ASH Clinical News ACN_5.1_Digital - Page 25

CLINICAL NEWS On Location American Society of Hematology’s 2018 ANNUAL MEETING & EXPOSITION he 2018 ASH Annual Meeting & Exposition featured practice- changing research from across the spectrum of hematologic malignancies and blood disorders. In this issue, ASH Clinical News is taking a look at the late-breaking abstracts presented at the meeting, including a new rapid screening tool for sickle cell disease, a safe strategy for interrupting direct oral anticoagulants for surgery, and a potential new standard combination for transplant- ineligible myeloma. Visit ashclinicalnews.org/on-location for our complete coverage of the meeting. ASH Clinical News also spoke with presenters and moderators about the groundbreaking research that was shared at the meeting. Watch all of the interviews at ashclinicalnews.org/multimedia. And look for more coverage in our special issue in mid-January, where we’ll take a deep dive into the 2018 ASH Annual Meeting. ASHClinicalNews.org Rivaroxaban Reduces Thrombotic Risk in Patients Undergoing Cancer Treatment Primary prevention with the direct oral anticoagulant (DOAC) rivaroxaban reduced venous thromboembolism (VTE) and VTE-related mortality in patients with cancer, according to results from the placebo-controlled, randomized CASSINI trial, which were presented as a late-breaking abstract at the 2018 ASH Annual Meeting. The benefit was seen without an increase in major or clinically relevant bleeding events, lead investiga- tor Alok A. Khorana, MD, from Cleveland Clinic in Ohio, noted. “In 2018, most of our cancer treatment takes place in the outpatient setting, so most of the clots occur in the outpatient setting,” Dr. Khorana explained. “From a public health perspective, that is important because most of our [previous] efforts at preventing blood clots have focused on the inpatient setting.” The CASSINI trial is the first to assess the use of DOACs – which can be taken as a daily pill at home – in patients who are actively receiving systemic chemotherapy. Investigators enrolled 1,080 adult ambulatory patients with various cancers who were initiating a new systemic regimen and who had an increased risk for VTE (defined as a score ≥2 on the Khorana scale, which assigns risk for VTE based on cancer type, hemoglobin level, and pre-chemotherapy platelet and leukocyte counts). Patients were screened for deep-vein thrombosis (DVT) prior to randomization. A total of 841 enrolled participants were randomized 1:1 to receive rivaroxaban 10 mg once daily or placebo for up to 180 days. During the study period, patients were screened with lower-extremity ultrasounds every eight weeks on study to test for symptomatic or asymptomatic lower-extremity proximal DVT. The primary efficacy endpoint was a composite of DVT, pulmonary embolism, and VTE-related death during the six-month observation period. As a sec- ondary, prespecified endpoint, the investigators reviewed thrombotic risk during the on- treatment period to account for patients with cancer who changed therapeutic regimens or stopped anticoagulation. ASH Clinical News 23