Research Priorities for Venous Thromboembolism in Cancer Patients

A recent article outlines different research priorities for the occurrence of venous thromboembolism (VTE) in patients with cancer for the National Cancer Institute and the National Heart, Lung, and Blood Institute.

"The risk for venous thromboembolism (VTE) is increased in cancer and particularly with chemotherapy, and it portends poorer survival among patients with cancer," lead author Nigel Key, MB, ChB, FRCP wrote in the article. "However, many fundamental questions about cancer-associated VTE, or Trousseau Syndrome, remain unanswered."

The CDC estimates that each year, 100,000 to 300,000 cases of VTE are fatal. Patients with pancreatic, ovarian, stomach, and brain cancers are more likely to develop VTE, according to a study published in Cancer Research.

These patients are more likely to experience major bleeding and death compared with patients who do not have VTE, and is a leading cause of death among patients receiving chemotherapy, according to the study.

Scientists said the epidemiology of VTW is a research priority to answer how common it is, how it contributes to morbidity and mortality, how to intervene, and how to prevent it.

“If you looked at the impact of thrombosis in the broadest sense, which includes stroke, heart attack, and venous thrombosis, it's still the number one killer in western society,” Key said. “If you were to ask if funding were proportionate to the number of people affected, it's not. It's underfunded, proportionately.”

In cancer-related VTE research, many unmet needs were discovered, such as platelet and white blood cell contributions to VTE, the role of clotting proteins, the impact of cancer treatment on VTE, inflammation as a trigger for prothrombotic changes, and evaluating specific cancers as determinants of VTE, according to the study.

Future research should include both in- and out-patient settings, optimal anticoagulant treatments, duration of thromboprophylaxis, and factors that can increase or decrease VTE risk.

"What typically happens is that an advocate within the Institute will promote the need for research funding in the identified areas," Key concluded. "They decide their budgets and whether a request for applications will be solicited in this field of research."