NEW YORK (Reuters Health) – Nadroparin, a low-molecular-weight heparin, reduces the incidence of thromboembolic events in ambulatory patients receiving chemotherapy for metastatic or locally advanced solid cancers, an Italian research team reports.

Dr. Giancarlo Agnelli, from the University of Perugia, and his associates note in The Lancet Oncology, published online September 1, that while cancer is know to promote coagulation, and chemotherapy is known to amplify these prothrombotic effects, little is known about the benefits of prophylaxis in ambulatory patients undergoing chemotherapy.

For their PROphylaxis of ThromboEmbolism during CHemoTherapy (PROTECHT) study, nadroparin was chosen over warfarin, because it posed fewer difficulties with regard to monitoring INR and drug interactions.

The study involved 1150 patients with cancers of the lung, gastrointestinal tract, pancreas, breast, ovary, or head and neck who received at least one dose of study treatment. Patients on adjuvant or neoadjuvant chemotherapy were excluded.

Subjects were randomly assigned in a 2:1 ratio to subcutaneous injections of nadroparin (3800 IU anti-Xa once daily, n = 779) or to placebo (n = 387). Study drugs were given for the duration of chemotherapy up to a maximum of 4 months.

Rates of thromboembolic events were 2.0% in the nadroparin group and 3.9% in the placebo group (p = 0.02).