TAKADA Takuma    Department   Graduate School of Medical Science, Graduate School of Medical Science    Position
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Real-world management and outcomes of venous thromboembolism in patients with cancer and limited life expectancy in the direct oral anticoagulant era: insights from the COMMAND VTE Registry-2.
Journal	Formal name：Cardio-oncology (London, England) Abbreviation：Cardiooncology ISSN code：20573804/20573804
Domestic / Foregin	Foregin
Volume, Issue, Page	11(1),pp.117
Author and coauthor	Takahiro Kuno, Norimichi Koitabashi, Yugo Yamashita, Takeshi Morimoto, Yoshiaki Ohyama, Noriaki Takama, Masaru Obokata, Ryuki Chatani, Kazuhisa Kaneda, Yuji Nishimoto, Nobutaka Ikeda, Yohei Kobayashi, Satoshi Ikeda, Kitae Kim, Moriaki Inoko, Toru Takase, Shuhei Tsuji, Maki Oi, Takuma Takada, Kazunori Otsui, Jiro Sakamoto, Yoshito Ogihara, Takeshi Inoue, Shunsuke Usami, Po-Min Chen, Kiyonori Togi, Seiichi Hiramori, Kosuke Doi, Hiroshi Mabuchi, Yoshiaki Tsuyuki, Koichiro Murata, Kensuke Takabayashi, Hisato Nakai, Daisuke Sueta, Wataru Shioyama, Tomohiro Dohke, Ryusuke Nishikawa, Hideki Ishii, Takeshi Kimura,
Publication date	2025/12
Summary	BACKGROUND:Optimal management strategies for venous thromboembolism (VTE) in patients with cancer and limited life expectancy (LLE) could still be challenging in the current era of widespread use of direct oral anticoagulants (DOACs). Real-world treatment patterns and outcomes in patients with LLE were investigated using a nationwide registry in Japan.METHODS:The COMMAND VTE Registry-2 is a multicenter registry that enrolled 5,197 consecutive acute symptomatic VTE patients from 31 centers in Japan between January 2015 and August 2020. In this cohort, baseline characteristics, anticoagulation strategies, and long-term clinical outcomes were compared between cancer patients with and without LLE. The main outcomes were the one-year cumulative incidences of VTE recurrence, major bleeding, and all-cause death. Incidences of VTE recurrence and major bleeding were estimated using a competing risk analysis, with death as the competing event.RESULTS:The study population consisted of 222 cancer patients with LLE (14.7%) and 1,285 patients without LLE (85.3%). Patients with LLE were older (mean age 69.9 vs. 67.8 years, P = 0.03) and received oral anticoagulants less frequently (80.6% vs. 92.1%, P < 0.001) than patients without LLE. Accounting for the competing risk of death, the one-year cumulative incidence of major bleeding was not significantly different between the two groups (11.0% vs. 10.5%, Gray’s test P = 0.91), whereas the incidence of VTE recurrence showed a trend to be lower in the LLE group (2.9% vs. 4.3%; P = 0.059). The cumulative one-year incidence of all-cause death was higher in the LLE group (94.1% vs. 35.4%, P < 0.001).CONCLUSION:Cancer patients with LLE were less likely to receive oral anticoagulants. Patients with LLE had a significantly higher one-year mortality rate than those without LLE. Accounting for the competing risk of death, there were no significant differences in the cumulative incidence of VTE recurrence or major bleeding between the two groups.SUPPLEMENTARY INFORMATION:The online version contains supplementary material available at 10.1186/s40959-025-00431-5.
DOI	10.1186/s40959-025-00431-5
PMID	41430344