Development in anticoagulant therapy

Venous thromboembolism is an important clinical problem. Cancer patients have higher risk to develop venous thrombosis and vice versa. The treatment consists of heparin followed by vitamin K antagonists. Both agents have several limitations. Especially in cancer patients, vitamin K antagonists cause bleeding or recurrence of VTE because of a small therapeutic window. Monotherapy with low-molecular weight heparin seems to cause less of these complications in cancer patients compared to vitamin K antagonists. Besides, the drug is thought to have anti-cancer properties. Several novel anticoagulants are being developed and are undergoing clinical evaluation. New anticoagulants should also be evaluated on the effect on progression of cancer and cancer-related survival.