fondaparinux and Lung-Neoplasms

To determine the efficacy and safety of heparin (unfractionated heparin (UFH) or low-molecular-weight-heparin (LMWH)) and fondaparinux in improving the survival of patients with cancer.. We conducted in January 2007 a comprehensive search for relevant randomized clinical trials (RCTs). We used a standardized form to extract in duplicate data on methodological quality, participants, interventions and outcomes of interest including all cause mortality, thromboembolic events, and bleeding events. We assessed the methodological quality for each outcome by grading the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Of 3986 identified citations, we included 5 RCTs, none of which evaluated fondaparinux. The quality of evidence was moderate for survival, low for major and minor bleeding, and very low for DVT. Heparin therapy was associated with a statistically and clinically significant survival benefit (hazard ratio (HR) = 0.77; 95%CI = 0.65-0.91). In subgroup analyses, patients with limited small cell lung cancer experienced a clear survival benefit (HR = 0.56; 95%CI = 0.38-0.83). The survival benefit was not statistically significant for either patients with extensive small cell lung cancer (HR = 0.80; 95%CI = 0.60-1.06) or patients with advanced cancer (HR = 0.84; 95%CI = 0.68-1.03). The increased risk of bleeding with heparin was not statistically significant (relative risk (RR) = 1.78; 95%CI = 0.73-4.38).. This review suggests a survival benefit of heparin in cancer patients in general, and in patients with limited small cell lung cancer in particular.

Topics: Anticoagulants; Carcinoma, Small Cell; Fondaparinux; Heparin, Low-Molecular-Weight; Humans; Lung Neoplasms; Polysaccharides; Survival Analysis; Treatment Outcome

Topics: Adult; Anticoagulants; Antithrombins; Dabigatran; Drug Therapy, Combination; Factor Xa Inhibitors; Fondaparinux; Humans; Lung Neoplasms; Male; Recurrence; Thrombophilia; Thrombosis; Venous Thromboembolism

We report a case of venous thromboembolism during the cisplatin-based adjuvant chemotherapy. A 49-year-old woman who was undergone left lower lobectomy for the lung cancer received adjuvant chemotherapy of cisplatin + vinorelbine ditartrate regimen. On day 11 after starting the chemotherapy, she presented a left lower leg pain and readmitted. Computed tomography revealed a deep venous thrombosis of the left lower leg and peripheral pulmonary embolism. The symptom and thromboembolism were successfully treated by anticoagulant drug and thrombolytic therapy. Although cisplatin-based chemotherapy is a risk factor of venous thromboembolism in patients with advanced malignancy, it should be also recognized as a complication of the adjuvant chemotherapy after surgery.

Topics: Anticoagulants; Chemotherapy, Adjuvant; Cisplatin; Drug Substitution; Drug Therapy, Combination; Echocardiography; Female; Fibrinolytic Agents; Fondaparinux; Humans; Lung Neoplasms; Middle Aged; Polysaccharides; Pyridines; Thiazoles; Thrombolytic Therapy; Tomography, X-Ray Computed; Treatment Outcome; Urokinase-Type Plasminogen Activator; Venous Thromboembolism

Venous thromboembolism (VTE) is a serious threat for all cancer patients. This study was aimed to assess the VTE treatment of cancer patients in the ambulatory care setting.. This is a prospective non-interventional study, which includes ambulatory cancer patients from office-based oncologists. A standardized case report form was used to obtain data on patient characteristics, treatment regimens, duration of treatment, and side effects.. Specialists from 34 centers included data from 76 patients. The median patient age was 62 years (range 33-81 years). The 4 most common cancer types were breast cancer (32%), colorectal cancer (18%), lymphoma and lung cancer (each 8%). 18% of the acute VTE cases were treated as inpatients, 80% as outpatients, and 99% with low-molecular-weight heparin (LMWH), unfractionated heparin (UFH), or fondaparinux. After the acute phase, secondary prophylaxis with LMWH/UFH/fondaparinux was planned in 61% of the patients, with oral anticoagulation in 39%. During acute-phase treatment and secondary prophylaxis, no patient had recurrent VTE. 4 patients (5%) experienced minor bleedings.. This study shows that many ambulatory cancer patients with VTE have early tumors, no metastases, and an excellent performance score. Most patients receive LMWHs for secondary prophylaxis, as recommended by the national and international guidelines. Still, a relevant percentage is switched to oral anticoagulants. © 2015 S. Karger GmbH, Freiburg.

Topics: Adult; Aged; Aged, 80 and over; Ambulatory Care; Breast Neoplasms; Colorectal Neoplasms; Female; Fondaparinux; Germany; Guideline Adherence; Heparin; Heparin, Low-Molecular-Weight; Humans; Lung Neoplasms; Lymphoma; Male; Middle Aged; Neoplasms; Polysaccharides; Prospective Studies; Recurrence; Surveys and Questionnaires; Venous Thromboembolism

Topics: Adenocarcinoma, Bronchiolo-Alveolar; Adrenal Cortex Hormones; Anticoagulants; Breast Neoplasms; Drug Hypersensitivity; Enoxaparin; Female; Fondaparinux; Histamine Antagonists; Humans; Hypersensitivity, Delayed; Lung Neoplasms; Middle Aged; Nadroparin; Patch Tests; Polysaccharides; Treatment Outcome; Vena Cava, Superior; Venous Thrombosis

Topics: Adult; Disease Management; Disease Progression; Fatal Outcome; Female; Fondaparinux; Humans; Lung Neoplasms; Polysaccharides; Recurrence; Thromboembolism; Venous Thrombosis