Cancer-associated thrombosis (CAT) is a leading cause of death among patients with cancer. CAT can manifest itself as venous thromboembolism (VTE), in the form of deep vein thrombosis or pulmonary embolism, or arterial thromboembolism. The pathophysiology of CAT is complex and depends on cancer-, patient-, treatment- and biomarkers-related factors. Treatment of VTE in patients with cancer is complex and includes three major classes of anticoagulant agents: heparin and its derivatives, e.g., low molecular weight heparins, direct oral anticoagulants (DOACs), and vitamin K inhibitors. Given the tremendous heterogeneity of clinical situations in patients with cancer and the challenges of CAT, there is no single universal treatment option for patients suffering from or at risk of CAT. Initial studies suggested that patients seemed to prefer an anticoagulant that would not interfere with their cancer treatment, suggesting the primacy of cancer over VTE, and favoring efficacy and safety over convenience of route of administration. Recent studies show that when the efficacy and safety aspects are similar, patients prefer the oral route of administration. Despite this, injectables are a valid option for many patients with cancer.
癌症相关血栓形成是癌症患者的主要死亡原因之一。其临床表现可为静脉血栓栓塞（包括深静脉血栓形成和肺栓塞）或动脉血栓栓塞。该疾病的病理生理机制复杂，涉及癌症相关因素、患者个体因素、治疗方案及生物标志物等多重维度。癌症患者静脉血栓栓塞的治疗具有复杂性，主要抗凝药物包括三大类：肝素及其衍生物（如低分子肝素）、直接口服抗凝药以及维生素K拮抗剂。鉴于癌症患者临床情况的巨大异质性和癌症相关血栓形成的治疗挑战，目前尚无适用于所有患者或高危人群的通用治疗方案。早期研究表明，患者倾向于选择不影响癌症治疗的抗凝药物，这反映出在治疗决策中癌症治疗优先于血栓管理，且疗效与安全性比给药途径的便捷性更为重要。最新研究显示，当疗效与安全性相当时，患者更倾向于选择口服给药途径。尽管如此，注射给药仍是许多癌症患者的有效选择方案。
The Role of Injectables in the Treatment and Prevention of Cancer-Associated Thrombosis
肿瘤(癌症)患者之家