Table 1.
Overview of randomized clinical trials of LMWHs on survival of cancer patients
| References | Cancer type | Heparin (number of patients) | Regimen | Effect on survival |
|---|---|---|---|---|
| Kakkar et al10 | Advanced cancer (breast, colorectal, ovarian, and pancreatic) | Dalteparin (385) | 5,000 IU/d, 1 year | Significant increase in median survival in patients with better prognosis (43.5 months vs 24.3 months; P=0.03) |
| Altinbas et al9 | Small-cell lung cancer | Dalteparin (84) | 5,000 IU/d, 18 weeks | Significant increase in median survival (13 months vs 8 months; P=0.01) |
| Klerk et al69 | Metastasized and advanced cancer (breast, lung, GIT, pancreas, renal, ovary, uterus) | Nadroparin (302) | Therapeutic dose 2 weeks + half dose 4 weeks | Significant increase in median survival in patients with better prognosis (15.4 months vs 9.4 months; P=0.01) |
| van Doormaal et al70 | Non-small-cell lung cancer, prostate, pancreatic | Nadroparin (503) | Therapeutic dose 2 weeks + half dose 4 weeks | Median survival 11.9 months (placebo) versus 13.1 months (LMWH) |
| Agnelli et al71 | Colorectal and lung | Semuloparin (3,212) | 20 mg/d, 3.5 months | 1-year survival rate 55.5% (placebo) versus 56.6% (LMWH) |
| Lecumberri et al11 | Limited small-cell lung cancer | Bemiparin (38) | 3,500 IU/d, 26 weeks | Median progression-free survival 272 days (placebo) versus 410 days (LMWH), P=0.022 Median overall survival was 345 days (placebo) versus 1,133 days (LMWH), P=0.017 |
| Lebeau et al12 | Small-cell lung cancer | Unfractionated heparin (277) | 500 U/kg/d, 5 weeks | Significant increase in median survival (317 days vs 261 days; P=0.01); response rates (23% vs 37%; P=0.004) At subgroup analysis, the results on survival were obtained for limited diseases (P=0.03) but not for extensive diseases (P=0.31) |
Abbreviations: LMWH, low molecular weight heparin; GIT, gastrointestinal tract.