The Effect of Apixaban on Clot Rate in Breast Cancer Patients Undergoing Chemotherapy, Letter

Dear Editor, We want to share the findings of our recent study investigating the efficacy of apixaban, a novel oral anticoagulant, in reducing clot formation in breast cancer patients receiving chemotherapy. Venous thromboembolism (VTE) is a well-known complication in cancer patients, particularly those undergoing chemotherapy, and it is crucial to prevent this complication. Our study included a carefully selected group of 113 breast cancer patients without metastasis, diabetes, or hypertension, aged 30–60, with normal ejection fraction at the baseline. The patients were recruited between 2022 and 2023 and were randomly divided into two groups after port insertion: one group received apixaban 2.5 mg twice daily (preventive dosage), while the other did not receive any anticoagulant therapy. All patients underwent a chemotherapy regimen with eight courses: four courses of AC (doxorubicin and cyclophosphamide) followed by four courses of endoxan (cyclophosphamide) and taxotere (docetaxel), administered every 3 weeks. The cancer-associated thrombosis (CAT) was evaluated using sonography and echocardiography at various times: before port insertion, after port insertion, after the first course of chemotherapy, and after every three courses. The results of our study showed that no clots were observed during our follow-up in the apixaban group (n = 57). However, in the group that did not receive anticoagulant therapy (n = 56), eight patients developed CAT: five patients after the first course of chemotherapy, one patient after the third course, and two patients after the eighth course. Our findings suggest that apixaban can significantly reduce the risk of CAT incidence in breast cancer patients undergoing chemotherapy. Previous studies also observed a similar CAT rate in the group without anticoagulant therapy (6%–7%), supporting our study. Our study highlights the importance of CAT prevention in breast cancer patients receiving chemotherapy. It provides evidence for the efficacy of apixaban as a preventive measure against CAT formation in this patient population. The potential implications of our findings could lead to a significant shift in the management of VTE in cancer patients, particularly those undergoing chemotherapy, and could potentially improve patient outcomes. We would be deeply honored to have our manuscript considered for publication in your esteemed journal. We sincerely appreciate your time and consideration in reviewing our research. Sincerely, Azin Alizadeasl, MD, FACC, FASE, Professor of cardiology, echocardiology, cardio-oncology, email: [email protected], website: cardionco.com, Fax: +982122042026, Postal code: 1995614331 Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.