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Reducing the Global Burden of Cancer-Associated VTE: Applying
Guideline-Concordant, Evidence-Based Care and Shared Decision-Making Strategies
to Improve Patient Outcomes

Co-Chair
Alok A. Khorana, MD, FACP, FASCO
Taussig Cancer Institute
Cleveland Clinic Lerner School of Medicine, Case Western Reserve University
Cleveland, Ohio
Co-Chair
Robert D. McBane, II, MD
Mayo Clinic Gonda Vascular Center
Rochester, Minnesota
Presenter
Dana Angelini, MD
Taussig Cancer Institute
Cleveland Clinic Lerner College of Medicine, Case Western Reserve University
Cleveland, Ohio
Chapter ContentActivity Chapters

Please complete and tap Submit at the end to continue.

Question 1/5
Which of the following risk factors would you consider for predicting the risk
of cancer-associated VTE based on the Khorana Risk Score?
   
   
 * Type of cancer, D-dimer, and soluble P-selectin
   
   
   
 * Type of cancer, blood counts, and body mass index
   
   
   
 * Blood counts, D-dimer, and soluble P-selectin
   
   
   
 * Cancer type and genetic mutation profile
   
   
   
 * I’m not sure
   
   

Question 2/5
According to current guidelines, in which of these patients might
thromboprophylaxis be considered due to an increased risk of VTE?
   
   
 * Ambulatory patient with multiple myeloma receiving lenalidomide
   
   
   
 * Ambulatory patient with multiple myeloma receiving bortezomib
   
   
   
 * Ambulatory patient with locally advanced prostate cancer receiving docetaxel
   
   
   
 * Ambulatory patient with locally advanced prostate cancer receiving
   abiraterone acetate
   
   
   
 * I’m not sure
   
   

Question 3/5
Which of the following statements best summarizes data from an international
two-center retrospective cohort study evaluating the incidence of ICH in
patients with brain metastases receiving either DOACs or LMWH?
   
   
 * The cumulative incidence of major ICH was higher in patients receiving DOACs
   
   
   
 * Safety was comparable for patients receiving LMWH and patients receiving
   DOACs
   
   
   
 * Both DOACs and LMWH had lower efficacy than other anticoagulants used in this
   setting
   
   
   
 * LMWH had a better safety–efficacy profile
   
   
   
 * I’m not sure
   
   

Question 4/5
Your patient, David—a 72-year-old man with stage III pancreatic cancer—develops
an acute symptomatic VTE while on FOLFIRINOX therapy. He has a port in place and
has a hemoglobin of 9 mg/dL and ECOG PS of 0. Which anticoagulant would you
recommend for David based on the current evidence and updated guidelines?
   
   
 * Unfractionated heparin
   
   
   
 * LMWH
   
   
   
 * DOAC (apixaban or rivaroxaban)
   
   
   
 * Warfarin
   
   
   
 * I’m not sure
   
   

Question 5/5
You are managing a 65-year-old patient, Matthew, who was recently diagnosed with
gastric cancer (unresectable stage IV) and was referred to your care team to
initiate thromboprophylaxis for prevention of cancer-associated VTE. Which of
the following anticoagulant therapies would you recommend for Matthew based on
the current evidence and updated guidelines? Assume he has a hemoglobin of 8
mg/dL and ECOG PS of 1.
   
   
 * Baby aspirin
   
   
   
 * Unfractionated heparin
   
   
   
 * Apixaban
   
   
   
 * Warfarin
   
   
   
 * I’m not sure
   
   

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ACTIVITY CHAPTERS

PRE-TEST


Management of Acute VTE in Patients With Cancer: Assessing the Global
Burden, Guideline Recommendations, and Latest Evidence on DOACs

CANCER-ASSOCIATED VTE: DISEASE BURDEN AND ETIOPATHOGENESIS - 5:54



MANAGEMENT OF ACUTE VTE IN PATIENTS WITH CANCER - 3:46



LATEST EVIDENCE ON DOACS FOR MANAGING ACUTE VTE - 2:53



CLINICAL PRACTICE GUIDELINES, ONGOING STUDIES, AND CONCLUSION - 1:48


Risk Stratification and Primary Prevention of Cancer-Associated VTE: Integrating
DOACs Into Clinical Practice for Improved Patient Outcomes

RISK STRATIFICATION AND APPLICATION OF KHORANA RISK SCORE IN CANCER-ASSOCIATED
VTE - 6:43



LATEST CLINICAL EVIDENCE ON PRIMARY PREVENTION - 2:57



CLINICAL PRACTICE GUIDELINES FOR THROMBOPROPHYLAXIS - 1:33



IMPLEMENTING THROMBOPROPHYLAXIS IN YOUR PRACTICE - 2:16


Bleeding-Related Risk Assessment in Patients With Cancer and VTE: Anticipating
and Combatting Bleeding Incidence Associated With Anticoagulants

BLEEDING-RELATED RISK ASSESSMENT IN PATIENTS WITH CANCER-ASSOCIATED VTE - 9:46



KEY TAKEAWAYS, CONCLUSION, AND AUDIENCE Q&A - 8:03



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