# The Role of Direct Oral Anticoagulants (DOACs) in Cancer-Associated Thrombosis: A Comprehensive Review of the Literature

## TL;DR

This paper reviews how direct oral anticoagulants (DOACs) can be used to treat blood clots in cancer patients, comparing them to traditional treatments and discussing their benefits and limitations.

## Contribution

The paper provides a comprehensive review of DOACs in cancer-associated thrombosis, highlighting their efficacy, safety, and practical advantages.

## Key findings

- DOACs are increasingly considered as alternatives to LMWHs in selected cancer patients.
- DOACs offer advantages like oral administration and improved patient adherence.
- Their use is limited in certain cancers and patients with renal or hepatic issues.

## Abstract

Venous thromboembolism (VTE) is a frequent and serious complication observed in patients with malignancy. The management of cancer-associated thrombosis (CAT) remains complex and multifactorial, influenced by cancer type, stage, comorbidities, and ongoing therapeutic regimens. Among anticoagulation strategies, direct oral anticoagulants (DOACs) have gained increasing attention as potential alternatives to low-molecular-weight heparins (LMWHs) in selected oncology populations. This narrative review evaluates the role of DOACs in the treatment of CAT, focusing on their clinical efficacy, safety considerations, and practical advantages, including oral administration and patient adherence. However, their use may be limited in certain cancer types and patients with renal or hepatic impairment. DOACs have also raised concerns regarding bleeding risks, drug interactions, and individualized dosing strategies. This review also highlights ongoing challenges such as optimal treatment duration, real-world applicability, and patient-specific considerations. The discussion aims to assess current data and clinical guidance while identifying future directions for integrating DOACs into standard oncology practice.