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“THE RESULTS of these two trials are more similar than different. I think the best conclusion would be that we now have two trials with consistent results and can probably, in most cases, replace low–molecular-weight heparin with direct oral anticoagulants,” said Dr. Raskob, lead investigator of the Hokusai VTE–Cancer trial. 

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“These results are important because they show direct oral anticoagulants are safe and appropriate in patients with cancer. The good news is there is a better way to administer anticoagulation. We can say these results are potentially practice-changing,” said Robert Brodsky, MD, Director of Hematology and Professor at Johns Hopkins Medicine in Baltimore and moderator of a press conference where these data were presented. 

“I think these studies will usher in a new standard of care for a common situation that oncologists face,” Dr. Brodsky continued. “Many patients can’t inject themselves [with low–molecular-weight heparin]; for example, those with fewer resources and older age may need someone else to inject them. The injections hurt. Direct oral anticoagulants have the potential to have a big impact, but the issues around bleeding in gastrointestinal cancers need to be addressed. As far as cost goes, I have no information on that.” ■

DISCLOSURE: Dr. Brodsky reported no conflicts of interest. 

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