API-CAT Trial reinforces NCCN Guidelines for cancer-Associated Venous Thromboembolism Management
New data from the API-CAT (Apixaban for the Treatment of Cancer-Associated Venous Thromboembolism) trial further validate current National Extensive Cancer Network (NCCN) guidelines for preventing and treating blood clots in cancer patients, offering reassurance too clinicians and patients navigating this complex area of care. Published in the New England Journal of Medicine in 2025, the findings demonstrate the continued efficacy and safety of extended reduced-dose apixaban for cancer-associated venous thromboembolism (VTE), solidifying it’s role as a viable treatment option.
Cancer significantly elevates the risk of VTE - including deep vein thrombosis and pulmonary embolism - due to factors like chemotherapy,surgery,and the cancer itself. Managing this risk is critical,as VTE can lead to serious complications and impact treatment outcomes. The NCCN guidelines emphasize individualized care, incorporating risk assessment, prophylactic measures, and tailored treatment plans. The API-CAT trial’s results, alongside previous research including the 2019 New England Journal of Medicine study by Carrier et al. demonstrating apixaban’s preventative benefits, provide strong evidence supporting the NCCN’s approach.
The API-CAT trial (Mahé I,et al., 2025) specifically investigated extended treatment with reduced-dose apixaban following an initial course of anticoagulation for cancer-associated VTE. Results showed sustained benefit with continued use of the medication. This aligns with the 2021 american Society of Hematology (ASH) guidelines (Lyman GH, et al., 2021) which address both prevention and treatment of VTE in cancer patients, and the 2020 ASCO clinical practice guideline update (Key NS, et al., 2020) which also supports individualized approaches.
Risk assessment tools, such as the Khorana model developed in 2008 (Khorana AA, et al., 2008), help clinicians identify patients at higher risk of chemotherapy-associated thrombosis, informing preventative strategies. Treatment options, as detailed in the NCCN guidelines and prescribing information for medications like Eliquis (Bristol myers Squibb, May 2025), range from traditional anticoagulants to newer oral anticoagulants like apixaban.Ultimately,the API-CAT findings underscore the importance of a collaborative approach to cancer care,where treatment decisions are made through ongoing discussion of risks,benefits,and patient preferences,as highlighted by the NCCN. Further research continues to refine these guidelines, building on the foundational work of experts like Donnellan and Khorana (2017) who initially reviewed the link between cancer and VTE.
