Editorial: Routine Heparin for Patients with Cancer? One Answer, More Questions — NEJM

Editorial

Routine Heparin for Patients with Cancer? One Answer, More Questions

N Engl J Med 2012; 366:661-662February 16, 2012

This article has no abstract; the first 100 words appear below. (requires subscription $$$)

The antithrombotic effect of heparins is established, and it is speculated that a direct antitumor effect of heparin might translate into a survival benefit in patients with cancer.

This antitumor activity of heparins mechanistically includes the inhibition of cell–cell interaction by blocking cell-adhesion molecules (selectins), the inhibition of extracellular-matrix protease heparanase, and the inhibition of angiogenesis.¹

Should heparin, thus, be offered to patients with cancer who have no standard indication for anticoagulation therapy?

A large, randomized clinical trial addressing this question is reported by Agnelli and colleagues in this issue of the Journal.² The SAVE-ONCO study (ClinicalTrials.gov number, NCT00694382) . . .

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

Source Information

From the Department of Medicine, State University of New York at Buffalo, Buffalo (E.A.A.); and the Departments of Clinical Epidemiology and Biostatistics (E.A.A., H.J.S.) and Medicine (H.J.S.), McMaster University, Hamilton, ON, Canada.