Presentation

Thrombosis represents a common clinical challenge in cardio-oncology, with coagulation disorders playing a significant role in the pathogenesis of many cancer diseases. Endothelial damage and increased prothrombotic readiness induced by various cancer therapies further contribute to thrombotic events.

Arterial and venous thromboembolism in cardio-oncology can lead to premature mortality, often due to suboptimal antithrombotic management or discontinuation of optimal anticancer therapy due to bleeding risks. Addressing these challenges is paramount to improving outcomes in cardio-oncology patients.

The basic scope of the group’s activities will be teaching on the personalised management of venous and arterial thromboembolic events, both in terms of primary and secondary prevention. Research activity of the group will be conducted through surveys. The first one was planned in cooperation with the European Heart Rhythm Association (EHRA). The next step will be to collect data from daily practice in different countries of the ESC. The special focus will be on understanding the real risk of thrombosis related to modern immunotherapy and targeted therapies in oncology/haematology. The final stage of the scientific research activity will be the construction of a study with pharmacological intervention.

The objectives

The objectives have been defined and divided into the following main areas:

Treatment

• Optimal treatment of venous thromboembolism including a choice of anticoagulation and its duration
• Optimal treatment of acute coronary syndromes including individualisation of dual antiplatelet therapy

Prevention

• Individualisation of stroke prevention in patients with atrial fibrillation
• Antiplatelet therapy in chronic coronary syndromes in patients with active cancer as well as in cancer survivors
• Defining primary antithrombotic prevention based on a type of active cancer therapy

The choice of antithrombotic therapy in cardio-oncology means selecting a type of antithrombotic therapy and defining its duration. It must be made by

• an individualised approach due to prothrombotic versus bleeding risks
• appropriate understanding of a risk associated with histological / molecular type of cancer disease and type of cancer therapy
• beneficial modification of antithrombotic therapy based on bleeding risk profile: thrombocytopenic cancer patients, comorbidities/toxicities with bleeding risk, cancer drugs increasing bleeding risk etc.

The main clinical goals for daily practice can be summarised as:

• Focus on improving the safety of patients vulnerable to or diagnosed with cancer-associated thrombosis through tailored preventive and therapeutic strategies
• Better understanding and dealing with interaction with anti-cancer treatment and anticoagulant treatment.

Members: 

Chair: Associate Professor Sebastian Szmit
Secretary: Professor Diana Gorog 
Committee member: Professor Anna Falanga
Committee member: Doctor Avi Leader 
Committee member: Doctor Deborah Siegal
Committee member: Professor Cihan Ay
Committee member: Professor Laurent Bertoletti 
Committee member: Professor Erik Klok
Committee member: Professor Joerg Herrmann 
Committee member: Associate Professor Sofie Gevaert 
Committee member: Professor Isabelle Mahé 
Committee member: Professor Giuseppe Boriani 
Committee member: Professor Mamas Mamas 
Committee member: Doctor Maria Clara Llamedo
Committee member: Doctor Jaroslaw Kepski