Send to

Choose Destination
Lancet Oncol. 2016 Oct;17(10):e452-e466. doi: 10.1016/S1470-2045(16)30369-2.

International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer.

Author information

Assistance Publique-Hôpitaux de Paris, Internal Medicine: Autoimmune and Vascular Disease Unit, Saint-Louis Hospital, Paris, France; Sorbonne Paris Cité, Paris 7 Diderot University, Paris, France. Electronic address:
Division of Angiology and Hemostasis, University Hospitals of Geneva and Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Assistance Publique-Hôpitaux de Paris, Service d'oncologie, Hôpital Pitié-Salpêtrière, Paris, France.
Institut Sainte Catherine, Avignon, France.
Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA.
Clinical Division of Hematology and Hemostaseology, Department of Internal Medicine, Medical University Vienna, Vienna, Austria.
Department of Medicine, McGill University, Montreal, QC, Canada.
Department of Medicine, McMaster University, Hamilton, ON, Canada.
Thrombosis Research Institute, London, UK; University College London, London, UK.


Venous thromboembolism (VTE) is the second leading cause of death in patients with cancer. These patients are at an increased risk of developing VTE and are more likely to have a recurrence of VTE and bleeding while taking anticoagulants. Management of VTE in patients with cancer is a major therapeutic challenge and remains suboptimal worldwide. In 2013, the International Initiative on Thrombosis and Cancer (ITAC-CME), established to reduce the global burden of VTE in patients with cancer, published international guidelines for the treatment and prophylaxis of VTE and central venous catheter-associated thrombosis. The rapid global adoption of direct oral anticoagulants for management of VTE in patients with cancer is an emerging treatment trend that needs to be addressed based on the current level of evidence. In this Review, we provide an update of the ITAC-CME consensus recommendations based on a systematic review of the literature ranked according to the Grading of Recommendations Assessment, Development, and Evaluation scale. These guidelines aim to address in-hospital and outpatient cancer-associated VTE in specific subgroups of patients with cancer.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center