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Enoxaparin Prevents VTEs in Advanced Pancreatic Cancer

Enoxaparin effective for preventing VTEs with no adverse effect on major bleeding, chemo efficacy

WEDNESDAY, May 20, 2015 (HealthDay News) -- For patients with advanced pancreatic cancer (APC), enoxaparin is effective for prevention and treatment of venous thromboembolic events (VTEs), according to a study published online May 18 in the Journal of Clinical Oncology.

Uwe Pelzer, M.D., Ph.D., from Universitätsmedizin Berlin, and colleagues randomized 312 patients with histologically proven APC to ambulant first-line chemotherapy and prophylactic use of enoxaparin (160 patients) or chemotherapy alone (152 patients).

The researchers found that within the first three months there were 15 symptomatic VTEs in the observation group and two in the enoxaparin group (hazard ratio, 0.12; 95 percent confidence interval [CI], 0.03 to 0.52; P = 0.001). There were five major bleeding events in the observation group and seven in the enoxaparin group (hazard ratio, 1.4; 95 percent CI, 0.35 to 3.72; P = 1.0). The overall cumulative incidence rates of symptomatic VTEs were 15.1 and 6.4 percent for the observation and enoxaparin groups, respectively (hazard ratio, 0.40; 95 percent CI, 0.19 to 0.83; P = 0.01). There were no significant between-group differences noted in progression-free (hazard ratio, 1.06; 95 percent CI, 0.84 to 1.32; P = 0.64) and overall survival (hazard ratio, 1.01; 95 percent CI, 0.87 to 1.38; P = 0.44).

"This study demonstrates the high efficacy and feasibility of primary pharmacologic prevention of symptomatic VTEs in outpatients with APC," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Amgen, Eli Lilly, and sanofi-aventis, which provided enoxaparin free of charge.

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