In September, Duke researchers warned cancer patients of the potential of developing blood clots, or venous thromboembolism (VTE), during treatment, and up to one year after receiving chemotherapy. Now, the SAVE-ONCO study, funded by Sanofi, reports that in patients who were treated with an experimental form of heparin the risk of developing a blood clot was reduced by 65%. For mesothelioma patients facing other life-threatening complications, the addition of a blood thinner, such as heparin, to their treatment regimen may make a difference in their prognosis.
Low-molecular-weight heparin (LMWH) is often used during surgical procedures to limit the risk of VTE. However, many doctors are hesitant to use heparin during other forms of treatment for fear that the risk of bleeding complications outweighs the risk of a patient having a VTE.
In an editorial in the New England Journal of Medicine, Drs. Elie Akl and Holger Schünemann of McMaster University discussed the potential benefits of adding ultra-low-molecular-weight heparin semuloparin during cancer treatment. The doctors referred to the results of the SAVE-ONCO study where patients receiving chemotherapy were also given a preventive dose of the medicine once daily for just over three months. The study demonstrated the benefits of the drug “without increase in major bleeding.”
The two doctors reported that the SAVE-ONCO study, taken together with prior similar studies, confirm their conclusion of “a likely small survival benefit” from the use of the drug.
The pair of doctors estimated “if 1,000 patients with cancer were to use a prophylactic dose of LMWH, approximately 30 would avert death, 20 would avert a clotting complication and one would suffer a major bleeding episode over a 12-month period.”
They added that daily injections of the LMWH could avert hospitalizations, and potentially, increase survival.
Duke researchers reported in their study that the average increase in costs associated with a VTE was $35,000 over patients without blood clots. Some doctors estimate that mesothelioma treatment already costs anywhere from $150,000 to $1 million. The added expense would place an undue, additional financial burden on the patients.
Akl and Schünemann added that patients looking for survival from their cancer will be faced with “some uncertainty” with the benefit from LMWH. They also added that more research is needed and “they are planning a sophisticated analysis of the published trials.”
Mesothelioma is a unique cancer affecting the lining of the lungs, and other organs, due to past exposure to asbestos. Treatment varies for the disease, depending on the stage of the cancer, but often involves surgery, chemotherapy and radiation. 3,000 Americans are diagnosed with the disease each year.