Anticoagulation in glioblastoma [Neurosurgery Wiki]

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====== Anticoagulation in glioblastoma ======

Le Rhun et al., from  University of Lille, France; Zurich, Brussels, Belgium. Lausanne, Switzerland.
CHU Timone, Marseille, France. University of Alabama at Birmingham, USA. Los Angeles, USA.
Dana-Farber Cancer Research Institute, Boston, USA. University Hospital Heidelberg and German Cancer Heidelberg, Germany assessed survival associations of [[anticoagulant]] use from baseline up to the start of [[temozolomide]] [[chemoradiotherapy]] (TMZ/RT) (period I) and from there to the start of maintenance TMZ chemotherapy (period II) by pooling data of three randomised clinical trials in newly diagnosed [[glioblastoma]] including 1273 patients. [[Progression free survival]] (PFS) and [[overall survival]] (OS) were compared between patients with anticoagulant use versus no use; therapeutic versus prophylactic versus no use; different durations of anticoagulant use versus no use; anticoagulant use versus use of anti-platelet agents versus neither anticoagulant nor anti-platelet agent use. Cox regression models were stratified by trial and adjusted for baseline prognostic factors.

Anticoagulant use was documented in 75 patients (5.9%) in period I and in 104 patients (10.2%) in period II. Anticoagulant use during period II, but not period I, was associated with inferior OS than no use on multivariate analysis (p = 0.001, hazard ratio [HR] = 1.52, 95% confidence interval [CI]: 1.18-1.95). No decrease in OS became apparent when only patients with prophylactic anticoagulant use were considered. No survival association was established for anti-platelet agent use.

Anticoagulant use was not associated with improved [[OS]]. Anticoagulants may not exert relevant anti-tumour properties in glioblastoma
((Le Rhun E, Genbrugge E, Stupp R, Chinot OL, Nabors LB, Cloughesy T, Reardon
DA, Wick W, Gorlia T, Weller M. Associations of anticoagulant use with outcome in
newly diagnosed glioblastoma. Eur J Cancer. 2018 Jul 20;101:95-104. doi:
10.1016/j.ejca.2018.06.029. [Epub ahead of print] PubMed PMID: 30036741.
)).