Practical guidance for direct oral anticoagulant use in the treatment of venous thromboembolism in primary and metastatic brain tumor patients

• DOI: 10.1002/cncr.35220
• Publication Date: 2024-01-30T12:53:25Z
• Authors: Surabhi Ranjan; Denise Leung; Ashley P. Ghiaseddin; Jennie W. Taylor; Mina Lobbous; Andrew Dhawan; Joshua A. Budhu; Elizabeth Coffee; Kaitlyn Melnick; Sajeel A. Chowdhary; Christine Lu‐Emerson; Sylvia C. Kurz; Joy E. Burke; Keng Lam; Mallika P. Patel; Erin M. Dunbar; Nimish A. Mohile; Katherine B. Peters
• Keywords: Brain Neoplasms; 610; Anticoagulants; Administration, Oral; Hemorrhage; Venous Thromboembolism; 03 medical and health sciences; 0302 clinical medicine; Neoplasms; Humans; Prospective Studies; Neoplasm Recurrence, Local

AbstractManagement of venous thromboembolism (VTE) in patients with primary and metastatic brain tumors (BT) is challenging because of the risk of intracranial hemorrhage (ICH). There are no prospective clinical trials evaluating safety and efficacy of direct oral anticoagulants (DOACs), specifically in patients with BT, but they are widely used for VTE in this population. A group of neuro‐oncology experts convened to provide practical clinical guidance for the off‐label use of DOACs in treating VTE in patients with BT. We searched PubMed for the following terms: BTs, glioma, glioblastoma (GBM), brain metastasis, VTE, heparin, low‐molecular‐weight heparin (LWMH), DOACs, and ICH. Although prospective clinical trials are needed, the recommendations presented aim to assist clinicians in making informed decisions regarding DOACs for VTE in patients with BT.