SynthesisBlood advances2020
Primary thromboprophylaxis in ambulatory cancer patients with a high Khorana score: a systematic review and meta-analysis.
Synthesis in Blood advances, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- SEOM clinical guidelines on venous thromboembolism (VTE) and cancer (2023).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024Guideline
- The Role of Anticoagulation on Venous Thromboembolism Primary Prophylaxis in Low- to Intermediate-Risk Ambulatory Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Asian Pacific journal of cancer prevention : APJCP · 2024Pooled it
- Efficacy of Factor Xa Inhibitors Versus Placebo in Thromboprophylaxis for Cancer-Associated Thromboembolism: A Systematic Review and Meta-analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Plasma proteomics improves thrombosis prediction in patients with cancer and identifies targetable IL-17-driven endothelial activation.Science translational medicine · 2026Article
- Navigating the Hemostatic Balance: Anticoagulation and Antiplatelet Therapy in Patients with Thrombocytopenia.Journal of clinical medicine · 2026Review
- Cancer-Associated Thrombosis in Patients Treated with Immune Checkpoint Inhibitors.International journal of molecular sciences · 2026Review
- The public health impact of cancer-associated venous thromboembolism: looking to the future.Research and practice in thrombosis and haemostasis · 2026Article
- Consensus on the Management of the Clinical Challenges of Venous Thromboembolism in Special Situations.Thrombosis and haemostasis · 2025Article
- Advancing thromboprophylaxis in ambulatory high-risk cancer patients: addressing challenges and new insights from the TARGET-TP trial.Annals of medicine and surgery (2012) · 2025Article
- Mortality risk after cancer-related venous thromboembolism has decreased over the last three decades: the HUNT and Tromsø studies.Haematologica · 2025Article
- A Direct Relationship Between 'Blood Stasis' and Fibrinaloid Microclots in Chronic, Inflammatory, and Vascular Diseases, and Some Traditional Natural Products Approaches to Treatment.Pharmaceuticals (Basel, Switzerland) · 2025Review
- The role of germline and somatic mutations in predicting cancer-associated thrombosis: a narrative review.Current opinion in hematology · 2025Review
- Cancer-associated venous thromboembolism: a comprehensive review.Thrombosis journal · 2025Review
- Khorana risk score in lung cancer patients treated with immune checkpoint inhibitors: a real-world study.Journal of thrombosis and thrombolysis · 2025Article
- Validating Khorana Risk Score in gastric cancer patients on immune checkpoint inhibitors and chemotherapy.Immunotherapy · 2025Article
- Risk Assessment Models for Predicting Venous Thromboembolism in Patients with Pancreatic Cancer.Cancers · 2025Article
- The Vienna CATScore for predicting cancer-associated venous thromboembolism: an external validation across multiple time points.ESMO open · 2025Article
- Article
- Risk assessment and prevention of cancer-associated venous thromboembolism in ambulatory patients with solid malignancies.Research and practice in thrombosis and haemostasis · 2025Article
- Review
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Guidelines suggest thromboprophylaxis for ambulatory cancer patients starting chemotherapy with an intermediate to high risk of venous thromboembolism (VTE) according to Khorana score. Data on thromboprophylaxis efficacy in different Khorana score risk groups remain ambiguous. We sought to evaluate thromboprophylaxis in patients with an intermediate- to high-risk (≥2 points) Khorana score and an intermediate-risk score (2 points) or high-risk score (≥3 points) separately. MEDLINE, Embase, and CENTRAL were searched for randomized controlled trials (RCTs) comparing thromboprophylaxis with placebo or standard care in ambulatory cancer patients. Outcomes were VTE, major bleeding, and all-cause mortality. Relative risks (RRs) were calculated in a profile-likelihood random-effects model. Six RCTs were identified, involving 4626 cancer patients. Thromboprophylaxis with direct oral anticoagulants (DOACs) or low molecular weight heparin (LMWH) significantly reduced VTE risk in intermediate- to high-risk (RR, 0.51; 95% confidence interval [CI], 0.34-0.67), intermediate-risk (RR, 0.58; 95% CI, 0.36-0.83), and high-risk patients (RR, 0.45; 95% CI, 0.28-0.67); the numbers needed to treat (NNTs) were 25 (intermediate to high risk), 34 (intermediate risk), and 17 (high risk), respectively. There was no significant difference in major bleeding (RR, 1.06; 95% CI, 0.69-1.67) or all-cause mortality (RR, 0.90; 95% CI, 0.82-1.01). The numbers needed to harm (NNHs) for major bleeding in intermediate- to high-risk, intermediate-risk, and high-risk patients were 1000, -500, and 334, respectively. The overall NNH was lower in DOAC studies (100) versus LMWH studies (-500). These findings indicate thromboprophylaxis effectively reduces the risk of VTE in patients with an intermediate- to high-risk Khorana score, although the NNT is twice as high for intermediate-risk patients compared with high-risk patients.
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