Venous thromboembolism prevention in cancer patients: the search for common antecedents

Venous thromboembolism (VTE) is a well-recognized concomitant of cancer. Although treatment with warfarin is often difficult and tedious, the heparins, and particularly the low molecular weight heparins, have afforded improved care of the patient with cancer-associated VTE, but with increased cost and the need for self-injection. Development by the pharmaceutical industry of inhibitors of specific activated coagulation factors and P-selectin holds promise for improved control of thrombosis with reduced toxicity. Increasing understanding of the interplay between the coagulation mechanism and neoplasia has yielded clues to the upstream origins of both, which may lead to experimental intervention potentially capable of preventing both.