discussing their preference alongside looking at all their clinical details including whether the cancer lesion is still there, what other medications are being taken and what other conditions the patient has so that we can choose the optimal VTE treatment for each patient."
-end-
For further details contact Nicola Jones, Media Relations Manager University of Warwick 07920531221 or N.Jones.1@warwick.ac.uk

Notes to Editors

Comparison of an Oral Factor Xa Inhibitor With Low Molecular Weight Heparin in Patients With Cancer With Venous Thromboembolism: Results of a Randomized Trial (SELECT-D) is published in the Journal of Clinical Oncology - May 10, 2018.

Authors

Annie M. Young, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom

Andrea Marshall, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom

Jenny Thirlwall, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom

Oliver Chapman, Department of Haematology, University Hospitals Coventry and Warwickshire, Coventry, United Kingdom

Anand Lokare, Department of Haematology, Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, United Kingdom

Catherine Hill, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom

Danielle Hale, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom

Janet A. Dunn, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom

Gary H. Lyman, Fred Hutchinson Cancer Research Center, Seattle, USA

Charles Hutchinson, Health Sciences, Warwick Medical School, University of Warwick, United Kingdom

Peter MacCallum, Queen Mary University of London, United Kingdom

Ajay Kakkar, Thrombosis Research Institute, London, United Kingdom

FD Richard Hobbs, Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom

Stavros Petrou, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom

Jeremy Dale, Health Sciences, Warwick Medical School, University of Warwick, United Kingdom

Christopher J. Poole, University Hospitals Coventry and Warwickshire, Coventry, United Kingdome

Anthony Maraveyas, Hull York Medical School, United Kingdome

Mark Levine, McMaster University, Hamilton, Ontario, Canada

University of Warwick

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.