Retrospective Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2019; 11(10): 866-876
Published online Oct 15, 2019. doi: 10.4251/wjgo.v11.i10.866
Evaluation of the safety and effectiveness of direct oral anticoagulants and low molecular weight heparin in gastrointestinal cancer-associated venous thromboembolism
Alejandro Recio-Boiles, Sumana Veeravelli, Jessica Vondrak, Hani M Babiker, Aaron J Scott, Rachna T Shroff, Hitendra Patel, Emad Elquza, Ali McBride
Alejandro Recio-Boiles, Hani M Babiker, Aaron J Scott, Rachna T Shroff, Emad Elquza, Department of Medicine, Hematology and Medical Oncology, University of Arizona Cancer Center, Tucson, AZ 85724, United States
Sumana Veeravelli, Jessica Vondrak, Department of Medicine, Internal Medicine Residency Program, University of Arizona, Tucson, AZ 85725, United States
Hitendra Patel, UC San Diego Health Moores Cancer Center, La Jolla, CA 92093, United States
Ali McBride, University of Arizona College of Pharmacy, Tucson, AZ 85725, United States
Author contributions: Recio-Boiles A, Patel H, Elquza E, and McBride A designed and drafted the study concept. Recio-Boiles A, Vondrak J, and Veeravelli S collected the data. Recio-Boiles A, Elquza E, and McBride A performed data analysis and interpretation. Recio-Boiles A, Babiker HM, Scott AJ, Shroff RT, Elquza E, and McBride A contributed to writing, revising and editing the manuscript. All authors helped to perform the research, revision of the manuscript and have approved the final version.
Institutional review board statement: This study has a statement on ethics approval by the Institutional Review Board of University of Arizona Cancer Center, which is a part of the University of Arizona The Human Subjects Protection Program.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Alejandro Recio-Boiles, MD, Assistant Professor of Medicine, Department of Medicine, Hematology and Medical Oncology, University of Arizona Cancer Center, 1515 N Campbell Ave, Tucson, AZ 85724, United States. areciomd@email.arizona.edu
Telephone: +1-520-6264703 Fax: +1-520-6268095
Received: February 26, 2019
Peer-review started: February 27, 2019
First decision: July 31, 2019
Revised: September 3, 2019
Accepted: September 12, 2019
Article in press: September 12, 2019
Published online: October 15, 2019
Processing time: 232 Days and 9 Hours
Core Tip

Core tip: Our study shows similar efficacy of low molecular weight heparin as compared to apixaban and rivaroxaban. However, side effect profiles of these new direct oral anticoagulants (DOAC)’s may lead to a preferred use of apixaban, which had lower bleeding events in the highly sensitive gastrointestinal cancer (GICA) patient population. GICA-venous thromboembolism (VTE) is a high-risk patient subpopulation and warrants additional dedicated prospective clinical analysis of the efficacy and safety of DOACs. In addition, evaluation of clinical predictors that may influence the risk of VTE recurrence and major bleeding should include GICA as a high-risk group.