Abstract
Background The noninterventional XALIA study compared rivaroxaban with standard anticoagulation
for deep vein thrombosis treatment. This substudy describes the demographics, clinical
characteristics, and outcomes of the patients with cancer.
Methods Therapy type, dose, and duration were at the physician's discretion. The cohorts
identified were rivaroxaban (rivaroxaban alone or after heparin or fondaparinux for
≤48 hours); early switchers (rivaroxaban after heparin or fondaparinux for >48 hours
to 14 days and/or a vitamin K antagonist [VKA] for 1–14 days); standard anticoagulation
(heparin or fondaparinux and a VKA); low-molecular-weight heparin (LMWH) alone; and
miscellaneous (other heparins, fondaparinux alone, VKA alone). Primary outcomes were
major bleeding, recurrent venous thromboembolism, and all-cause mortality.
Results In XALIA, 587 patients (11.4% of the XALIA cohort) were with cancer: 146 (24.9%)
rivaroxaban, 30 (5.1%) early switchers, 141 (24.0%) standard anticoagulation, 223
(38.0%) LMWH, and 47 (8.0%) miscellaneous. Patients with gastrointestinal or lung
cancer more commonly received LMWH than rivaroxaban; the opposite occurred in patients
with breast or genitourinary cancer. Rates of primary outcome in the rivaroxaban group
were as follows: major bleeding, 1.4% (n = 2); recurrent venous thromboembolism, 3.4% (n = 5); and all-cause mortality, 4.8% (n = 7).
Conclusion In XALIA, physicians treated cancer-associated thrombosis with various anticoagulant
regimens, most commonly LMWH. In addition, the choice of anticoagulant varied with
cancer type. In rivaroxaban-treated patients, rates for the primary outcomes were
low, suggesting that patients administered rivaroxaban were a good prognosis group.
Keywords
cancer-associated thrombosis - low-molecular-weight heparin - rivaroxaban - routine
clinical practice - venous thromboembolism
