Spots Global Cancer Trial Database for Optimal Duration of Anticoagulation Therapy for Low-risk Pulmonary Embolism Patients With Cancer

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Trial Identification

Brief Title: Optimal Duration of Anticoagulation Therapy for Low-risk Pulmonary Embolism Patients With Cancer

Official Title: Optimal Duration of Anticoagulation Therapy for Low-risk Pulmonary Embolism Patients With Cancer

Study ID: NCT04724460

Conditions

Venous Thrombosis

Neoplasms

Anticoagulants

Interventions

Long DOAC

Short DOAC

Study Description

Brief Summary: The primary purpose of this study is to determine the optimal duration of anticoagulation therapy (6 months versus 18 months) with direct oral anticoagulant (DOAC) for cancer-associated low-risk pulmonary embolism patients. The major secondary purpose of this study is to investigate whether home treatment of cancer-associated low-risk pulmonary embolism patients with rivaroxaban is feasible, effective, and safe through an observational management study.

Detailed Description: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a major health problem in the world. There have been many clinical studies evaluating VTE, although data on low-risk PE, including incidental PE and asymptomatic PE has been quite limited. However, low-risk PE was reported to account for a large proportion of all the diagnoses of PE detected on computed tomography in daily clinical practice, and optimal management strategies for these patients are becoming clinically more relevant. The current American College of Chest Physicians (ACCP) guidelines weakly suggest the same approach for low-risk PE patients with cancer as other PE patients with cancer. However, whether anticoagulation therapy should be continued indefinitely remains uncertain and the duration of treatment in these patients might vary widely in daily clinical practice. Recently, some observational studies reported that low-risk patients with cancer have a high risk of VTE recurrence, suggesting the benefit of prolonged anticoagulation therapy. In this open-label, superiority trial, the investigators randomly assign low-risk PE patients with active cancer to receive either rivaroxaban for 6 months (short DOAC group) or rivaroxaban for 18 months (long DOAC group).