Current evidence of rivaroxaban in cancer associated thrombosis

Patients with cancer have a high risk of developing cancer-associated thrombosis (CAT). Current guidelines suggest preferential use of low molecular weight heparins (LMWH) in CAT. The real-world data show that compliance with recommended LMWH therapy in cancer patients is low. Many patients discontinue injectable anticoagulants prematurely, in some cases even after a month, despite a high recurrence rate in this population. In recent years an increasing number of cancer patients are treated with direct oral anticoagulants, mainly rivaroxaban. Recent data confirming the safety and efficacy of rivaroxaban are starting to emerge and support the growing trend of using direct oral anticoagulants in cancer patients. If positive results of the recently completed SELECT-D trial are confirmed in the upcoming trials and registries of CALLISTO project, the guidelines for the treatment of CAT will have to be revised in favour of DOAC use in cancer-associated thrombosis.