Using a Blood Test and Software Tool to Guide Treatment for Venous Thromboembolism

Who can take part

• Age ≥ 18 with a history of cancer-associated VTE (objectively confirmed symptomatic or incidental/unsuspected proximal lower-limb DVT, symptomatic pulmonary embolism [PE] or incidental PE in a segmental or more proximal pulmonary artery) and completion of between 3 and 12 months of anticoagulation with enoxaparin, dalteparin,rivaroxaban, or apixaban without current VTE-related symptoms (imaging to confirm resolution not required); Diagnosis of DVT requires evidence of one or more filling defects at compression ultrasonography, venography, CT venography, or MR venography involving at least the popliteal or more proximal veins; Diagnosis of PE requires an intraluminal filling defect in segmental or more proximal arteries
• Diagnosis of one of the following solid tumors in either advanced (i.e. unresectable) stage or receiving systemic anticancer treatment within six weeks of enrollment (maintenance therapy included):; breast cancer regardless of cytotoxic-chemotherapy status; hepatobiliary cancer regardless of cytotoxic-chemotherapy status; prostate cancer regardless of cytotoxic-chemotherapy status; non-small cell lung cancer with cytotoxic-chemotherapy received within 30 days; pancreatic cancer with cytotoxic-chemotherapy received within 30 days; bladder cancer with cytotoxic-chemotherapy received within 30 days
• Signed and dated informed consent by study participant/Legally Authorized Representative (LAR)

Who cannot take part

• Contraindication to discontinuation of anticoagulation (examples include but not limited to: known antiphospholipid syndrome or factor V leiden, active arterial thrombus, catheter-associated thrombus, on anticoagulation for atrial fibrillation or other non-oncologic reasons)
• Diagnosis of an active hematologic malignancy
• History of major bleeding in the last six months (major bleeding defined as fatal bleeding, and/or symptomatic bleeding in a critical area or organ, such as intracranial, intraspinal, intraocular, retroperitoneal, intra-articular or pericardial, or intramuscular with compartment syndrome; bleeding that necessitates acute surgical intervention; bleeding causing a fall in hemoglobin levels of 1.24 mmol/L (2 g/dL or greater) or more; or bleeding leading to a transfusion of 2 U or more of whole blood or red cells)
• Contraindication to ongoing anticoagulation
• Known diagnosis of disseminated intravascular coagulation (DIC)
• Suspicion for tumor thrombus on the imaging leading to original diagnosis of VTE
• Enrolled in hospice care
• Currently has inferior vena cava (IVC) filter