Ovarian cancer carries the highest incidence of venous thromboembolism (5% to 14%) among female-specific malignancies, largely due to advanced disease, ascites, and platinum-based chemotherapy.
Female-specific malignancies present distinct thrombotic profiles that require individualized, patient-centered pharmacotherapeutic approaches to optimize thrombosis prevention and minimize bleeding risk.
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ABSTRACT Cancer‐associated thrombosis (CAT) remains a leading cause of morbidity and mortality among patients with cancer. Female‐specific malignancies such as breast, ovarian, endometrial, and cervical cancers exhibit distinct thrombotic profiles driven by hormonal, anatomical, and treatment‐related factors. This review summarizes current evidence on CAT in these malignancies, emphasizing chemotherapy‐ and hormone‐related risk, thromboprophylactic strategies, and pharmacologic considerations in anticoagulant selection. Ovarian cancer carries the highest incidence of venous thromboembolism (VTE), ranging from 5% to 14%, largely due to advanced disease, ascites, and platinum‐based chemotherapy. Breast cancer accounts for approximately 15% of all CAT cases, with increased risk observed among patients treated with selective estrogen receptor modulators or cyclin‐dependent kinase 4/6 inhibitors. Endometrial cancer presents a moderate to high risk for CAT, especially in obese patients and those receiving hormonal therapy or radiation. Prophylaxis with low‐molecular‐weight heparins (LMWHs) or direct oral anticoagulants (DOACs) effectively reduces VTE incidence in high‐risk patients. In the API‐CAT trial, reduced‐dose apixaban (2.5 mg twice daily) was non‐inferior to full‐dose therapy for extended anticoagulation after 6 months of treatment (2.1% vs. 2.8%; adjusted subhazard ratio, 0.76; 95% Confidence Interval (CI), 0.58–0.97; p = 0.001). Drug–drug interactions with anticoagulants and agents such as doxorubicin, ribociclib, and tamoxifen warrant individualized anticoagulant selection and close monitoring. A patient‐centered pharmacotherapeutic approach, supported by multidisciplinary collaboration, is essential to optimize thrombosis prevention and minimize bleeding risk in women with cancer.
Aghakouchakzadeh et al. (Fri,) reported a other. Ovarian cancer carries the highest incidence of venous thromboembolism (5% to 14%) among female-specific malignancies, largely due to advanced disease, ascites, and platinum-based chemotherapy.