The impact of thromboprophylaxis with LMWHs on the survival of patients with pancreatic cancer

Pancreatic cancer (PC) is the fourth leading cause of cancer-related deaths, with a five-year survival rate of less than 10%. Venous thromboembolism (VTE) occurs in 20% of PC patients and is associated with a dismal prognosis and reduced survival. VTE is considered the second leading cause of death in these patients and the median time from PC diagnosis to VTE occurrence is 4.49 months. For these reasons, there is an emergent need for the optimization of supportive care. Low molecular weight heparins (LMWHs) have played a quite important role in thromboprophylaxis in recent years in comparison to other anticoagulants such as unfractionated heparin and DOACs. The main advantages of their use in clinical practice are the low occurrence of heparin-induced thrombocytopenia (HIT), limited post-administration bleeding events, as well as the possibility of self-administration, via subcutaneous injection. In addition, numerous studies have shown their role in reducing the incidence of VTE and prolonging the survival of patients, without bleeding events. There are recent studies suggesting that LMWHs in combination with chemotherapy contribute to a greater survival of pancreatic cancer patients, due to their properties against tumor progression and metastatic dissemination. In conclusion, they could act as a complementary treatment to provide prolonged survival and improved quality of life for PC patients.