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| Therapeutic Advances in treating and preventing CA Associated Thrombosis Marc Carrier. |
Abstract
Cancer-associated thrombosis (CAT) remains a leading cause of morbidity and mortality in patients with malignancy. Although direct oral anticoagulants (DOACs) have improved efficacy compared with low-molecular-weight heparin (LMWH), their use is accompanied by increased bleeding risk, particularly in patients with gastrointestinal and genitourinary cancers. This persistent efficacy–safety trade-off highlights important unmet needs in CAT management. Advances in the understanding of coagulation biology have identified Factor XI (FXI) as a promising therapeutic target. By selectively inhibiting the intrinsic/contact pathway, FXI inhibitors aim to “uncouple” pathological thrombosis from physiological hemostasis, potentially reducing thrombotic events without significantly increasing bleeding. Both monoclonal antibodies and small-molecule FXI/XIa inhibitors are now in advanced clinical development. This presentation will review the evolving standard of care for CAT, the biological rationale for FXI inhibition, and emerging data from recent phase 2 and phase 3 trials. We will critically appraise the successes and limitations of FXI-targeted therapies and discuss their potential future role in the prevention and treatment of CAT.
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