Page 332 - Haematologica March 2020

C. Becattini et al.
should be considered that it has not been determined whether these events have different prognoses.50 Our analysis cannot answer the issue of the duration of anti- coagulant prophylaxis in cancer patients receiving chemotherapy. Thanks to new anticancer treatments, the life expectancy of patients with several types of cancer has increased dramatically. The duration of prophylaxis tested in the studies included in this meta-analysis ranged from a minimum of 4 weeks to a maximum of 6 months for studies having VTE as the primary outcome and to a maximum of 12 months in studies having death as the primary outcome. Whether longer-lasting prophy- laxis could be of benefit and maintain the same safety profile remains undefined. Finally, further data are
required on the efficacy and safety of anticoagulant pro- phylaxis in patients receiving newer anticancer therapies, such as immunotherapy or biologics.
Our study also has some strengths. This is a meta- analysis of randomized studies, with results consistent across different sensitivity analyses and no heterogeneity. Moreover, differently from previous meta-analyses, we limited our primary efficacy analysis to randomized clin- ical trials with VTE as the primary outcome. Even though high-quality trials with death as the primary outcome have been conducted in this setting, our choice was aimed at reducing heterogeneity related to the use of therapeutic regimens of anticoagulants, to the longer duration of anticoagulant treatment and to gaining a more
Figure 3. Efficacy of anticoagulant prophylaxis for the prevention of venous thromboembolism in ambulatory cancer patients receiving chemotherapy according to the primary site of cancer.
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haematologica | 2020; 105(3)