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<p>Venous thromboembolism in cancer patients constitutes a complex and clinically significant disease due to its pathophysiology, morbidity and mortality. Pulmonary embolism is a potentially life-threatening disease, and therefore it represents the second leading cause of death among cancer patients, surpassed only by cancer itself. In recent years, direct-acting oral anticoagulants have emerged as the preferred option for the treatment of cancer-related venous thromboembolism, although low-molecular weight heparins are still specifically recommended for patients with high bleeding risk. The management of anticoagulant therapy beyond the first 6 months following pulmonary embolism remains a challenging scenario, requiring careful evaluation of the balance between benefits and risks. Anti-thrombotic prophylaxis is not routinely recommended in the outpatient setting, although emerging data suggest validated risk tools could help identify high-risk populations who might benefit. This review summarizes available clinical trial data, meta-analyses, real-world studies, both national and international guidelines providing a practical approach to the management of pulmonary embolism in patients with cancer.</p>

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Practical considerations about management of pulmonary embolism in patients with cancer

  • 期刊论文

  • 发表日期：

    2025年8月29日

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  • Lorenzo Bianchi,
  • Giorgio Ghigliotti,
  • Matteo Sarocchi,
  • Claudia Canale,
  • Matteo Toma,
  • Italo Porto,
  • Paolo Spallarossa

摘要

Venous thromboembolism in cancer patients constitutes a complex and clinically significant disease due to its pathophysiology, morbidity and mortality. Pulmonary embolism is a potentially life-threatening disease, and therefore it represents the second leading cause of death among cancer patients, surpassed only by cancer itself. In recent years, direct-acting oral anticoagulants have emerged as the preferred option for the treatment of cancer-related venous thromboembolism, although low-molecular weight heparins are still specifically recommended for patients with high bleeding risk. The management of anticoagulant therapy beyond the first 6 months following pulmonary embolism remains a challenging scenario, requiring careful evaluation of the balance between benefits and risks. Anti-thrombotic prophylaxis is not routinely recommended in the outpatient setting, although emerging data suggest validated risk tools could help identify high-risk populations who might benefit. This review summarizes available clinical trial data, meta-analyses, real-world studies, both national and international guidelines providing a practical approach to the management of pulmonary embolism in patients with cancer.