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ASCO 2026 | DOACs versus LMWH in patients with liver metastases & cancer-associated thrombosis
Jowan Al-Nusair, MD, Marshall University, Huntington, WV, discusses the findings of a retrospective multi-center real-world analysis comparing direct oral anticoagulants (DOACs) with low-molecular-weight heparin (LMWH) in patients with liver metastases and cancer-associated thrombosis. Dr Al-Nusair notes that DOACs may be favored over LMWH in this population, although anticoagulation should be individualized based on each patient’s bleeding risk and cancer burden. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.
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Transcript
I also had the opportunity to present a poster today basically comparing DOAC versus low molecular weight heparin in a very special population. So we’re talking about patients with liver metastasis who developed cancer-associated thrombosis. This was a retrospective propensity matched cohort study. And we basically followed these patients for one year looking at different outcomes, including all-cause mortality, ICU admission, GI bleeding, and thrombotic recurrence...
I also had the opportunity to present a poster today basically comparing DOAC versus low molecular weight heparin in a very special population. So we’re talking about patients with liver metastasis who developed cancer-associated thrombosis. This was a retrospective propensity matched cohort study. And we basically followed these patients for one year looking at different outcomes, including all-cause mortality, ICU admission, GI bleeding, and thrombotic recurrence. Interestingly, our DOAC patients, they did have improved overall survival over one year. And the bleeding risk was trade-off, you could say, was small. And I do think that our results do favor DOAC in comparison with low molecular weight heparin. We could have been confounded by different factors like tumor burden, performance status, and prognosis or hospice referral. But in general, I think that anticoagulation should definitely be, you know, individualized based on every patient’s like bleeding risk and cancer burden.
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