Ay C, Pabinger I, Cohen AT. Cancer-associated venous thromboembolism: Burden, mechanisms, and management. Thromb Haemost. 2017;117:219-230.
Carrier M, Abou-Nassar K, Mallick R, et al. Apixaban to prevent venous thromboembolism in patients with cancer. N Engl J Med. 2019;380:711-719.
COUMADIN® (warfarin) [prescribing information]. Princeton, NJ: Bristol-Myers Squibb Company; Approved 1954. Revised October 2011.
Farge D, Frere C, Connors JM, et al. 2019 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer. Lancet Oncol. 2019;20:e566-e581.
Key NS, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update. J Clin Oncol. 2019. doi: 10.1200/JCO.19.01461. [Epub ahead of print].
Khorana AA, Dalal MR, Lin J, Connolly GC. Health care costs associated with venous thromboembolism in selected high-risk ambulatory patients with solid tumors undergoing chemotherapy in the United States. Clinicoecon Outcomes Res. 2013;5:101-108.
Khorana AA, Dalal M, Lin J, Connolly GC. Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States. Cancer. 2013;119:648-55.
Khorana AA, Francis CW, Culakova E, Kuderer NM, Lyman GH. Thromboembolism is a leading cause of death in cancer patients receiving outpatient chemotherapy. J Thromb Haemost. 2007;5:632-634.
Khorana AA, Kuderer NM, Culakova E, Lyman GH, Francis CW. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111:4902-4907.
Khorana AA, Noble S, Lee AYY, et al. Role of direct oral anticoagulants in the treatment of cancer-associated venous thromboembolism: guidance from the SSC of the ISTH. J Thromb Haemost. 2018;16:1891-1894.
Khorana AA, Soff GA, Kakkar AK, et al. Rivaroxaban for thromboprophylaxis in high-risk ambulatory patients with cancer. N Engl J Med. 2019;380:720-728.
Khorana AA, McCrae KR, Milentijevic D, et al. Current practice patterns and patient persistence with anticoagulant treatments for cancer-associated thrombosis. Res Pract Thromb Haemost. 2017;1:14–22.
Konstantinides SV, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS). Eur Heart J. 2019 00:1-16.
Lee AYY. Evidence-based medicine for thromboprophylaxis in hospitalized patients with cancer: why aren't we there yet? J Clin Oncol. 2014;32:1754-1756. doi:10.1200/JCO.2014.55.4980
Lustig DB, Rodriguez R, Wells PS. Implementation and validation of a risk stratification method at The Ottawa Hospital to guide thromboprophylaxis in ambulatory cancer patients at intermediate-high risk for venous thrombosis. Thromb Res. 2015;136:1099-1102.
Navi BB, Reiner AS, Kamel H et al. Risk of arterial thromboembolism in patients with cancer. J Am Coll Cardiol. 2017;70:926-938.
Raskob GE, van Es N, Verhamme P, et al. Edoxaban for the treatment of cancer-associated venous thromboembolism. N Engl J Med. 2018;378:615-624.

CME / CE

VTE and Cancer: How to Talk to Your Patient

Authors: Alok A. Khorana, MD; Michael B. Streiff, MD
CME / CE Released: 12/22/2019
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 12/22/2020, 11:59 PM EST

Target Audience and Goal Statement

This activity is intended for cardiologists, hematologists/oncologists, primary care physicians, nurses and pharmacists.

The goal of this activity is to provide strategies to effectively communicate the need for reducing thrombosis risk in patients with cancer.

Upon completion of this activity, participants will:

Have greater competence related to
- Application of latest evidence and recommendations into management of VTE in patients with cancer

Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

As a provider accredited by the ACCME, The University of Chicago Pritzker School of Medicine asks everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. This includes any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME defines “relevant financial relationships” as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner that could create a conflict of interest. Mechanisms are in place to identify and resolve any potential conflict of interest prior to the start of the activity. Additionally, The University of Chicago Pritzker School of Medicine requires Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration at first mention and where appropriate in the content.

Faculty

Alok A. Khorana, MD

Professor of Medicine
Cleveland Clinic Lerner College of Medicine
Cleveland, Ohio

Disclosures

Disclosure: Alok. A Khorana, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AngioDynamics; Bayer HealthCare; Halozyme Therapeutics; Janssen Pharmaceuticals; Pfizer Inc.; Seattle Genetics, Inc.
Received grants for clinical research from: Amgen Inc.

Michael B. Streiff, MD

Professor of Medicine and Pathology
Division of Hematology
Johns Hopkins University School of Medicine
Baltimore, Maryland
Participation by Dr Streiff does not constitute or imply endorsement by the Johns Hopkins University or the Johns Hopkins Hospital and Health System.

Disclosures

Disclosure: Michael B. Streiff, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Bayer HealthCare; Janssen Pharmaceuticals; Pfizer Inc.
Served as a speaker or a member of a speakers bureau for: Bayer HealthCare; Portola Pharmaceuticals, Inc.
Received grants for clinical research from: Janssen Pharmaceuticals; Novo Nordisk; Sanofi
Owns stock, stock options, or bonds from: Novo Nordisk

Steering Committee

Deepak L. Bhatt, MD, MPH

Professor of Medicine
Harvard Medical School
Executive Director of Interventional Cardiovascular Programs
Brigham and Women's Hospital Heart and Vascular Center
Boston, Massachusetts

Disclosures

Disclosure: Deepak L. Bhatt, MD, MPH, has disclosed the following relevant financial relationships:
Received grants for clinical research from: Abbott Laboratories; Amarin Corporation plc; Amgen Inc.; AstraZeneca Pharmaceuticals LP; Bayer HealthCare; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Chiesi Pharmaceuticals, Inc.; Eisai Inc.; Ethicon, Inc.; Idorsia Pharmaceuticals Ltd.; Ironwood Pharmaceuticals, Inc.; Ischemix, Inc.; Lilly USA, LLC; Medtronic, Inc.; PhaseBio Pharmaceuticals, Inc.; Pfizer Inc.; Regeneron Pharmaceuticals, Inc.; Roche; Sanofi; Synaptic; The Medicines Company

Marc P. Bonaca, MD, MPH

Associate Professor of Cardiology
Director of Vascular Research
University of Colorado School of Medicine
Executive Director
The CPC
Aurora, Colorado

Disclosures

Disclosure: Marc P. Bonaca, MD, MPH, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Amgen Inc.; AstraZeneca Pharmaceuticals LP; Bayer HealthCare; Janssen Pharmaceuticals; Merck & Co., Inc.; Novo Nordisk; Pfizer Inc.; Regeneron Pharmaceuticals, Inc.; Sanofi
Received grants for clinical research from: Amgen Inc.; AstraZeneca Pharmaceuticals LP; Bayer HealthCare; Merck & Co., Inc.; Novo Nordisk; Pfizer Inc. Sanofi

Anthony J. Comerota, MD

Medical Director
Eastern Region
Inova Heart and Vascular Institute
Falls Church, Virginia

Disclosures

Disclosure: Anthony J. Comerota, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Janssen Pharmaceuticals; Tactile Medical
Served as a speaker or a member of a speakers bureau for: Bristol-Myers Squibb Company; Pfizer Inc.

Alok A. Khorana, MD

Disclosures

As listed above

David Morrow, MD

Professor of Medicine
Harvard Medical School
Cardiovascular Medicine
Director
Levine Cardiac Intensive Care Unit
Boston, Massachusetts

Disclosures

Disclosure: David Morrow, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Bayer HealthCare; InCarda Therapeutics, Inc.; Roche
Received grants for clinical research from: Abbott Laboratories; Amgen Inc.; AstraZeneca Pharmaceuticals LP; Daiichi Sankyo, Inc.; Eisai Inc.; Merck & Co., Inc.; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Quark Pharmaceuticals, Inc.; Roche; Takeda Pharmaceuticals North America, Inc.; The Medicines Company; Zora Biosciences

Alex C. Spyropoulos, MD

Professor of Medicine
Donald and Barbara Zucker School of Medicine
Hofstra/Northwell Health
Manhasset, New York

Disclosures

Disclosure: Alex C. Spyropoulos, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Bayer HealthCare; Boehringer Ingelheim Pharmaceuticals, Inc.; Janssen Pharmaceuticals; Portola Pharmaceuticals, Inc.
Received grants for clinical research from: Boehringer Ingelheim Pharmaceuticals, Inc.; Janssen Pharmaceuticals

Editors

Caroline M. Padbury, BPharm

Senior Medical Education Director, Medscape, LLC

Disclosures

Disclosure: Caroline M. Padbury, BPharm, has disclosed no relevant financial relationships.

Asha P. Gupta, PharmD, RPh

Scientific Content Manager, Medscape, LLC

Disclosures

Disclosure: Asha P. Gupta, PharmD, RPh has disclosed no relevant financial relationships.

CE Reviewer / Nurse Planner

Hazel Dennison, DNP, RN, FNP, CPHQ, CNE

Associate Director, Accreditation and Compliance , Medscape, LLC

Disclosures

Disclosure: Hazel Dennison, DNP, RN, FNP, CPHQ, CNE, has disclosed no relevant financial relationships.

Course Reviewer

Matthew Sorrentino, MD, FACC, FAHA

Vice Chair for Clinical Operations
Department of Medicine
Section of Cardiology
University of Chicago Medicine

Disclosures

Disclosure: Matthew Sorrentino, MD, FACC FAHA, has disclosed no relevant financial relationships.
The University of Chicago CME staff have disclosed that they have no relevant financial relationships.

Accreditation Statements

Developed through a collaboration between the University of Chicago Medicine and Medscape Education

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From Medscape Education Cardiology

CME / CE

VTE and Cancer: How to Talk to Your Patient

Authors: Alok A. Khorana, MD; Michael B. Streiff, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / CE Released: 12/22/2019

Valid for credit through: 12/22/2020, 11:59 PM EST

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Disclaimer

The educational activity presented above may involve simulated, case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient, whether living or deceased, is intended or should be inferred. The material presented here does not necessarily reflect the views of Medscape, LLC, or any individuals or commercial entities that support companies that support educational programming on medscape.org. These materials may include discussion of therapeutic products that have not been approved by the US Food and Drug Administration, off-label uses of approved products, or data that were presented in abstract form. These data should be considered preliminary until published in a peer-reviewed journal. Readers should verify all information and data before treating patients or employing any therapies described in this or any educational activity. A qualified healthcare professional should be consulted before using any therapeutic product discussed herein.

References

Faculty and Disclosures

Faculty

Alok A. Khorana, MD

Michael B. Streiff, MD

Steering Committee

Deepak L. Bhatt, MD, MPH

Marc P. Bonaca, MD, MPH

Anthony J. Comerota, MD

Alok A. Khorana, MD

David Morrow, MD

Alex C. Spyropoulos, MD

Editors

Caroline M. Padbury, BPharm

Asha P. Gupta, PharmD, RPh

CE Reviewer / Nurse Planner

Hazel Dennison, DNP, RN, FNP, CPHQ, CNE

Course Reviewer

Matthew Sorrentino, MD, FACC, FAHA

CME / CE

VTE and Cancer: How to Talk to Your Patient

Target Audience and Goal Statement

Disclosures

Faculty

Alok A. Khorana, MD

Michael B. Streiff, MD

Steering Committee

Deepak L. Bhatt, MD, MPH

Marc P. Bonaca, MD, MPH

Anthony J. Comerota, MD

Alok A. Khorana, MD

David Morrow, MD

Alex C. Spyropoulos, MD

Editors

Caroline M. Padbury, BPharm

Asha P. Gupta, PharmD, RPh

CE Reviewer / Nurse Planner

Hazel Dennison, DNP, RN, FNP, CPHQ, CNE

Course Reviewer

Matthew Sorrentino, MD, FACC, FAHA

Accreditation Statements

For Physicians

For Nurses

For Pharmacists

Instructions for Participation and Credit

VTE and Cancer: How to Talk to Your Patient