Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists
PurposeThis study investigates current practices and challenges in managing cancer-associated thrombosis (CAT) among Italian oncologists, with the objective of evaluating adherence to guidelines for primary thromboprophylaxis, treatment approaches, and safety considerations. Additionally, it aims to...
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Frontiers Media S.A.
2025-08-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1579464/full |
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| author | Andrea Antonuzzo Paola Ermacora Gaetano Lanzetta Maurizio Lucchesi Marco Platania Paolo Bossi Paolo Bossi |
| author_facet | Andrea Antonuzzo Paola Ermacora Gaetano Lanzetta Maurizio Lucchesi Marco Platania Paolo Bossi Paolo Bossi |
| author_sort | Andrea Antonuzzo |
| collection | DOAJ |
| description | PurposeThis study investigates current practices and challenges in managing cancer-associated thrombosis (CAT) among Italian oncologists, with the objective of evaluating adherence to guidelines for primary thromboprophylaxis, treatment approaches, and safety considerations. Additionally, it aims to identify areas for potential improvement in clinical decision-making and standardization of CAT management.MethodsA cross-sectional survey was conducted between February and June 2024 among Italian oncologists, facilitated by the Italian Network for Supportive Care in Oncology (NICSO). The online survey comprised 16 multiple-choice questions that addressed primary thromboprophylaxis practices, thrombosis treatment, and anticoagulation safety concerns.ResultsA total of 75 oncologists, evenly distributed across the Italian territory, participated in the survey. Among them, 48% consistently administered primary thromboprophylaxis, with a higher prevalence observed in cases of pancreatic (64%) and lung cancers (12%). Overall, 61% utilized risk assessment models (RAMs), mainly the Khorana score. Drug preference varied, with 89% favoring low-molecular-weight heparin (LMWH) for thromboprophylaxis. For established thrombosis, 72% preferred LMWH, administering treatment to 52% of patients for 3 to 6 months. Awareness of drug-drug interactions was high (93%), and 83% expressed concerns about bleeding risks, with renal impairment identified as a significant comorbidity.ConclusionThe survey highlights variability in CAT management, with limited use of RAMs and personalized treatment plans. These findings underscore the need for enhanced clinician education and standardized guidelines to optimize CAT management, including strategies to address bleeding risk and improve the safety of anticoagulation therapy. |
| format | Article |
| id | doaj-art-c05a5aaa79cd4f2eb2e474e290e4d40d |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj-art-c05a5aaa79cd4f2eb2e474e290e4d40d2025-08-20T03:39:29ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.15794641579464Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologistsAndrea Antonuzzo0Paola Ermacora1Gaetano Lanzetta2Maurizio Lucchesi3Marco Platania4Paolo Bossi5Paolo Bossi6Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, ItalyOncology department, Presidio Ospedaliero S. Maria della Misericordia di Udine, Udine, ItalyMedical Oncology Unit , Italian Neuro-Traumatology Institute, Grottaferrata, ItalyU.O. Oncologia Medica delle Apuane, Azienda USL Toscana Nord Ovest, Pisa, ItalyMedical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Milan, ItalyIRCCS Humanitas Research Hospital, Milan, ItalyPurposeThis study investigates current practices and challenges in managing cancer-associated thrombosis (CAT) among Italian oncologists, with the objective of evaluating adherence to guidelines for primary thromboprophylaxis, treatment approaches, and safety considerations. Additionally, it aims to identify areas for potential improvement in clinical decision-making and standardization of CAT management.MethodsA cross-sectional survey was conducted between February and June 2024 among Italian oncologists, facilitated by the Italian Network for Supportive Care in Oncology (NICSO). The online survey comprised 16 multiple-choice questions that addressed primary thromboprophylaxis practices, thrombosis treatment, and anticoagulation safety concerns.ResultsA total of 75 oncologists, evenly distributed across the Italian territory, participated in the survey. Among them, 48% consistently administered primary thromboprophylaxis, with a higher prevalence observed in cases of pancreatic (64%) and lung cancers (12%). Overall, 61% utilized risk assessment models (RAMs), mainly the Khorana score. Drug preference varied, with 89% favoring low-molecular-weight heparin (LMWH) for thromboprophylaxis. For established thrombosis, 72% preferred LMWH, administering treatment to 52% of patients for 3 to 6 months. Awareness of drug-drug interactions was high (93%), and 83% expressed concerns about bleeding risks, with renal impairment identified as a significant comorbidity.ConclusionThe survey highlights variability in CAT management, with limited use of RAMs and personalized treatment plans. These findings underscore the need for enhanced clinician education and standardized guidelines to optimize CAT management, including strategies to address bleeding risk and improve the safety of anticoagulation therapy.https://www.frontiersin.org/articles/10.3389/fonc.2025.1579464/fullcancer-associated thrombosisvenous thromboembolismthromboprophylaxis in oncologydirect oral anticoagulantsthrombosis management |
| spellingShingle | Andrea Antonuzzo Paola Ermacora Gaetano Lanzetta Maurizio Lucchesi Marco Platania Paolo Bossi Paolo Bossi Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists Frontiers in Oncology cancer-associated thrombosis venous thromboembolism thromboprophylaxis in oncology direct oral anticoagulants thrombosis management |
| title | Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists |
| title_full | Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists |
| title_fullStr | Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists |
| title_full_unstemmed | Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists |
| title_short | Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists |
| title_sort | current practices and challenges in the management of cancer associated thrombosis a survey of italian oncologists |
| topic | cancer-associated thrombosis venous thromboembolism thromboprophylaxis in oncology direct oral anticoagulants thrombosis management |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1579464/full |
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