Cancer-associated venous thromboembolism: the Onco-VTE START2 - Registry

Introduction: Cancer-associated thrombosis (CAT) is a major cause of morbidity and mortality in patients with malignancy. Anticoagulant treatment remains challenging because of the increased risk of recurrent venous thromboembolism (VTE) and bleeding. Information about the management of patients with CAT in real life are still scanty. Aim: The purposes of the “START2 – Registry: Survey on Anticoagulated Patients - registry” venous thromboembolism in the cancer patient (ONCO-VTE) are: 1) To prospectively collect data about CAT patients, in particular the type of anticoagulant administered and the duration of treatment; 2) To collect information about the management of these patients in real life: the choice of anticoagulant drug and the duration in relation to type of tumor, stage of disease, comorbidities, associated therapies; 3) To evaluate the incidence of thromboembolic and haemorrhagic complications in relation to anticoagulant treatment. Materials and Methods: Patients’ demographic and clinical data were collected as electronic file in anonymous form on the web-site of the START2-Registry, ongoing italian, independent, observational, database aimed at prospectively recording the clinical history of patients on anticoagulant treatment in “everyday clinical practice”. Results: Presently, in START-ONCO VTE, the fi rst 100 patient were enrolled; 42% males; median age (IQR) 66 (58–73) years; 48% with hematological cancer. VTE events (about 60% venous thromboembolism with or without pulmonary embolism) were treated in 49% of patients with direct oral anticoagulant (DOAC); 4% of patients were treated with Vitamin K Antagonist (VKA) 20% with fondaparinux and 27% with low molecular weight heparin (LMWH). Conclusions: Management of CAT in ‘real world’ seems diff erent from randomized clinical trial and guideline practice. The implement of enrollement and a close follow-up are necessary to point out factors that infl uence effi cacy and safety of treatment and to obtain suggestions for their resolution in clinical practice. Acknowledgement: The Foundation has received an unrestricted research grant from LEO Pharma S.p.A., specifi cally dedicated to the realization of this study