ASH Clinical News August 2015_updated | Page 53

FEATURE recurrence, the practical approach is to simply switch to a less burdensome treatment after the initial six months of LMWH. Again, we don’t have a definitive answer as to what that treatment should be – whether it is warfarin or one of the direct oral agents – at this juncture, but simply switching to some lessburdensome treatment for the patient would be beneficial. The patient also needs to be aware and vigilant for signs and symptoms of recurrent thrombosis. If a recurrent thrombosis occurs, the threshold to initiate LMWH would certainly be lower. The one aspect we can’t ignore in this decision is the financial and lifestyle burden of injectable LMWH therapy. Both are substantial. Without clear-cut proof that extending LMWH therapy is better than switching to an oral agent – say, warfarin or one of the direct oral anticoagulants – after six months, it is hard to make the argument to a patient who is weary of injecting a needle into his or her abdomen every day that he or she needs to continue to do that. Dr. Lee: Yes, no one likes injections and they are expensive. Personally, when I see patients at that six-month time point, I have a frank conversation with them about their treatment options. I tell them: “We have no evidence to tell us which agent to use at this point. The decision is up to you and how you feel about continuing injections or switching to something else.” That’s the point when I review the available evidence with them. Surprisingly, many patients choose to remain on LMWH, even if I give them the option to switch. If the alternative is warfarin, many would rather not have to go to a lab for more blood work or have to closely monitor their diet and drug interactions. From a quality-of-life and convenience standpoint, some patients do prefer to just get their daily injection over with and go about their daily activities – without having to constantly worry about going to the lab, what to eat or drink, when their doctor will call with more dosing instructions. Patient preference is definitely very important – especially with the lack of data to guide treatment decisions. So, I strongly support whatever the patient decides. A higher-risk patient – for instance, a patient with metastatic pancreatic cancer or a patient with progressive tumors unresponsive to chemotherapy – needs no convincing to stick with the LMWH injections. Usually, his or her life is complicated enough without having to get accustomed to a new treatment regimen and more blood tests. I tell my patients to think about it this way: “I cannot tell you what risk you want to bear, but it is my job to tell you about the risks. As long as you are aware that you might have another clot if you switch to oral therapy and you accept that as a potential consequence, then I support your decision.” Dr. Garcia: Now, we actually do have quite a bit of evidence showing that LMWH is superior to warfarin, but it has not been compared head-to-head with a direct oral agent. So, while it’s reasonable to consider patient preference after six months of therapy, you would need to be sure that the patient understood that using LMWH injections (rather than any other anticoagulant) for the first six months is the preferred, strong recommendation. Dr. Lee: Unfortunately, though, the guideline panels don’t ask patients for their opinions. There has always been an assumption that people would prefer an ASHClinicalNews.org oral therapy over an injectable therapy, but there are actually good data about the effect on quality of life to show that cancer patients actually do not mind injections – especially when weighed against the downsides of warfarin therapy.6 In my experience, many patients are hesitant to use one of the newer direct oral anticoagulants when I present the evidence to them. They are concerned about the lack of comparative data. Subgroup analyses from the large, registration trials have shown some promising evidence against warfarin in highlyselected cancer patients, but it is premature to use these agents in most patients with cancer-associated thrombosis. There are now ongoing trials comparing direct oral anticoagulants with LMWH, but it will be several years before we have the results. Many of my patients have said, “I don’t want to take the risk of dying from a blood clot. I have accepted that I am struggling with my cancer and I might die from that. I’ve lost my hair, I am nauseated, I look like hell, but I put up with all that because I want the best therapy for my cancer. If I have to inject myself once a day to avoid having another clot, that is not such a big deal in the whole scheme of things.” We should never assume we know what our patients’ preferences are. “We can all agree that – even in the absence of a clinical trial – anticoagulation would be the choice over no anticoagulation at the six-month point. The million-dollar question is, though, after those six months, how should we treat these patients?” —AGNES Y. LEE, MD Dr. Garcia: That’s a great point. But what about one exception: the patient who has a thrombosis in the setting of an imminently curable malignancy? For instance, diffuse large B-cell lymphoma in a relatively youn