From the Guidelines
Phesgo can be administered to patients with a history of deep vein thrombosis (DVT) after adequate treatment and stabilization with anticoagulation therapy. When considering Phesgo treatment in patients with DVT, it is essential to weigh the benefits of the treatment against the potential risks, taking into account the patient's overall clinical condition and cancer treatment goals 1.
Key Considerations
- The patient's DVT should be adequately treated and stabilized, typically with anticoagulation therapy, before proceeding with Phesgo treatment.
- The treating oncologist should consult with the patient's hematologist or vascular specialist to ensure the DVT is properly managed.
- Patients with a history of DVT should be monitored closely for signs of recurrent thrombosis or progression during Phesgo treatment.
- Anticoagulation therapy may need to be continued throughout Phesgo treatment, with appropriate dose adjustments and monitoring of bleeding risk, as recommended by guidelines such as the NCCN guidelines for cancer-associated venous thromboembolic disease 1.
Management of DVT
- Selection of anticoagulation agents should be based on the clinical setting, cost, ease of administration, monitoring, bleeding risk assessment, and patient- and case-specific factors, as outlined in the NCCN guidelines 1.
- The NCCN guidelines provide a list of recommended regimens, including single-agent low-molecular-weight heparin (LMWH), edoxaban, and rivaroxaban, which are considered preferred regimens by many panel members 1.
From the Research
Administration of Phesgo after DVT
There is no direct evidence in the provided studies regarding the administration of Phesgo after Deep Vein Thrombosis (DVT).
Anticoagulation Therapy for DVT
- The standard therapy for DVT typically involves anticoagulation to prevent extension of thrombi, pulmonary embolism, recurrence of thrombi, and the development of complications such as pulmonary hypertension and post-thrombotic syndrome 2.
- Anticoagulant therapy is an essential part of therapy, with current guidelines clearly favouring regimens based on direct oral anticoagulants over the traditional sequential therapy of parenteral anticoagulants and vitamin K antagonists 3.
- Direct oral anticoagulants (DOACs) are the preferred treatment for DVT because they are at least as effective, safer, and more convenient than warfarin 4.
Considerations for Anticoagulation Therapy
- The choice of anticoagulant therapy should take into account the individual bleeding risk and patient's preferences 3.
- DOACs may require dose reduction or avoidance in patients with renal dysfunction, and should be avoided in pregnancy 4.
- Recent evidence shows that DVT in patients with cancer may be treated with edoxaban or rivaroxaban, but the risk of gastrointestinal bleeding is higher with DOACs than with low molecular weight heparin (LMWH) in patients with gastrointestinal cancer 4.