Journal of Modern OncologyJournal of Modern Oncology1815-14341815-1442LLC Obyedinennaya Redaktsiya3353310.26442/18151434.2019.1.190247Research ArticleTreatment of cancer-related thrombosis: from recommendations to real clinical practiceSomonovaOksana VMD, Ph.D., Leading Researchersomonova@mail.ruElizarovaAnna LCand. Sci. (Biol.), Senior Researcher-BlindarValentina NPh.D biology, Leading Researcher-DobrovolskayaMarina BCand. Sci. (Biol.), Researcher-NesterovaYulia AResearch Assistant-BorisenkoNatalia NResearcher-KornyushenkoUstin AResearch Assistant-DavidovaTatiana VHead of Clinical Laboratory Diagnostics-N.N.Blokhin National Medical Research Center of Oncology of the Ministry of Health of the Russian Federation15032019211606516042020Copyright © 2019, Consilium Medicum2019Aim. To highlight the modern treatment and secondary prevention of recurrent thrombotic complications in patients with cancer. Materials and methods. We studied 40 scientific sources published in the Russian and foreign press in the period of 1997 to 2018. Results. Oncology patients are at higher risk of thrombotic complications which can worse outcomes of antitumor treatment and occupy one of the leading places among causes of death. Low molecular weight heparins (LMWHs) are the drugs of first choice for the treatment of cancer-associated thrombosis. Taking into account the complexity of LMWH application, many patients stop receiving the recommended therapy and are switching to oral anticoagulants. For instance, according to the GARFIELD-AF prospective registry direct oral anticoagulants (DOACs) are used in 25% of cancer patients. The most promising drug in this group is rivaroxaban (Xarelto). Multiple studies are currently undergoing in the framework of CALLISTO Program, designed to study various issues of managing patients with cancer-associated thrombosis: primary and secondary prevention of thrombosis using rivaroxaban, to study quality of life and the treatment adherence. In the Mayo Clinic Thrombophilia database retrospective study was demonstrated comparable efficacy of rivaroxaban and LMWH and in the studies US claims analysis and US Humana database were noted the reduction of recurrences of thromboembolic complications on using rivaroxaban treatment in comparison with LMWH on the same frequency of severe bleeding. In subanalysis of the prospective XALIA study was showed a favorable profile of efficacy and safety of rivaroxaban therapy in cancer patients, so the results proved the results of real practice. Conclusion. In 2018 the results of submitted studies helped several international societies, such as International Society on Thrombosis and Hemostasis and The National Comprehensive Cancer Network, to recommend rivaroxaban as one of the treatment options for patients with cancer-associated thrombosis with low risk of bleeding and no drug-drug interactions with current systemic therapy. Rivaroxaban can be considered as an alternative to low molecular weightoncological patientsthrombotic complicationslow molecular weight heparinsdirect oral anticoagulantsонкологические больныетромботические осложнениянизкомолекулярные гепариныпрямые оральные антикоагулянты[Agnelli G, Verso M. Management of venous thromboembolism in patients with cancer. J Thromb Haemost 2011; 9 (Suppl. 1): 316-24. DOI: 10.1111/j.1538-7836.2011.04346.x][Barsam S.J, Patel R, Arya. Anticoagulation for prevention and treatment of cancer-related venous thromboembolism. Br J Haematol 2013; 161 (Iss. 6): 764-77. 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