New Drug of Choice for Treatment of Cancer-Associated Venous Thromboembolism (VTE)

It is well known that cancer patients are at a higher risk of developing blood clots. A new randomized clinical trial demonstrated that apixaban, a direct oral anticoagulant (DOAC), was as effective as dalteparin, a low molecular weight heparin given by injection, for the treatment of cancer-associated VTE, without increasing the risk of major bleeding. The study, named the Caravaggio Trial, enrolled 1,170 patients from 119 centers across Europe, the USA, and Israel.

The results were presented by Professor Giancarlo Agnelli at the American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC). The congress was held virtually on March 28-30, 2020. The study was published in the New England Journal of Medicine on March 29, 2020. 

The American Society of Clinical Oncology (ASCO) recently updated (August 2019) its Clinical Practice Guideline for Venous Thromboembolism Prophylaxis and Treatment in Patients with Cancer. Apixaban was included in the updated guideline published in the Journal of Clinical Oncology.  

Shorter MRIs More Effective than 3D Mammography, Study Indicates

Dr. Christopher Comstock

Dr Christopher Comstock. Photo by Ethan Kavet.

Anyone who has undergone a breast MRI knows that the procedure can be lengthy, expensive, and uncomfortable. A new study in JAMA from the ECOG-ACRIN Cancer Research Group, lead by MSK’s Dr. Christopher Comstock, indicates there may be an effective alternative.

Researchers from 48 institutions compared 10-minute breast MRI exams to 3D mammography in a multi-center study of nearly 1,500 women with dense breasts. The abbreviated MRI found invasive cancers in 17 women and non-invasive cancer in 5 women. 3D mammography found invasive cancers in 7 women and non-invasive cancer 2 women.

In an interview with NPR, Dr. Comstock said that an MRI that takes a third of the time as normal could cut down the cost significantly. But more research is needed before it becomes a standard practice.

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