Center for Global Research Data

Anticoagulation for the Prevention of Arterial Thrombosis in Ambulatory Patients with Cancer: A Systematic Review

Lead Investigator: Marc Carrier, University of Ottawa
Title of Proposal Research:  Anticoagulation for the Prevention of Arterial Thrombosis in Ambulatory Patients with Cancer: A Systematic Review
Vivli Data Request: 7823
Funding Source: None
Potential Conflicts of Interest: None

Summary of the Proposed Research:

Thrombosis (clots) associated with cancer is a major cause of complications and deaths among patients with cancer. The risk of artery-related clots (such as strokes, heart attacks and clots in leg arteries) are perceived to be high among patients on anti-cancer therapies. However, current evidence on whether anticoagulants (or blood-thinners) can prevent arterial clots in this population is unknown. This is a crucial topic, as current guidelines recommend use of preventive blood-thinners among patients starting anti-cancer therapies for prevention of blood clots in the vein systems (such as those involving the legs or lungs) among high-risk patients, but no recommendations current exist on whether the same dose and type of blood-thinning medications should be used for the prevention of artery-related clots. In 2018, 9.8 million people globally are estimated to have started anti-cancer therapy, and this represents a large evidence gap in the care of patients with cancer.

We will undertake a systematic search of the literature and identify all high-quality studies (such as clinical trials) in which patients starting anti-cancer therapy were randomly assigned to receive a blood-thinner or no blood-thinner. This is known as a systematic review of literature. We will then combine the data from all included studies to analyze rates of artery-related clots (such as strokes, heart attacks and clots in leg arteries), as well as risks of bleeding (a known complication of blood-thinners) and overall deaths. This is known as a meta-analysis. If a study included patients with or without anti-cancer therapy, we would attempt to only include patients that received anti-cancer therapy. This study will provide key insights into whether blood-thinners currently recommended for prevention of vein-related clots are also effective in prevention artery-related clots.

Requested Studies:

A Randomized, Controlled Trial to Evaluate the Effects of Nadroparin on Survival and Disease Progression in Patients With Advanced Malignancies of the Lung, Pancreas, or Prostate
Data Contributor: GlaxoSmithKline
Study ID: NCT00312013
Sponsor ID: FRX106365

A Multinational, Randomized, Double Blind, Placebo-controlled Study to Evaluate the Efficacy and Safety of AVE5026 in the Prevention of Venous Thromboembolism (VTE) in Cancer Patients at High Risk for VTE and Who Are Undergoing Chemotherapy
Data Contributor: Sanofi
Study ID: NCT00694382
Sponsor ID: EFC6521