Direct-Acting Oral Anticoagulant Therapy in Cancer Patients—A Review

SIMPLE SUMMARY: Direct-acting oral anticoagulants are becoming popular therapeutic option in patients with cancer. We investigated the available literature in order to try to sum up the information’s about them. In this article we present both, advantages and disadvantages of direct-acting oral anticoagulants. We found out that vitamin K antagonists are being slowly replaced by direct-acting oral anticoagulants, whereas compared to low-molecular-weight heparins they are mostly considered as an alternative option. Main concerns when using direct-acting oral anticoagulants are: a higher risk of major bleeding and drug-to-drug interactions with antineoplastic agents. We noticed that current guidelines of different scientific associations are not unanimous. We presented clinical trials on direct-acting oral anticoagulants in regard to cancer patients. Overall there are still a lot of discrepancies in field of by direct-acting oral anticoagulants therapy. In conclusion, this review supports the use of DOACs in various clinical situations. ABSTRACT: Venous thromboembolism (VTE) is an important aspect in cancer patients. There are various pharmacological methods used for thrombotic event treatment. DOACs (direct-acting oral anticoagulants) are gaining popularity among both physicians and researchers and are slowly starting to replace VKAs (vitamin K antagonists), thus becoming a substitute or alternative option for LMWHs (low-molecular-weight heparins). In this article, we present DOACs’ main therapeutic advantages and disadvantages in patients with cancer. The only major concern with using DOACs is the higher risk of bleeding; however, there are discrepancies in this matter. There are still some types of cancer for which DOACs are not recommended. Specific cancer types may influence the efficacy of DOAC therapy. Additionally, race and ethnicity may affect therapy in cancer patients with DOACs. A sizeable number of clinical trials are focused on comparing DOACs with other anticoagulants. The current guidelines of different scientific associations are not unanimous in their DOAC assessments. There is still a need for more evidence of DOACs’ potential advantages over other methods of anticoagulation in cancer patients to facilitate their position in this recommendation. This literature review presents the current state of knowledge about the use of DOACs in patients with neoplastic growth.