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Anticoagulant use predicted survival in metastatic castration-resistant prostate cancer
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The use of any anticoagulant was associated with improvements in OS in a cohort of men with metastatic castration-resistant prostate cancer, according to findings presented at the 2013 Genitourinary Cancers Symposium.
The aim of the retrospective analysis was to determine the effect of therapeutic anticoagulation on OS in a cohort of 247 patients, all of whom had been assigned first-line chemotherapy with docetaxel.
The researchers analyzed data on anticoagulant use, type of anticoagulant administered, indication for anticoagulation and duration of anticoagulation.
The overall rate of anticoagulation use was 11.7% (n=29). Seventeen of those patients were treated with low–molecular-weight heparin, and 12 received warfarin.
Fifteen patients were treated for deep vein thrombosis, nine were treated for pulmonary embolism and five were treated for both conditions.
Univariate results suggested a link between anticoagulant use and OS (any anticoagulant, HR=0.61; 95% CI 0.40-0.94). Low–molecular-weight heparin yielded an HR for OS of 0.58 (95% CI, 0.34-0.99), whereas the ratio for warfarin was 0.82 (95% CI, 0.55-1.28).
Researchers reported OS of 20.9 months among patients who used any anticoagulant vs. 17.1 months for patients who did not use anticoagulants.
Multivariate results indicated that anticoagulant use continued to predict survival after adjustments were made for other factors such as alkaline phosphatase, albumin and hemoglobin.
“This finding is surprising given that the occurrence of venous thrombosis might be expected to negatively influence OS,” the researchers concluded. “If validated, these data may provide the impetus to explore the antitumor potential of anticoagulants in prospective clinical trials.”
For more information:
Pratz CF. Abstract #28. Presented at: 2013 Genitourinary Cancers Symposium. Feb. 14-16, 2013; Orlando, Fla.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Mark K. Buyyounouski, MD
This study adds to the growing body of evidence that anticoagulants improve outcome following treatment for prostate cancer. These results are particularly compelling, given the advanced nature of the disease in the study population. The ideal method of anticoagulation, dose, timing and associated risks all need to be better defined and require further study. It is too early for men to begin taking anticoagulants with the hope of improving the treatment for prostate cancer. Validation of these results are needed. However, men requiring anticoagulation for other causes may also benefit in terms of controlling their prostate cancer.
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