Impact of Primary Ambulatory Thromboprophylaxis (PATP) with Low-Molecular Weight Heparins (LMWHs) on Survival in Patients with Lung Cancer Receiving Chemotherapy

Lung. 2020 Jun;198(3):575-579. doi: 10.1007/s00408-020-00347-0. Epub 2020 Mar 18.


Lung cancer (LC) is the leading cause of cancer mortality. PATP was provided in experimental trials to decrease the venous thromboembolism (VTE), with ultimate aim to improve overall survival (OS). We undertook an updated systematic review and meta-analysis of randomized controlled trials (RCTs) to determine the impact of PATP with LMWHs on OS and VTE in patients with LC. 5443 patients with LC from nine RCTs were included. The pooled hazard ratio (HR) for OS was 1.02 (95% CI 0.83 to 1.26; P = 0.83) and for progression or metastasis-free survival was 1.03 (95% CI 0.86 to 1.24; P = 0.74). The pooled risk ratio (RR) for VTE was 0.54 (95% CI 0.43 to 0.69; P < 0.00001) and the risk difference (RD) was-0.03 (- 0.05 to - 0.02; P < 0.00001). Our analysis showed no survival advantage with the addition of PATP with LMWHs to standard chemotherapy in patients with LC, regardless of histology or stages of small cell LC.

Keywords: Lung cancer; Meta-analysis; Overall survival; Primary ambulatory thromboprophylaxis; Recurrence or metastasis-free survival.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Antineoplastic Agents / therapeutic use*
  • Global Health
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / mortality
  • Primary Prevention / methods*
  • Survival Rate / trends
  • Venous Thromboembolism / etiology
  • Venous Thromboembolism / prevention & control*


  • Anticoagulants
  • Antineoplastic Agents
  • Heparin, Low-Molecular-Weight