BRIEF RESEARCH REPORT article
Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1579464
This article is part of the Research TopicUpdates on the Management of Hematologic Malignancies from SOHO Italy: Educational Insights and Clinical PerspectivesView all 7 articles
Current practices and challenges in the management of cancer-associated thrombosis: a survey of Italian oncologists
Provisionally accepted
- 1Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Lombardy, Italy
- 2Ospedale Santa Maria della Misericordia di Udine, Udine, Italy
- 3Italian Neuro-Traumatology Institute, Grottaferrata, Italy
- 4Azienda USL Toscana Nord Ovest, Pisa, Tuscany, Italy
- 5Humanitas Research Hospital, Rozzano, Lombardy, Italy
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Purpose: This 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. Methods: A 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. Results: A 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. Conclusion: The 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.
Keywords: Cancer-associated thrombosis, Venous Thromboembolism, thromboprophylaxis in oncology, direct oral anticoagulants, thrombosis management
Received: 19 Feb 2025; Accepted: 14 Jul 2025.
Copyright: © 2025 Antonuzzo, Ermacora, Lanzetta, Lucchesi, Platania and Bossi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Andrea Antonuzzo, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Lombardy, Italy
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.