REVIEW   Free

Minerva Medica 2019 June;110(3):251-8

DOI: 10.23736/S0026-4806.19.06026-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Treatment of venous thromboembolism with tinzaparin in oncological patients

Walter AGENO ¹ ✉, Sandro BARNI ², Marcello DI NISIO ³, Anna FALANGA ⁴, Davide IMBERTI ⁵, Roberto F. LABIANCA ⁶, Lorenzo MANTOVANI ⁷

¹ Department of Medicine and Surgery, University of Insubria, Varese, Italy; ² Department of Oncology, ASST Bergamo Ovest, Treviglio Hospital, Treviglio, Bergamo, Italy; ³ Department of Medicine and Ageing Sciences, G. D’Annunzio University of Chieti-Pescara, Chieti, Italy; ⁴ Department of Immunohematology and Transfusion Medicine, Papa Giovanni XXIII Hospital, Bergamo, Italy; ⁵ Service of Internal Medicine, Thrombosis and Hemostasis Center, Piacenza Civil Hospital, Piacenza, Italy; ⁶ Center of Oncology, Papa Giovanni XXIII Hospital, Bergamo, Italy; ⁷ University of Milano-Bicocca, Milan, Italy

Venous thromboembolism (VTE) is a major cause of morbidity and mortality in patients with cancer. For over a decade, the gold standard of treatment and secondary prevention of cancer-associated thrombosis (CAT) has been represented by low-molecular-weight heparins (LMWHs), which are currently recommended as the first-line treatment for CAT. Among the LMWHs that were more extensively tested in patients with CAT, tinzaparin is a LMWH produced by the enzymatic degradation of porcine-derived unfractionated heparin. The efficacy of tinzaparin in this setting is supported by well-grounded evidence. However, there is a need to discuss the positioning of tinzaparin in the continuously evolving treatment scenario of VTE therapy in cancer patients. In this paper, which was developed by a group of clinicians with wide experience in the treatment of VTE in cancer patients, we discuss the current therapeutic options and the role of tinzaparin for the treatment of CAT.

KEY WORDS: Neoplasms - Venous thromboembolism - Venous thrombosis - Low-molecular-weight heparin - Tinzaparin