Effect of therapeutic anticoagulation on overall survival in men receiving docetaxel for mCRPC
Dr Caroline Pratz – Kimmel Cancer Center, Johns Hopkins University, Balitmore
We found that patients that were treated for anticoagulation with anticoagulation had an overall longer survival than those that did not have any clots and were not treated with anticoagulation. It was a retrospective study of 247 patients; we found that 29 patients had an incidence of VTE, or venous thromboembolism, and of those that were treated they had an overall longer survival and those that actually received low molecular heparin actually survived longer than those who were treated with warfarin.
Does this work in the same way that aspirin might?
I don’t know, because aspirin is an anti-platelet agent so that potentially could be working in a different mechanism. We unfortunately didn’t look at patients with aspirin but that also potentially deserves a further look.
What are the implications for prostate cancer treatment?
I know in our clinical care we have chosen to extend anticoagulation in patients that we potentially might have stopped anticoagulation in. Consider extending those that have had a VT incidence to continue their anticoagulation, it potentially could impact the overall survival on patients. We will probably move this forward from here and take a look back on some things.
What is the main take home message?
If I were to choose an anticoagulation agent it would be low molecular heparin for patients, rather than warfarin, and I would choose to extend it until you’ve cured their cancer but, unfortunately, in metastatic castration resistant prostate cancer that’s not the case, so lifelong anticoagulation.
