Anticoagulant Use May Improve Survival in mCRPC Patients

ORLANDO, Fla.—Anticoagulant therapy is associated with improved overall survival (OS) in men with metastatic castration-resistant prostate cancer (mCRPC) receiving first-line docetaxel chemotherapy, researchers reported at the annual Genitourinary Cancers Symposium

Caroline F. Pratz, MHS, a nurse practitioner at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore, and colleagues reviewed data from 247 mCRPC patients receiving first-line docetaxel treatment. Of these, 29 (11.7%) received anticoagulation treatment: 15 for deep venous thrombosis, nine for pulmonary embolism, and five for both conditions. The median OS was 20.9 months for patients who received anticoagulants compared with 17.1 months for those who did not. After adjusting for multiple variables, anticoagulant use was associated with a significant 37% decreased risk of death compared with non-use.

The survival benefit was more significant with low-molecular-weight (LMW) heparin than warfarin, Pratz said.  LMW heparin was associated with a significant 42% decreased risk of death, whereas warfarin was associated with a nonsignificant 18% decreased risk.

As a result of their study, Pratz said, her institution has changed practice such that patients who potentially could be taken off anticoagulant medications are continued on the treatment.

The finding that anticoagulant use independently predicts OS in this group of patients is surprising given that the occurrence of venous thrombosis might be expected to negatively influence OS, the authors commented. “If validated, these data may provide the impetus to explore the antitumor potential of anticoagulants in prospective clinical trials,” they wrote.

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