Literature Review: Dampak Warfarin terhadap Risiko Kanker
DOI:
https://doi.org/10.57213/antigen.v3i3.740Keywords:
Warfarin, Cancer, Venous Thromboembolism (VTE)Abstract
Venous Thromboembolism (VTE) is a common complication in cancer patients. The treatment of VTE in cancer patients involves anticoagulant therapy using Vitamin K Antagonists (VKAs), including warfarin. VTE can be managed with warfarin administration, typically preceded by bridging therapy with heparin. The objective of this literature review is to examine and analyze studies related to the impact of warfarin use on cancer risk. The review was conducted on articles published in English over the past 10 years (2013–2024) using electronic databases such as Google Scholar and PubMed. The findings suggest that warfarin may be associated with improved overall survival in cancer patients and may have protective effects against certain types of cancer. Warfarin may exhibit antineoplastic properties through mechanisms both dependent on and independent of coagulation pathways, the latter mediated by the inhibition of the GAS6-AXL signaling pathway.
References
Beckman, M. G., Hooper, W. C., Critchley, S. E., & Ortel, T. L. (2010). Venous thromboembolism: A public health concern. American Journal of Preventive Medicine, 38(4), S495–S501.
Blanc-Lapierre, A., Weiss, D., & Parent, M. É. (2014). Use of oral anticoagulants and risk of prostate cancer: A population-based case–control study in Montreal, Canada. Cancer Causes & Control, 25, 1159–1166.
Delate, T., Charlu, M., Zhu, S., Pai, A., Clark, N. P., Witt, D. M., ... & King, J. B. (2020). Temporal trends in first-line outpatient anticoagulation treatment for cancer-associated venous thromboembolism. Thrombosis Research, 196, 367–370.
Giugliano, R. P., Ruff, C. T., Braunwald, E., Murphy, S. A., Wiviott, S. D., Halperin, J. L., ... & Antman, E. M. (2013). Edoxaban versus warfarin in patients with atrial fibrillation. New England Journal of Medicine, 369(22), 2093–2104.
Haaland, G. S., Falk, R. S., Straume, O., & Lorens, J. B. (2017). Association of warfarin use with lower overall cancer incidence among patients older than 50 years. JAMA Internal Medicine, 177(12), 1774–1780.
Hirsh, J., & Hoak, J. (1996). Management of deep vein thrombosis and pulmonary embolism: A statement for healthcare professionals from the Council on Thrombosis (in consultation with the Council on Cardiovascular Radiology), American Heart Association. Circulation, 93(12), 2212–2245.
Khalid, U., Riaz, I. B., & Khan, A. R. (2013). Anticoagulant treatment of venous thromboembolism in cancer patients: Comparative efficacy between direct oral anticoagulants and warfarin. Thrombosis and Haemostasis, 110(7), 1133–1141.
Khorana, A. A., Soff, G. A., Kakkar, A. K., Vadhan-Raj, S., Riess, H., Wun, T., ... & Lee, A. Y. Y. (2019). Rivaroxaban for thromboprophylaxis in high-risk ambulatory patients with cancer. New England Journal of Medicine, 380(14), 1318–1328.
Kinnunen, P. T., Murtola, T. J., Talala, K., Taari, K., Tammela, T. L., & Auvinen, A. (2016). Warfarin use and prostate cancer risk in the Finnish Randomized Study of Screening for Prostate Cancer. Scandinavian Journal of Urology, 50(6), 413–419.
Kirane, A., Ludwig, K. F., Sorrelle, N., Haaland, G., Sandal, T., Ranaweera, R., ... & Brekken, R. A. (2015). Warfarin blocks Gas6-mediated Axl activation required for pancreatic cancer epithelial plasticity and metastasis. Cancer Research, 75(18), 3699–3705.
Kristensen, K. B., Jensen, P. H., Skriver, C., Friis, S., & Pottegård, A. (2019). Use of vitamin K antagonists and risk of prostate cancer: Meta-analysis and nationwide case–control study. International Journal of Cancer, 144(7), 1522–1529.
Lyman, G. H., Carrier, M., Ay, C., Di Nisio, M., Hicks, L. K., Khorana, A. A., ... & Alonso-Coello, P. (2021). American Society of Hematology 2021 guidelines for management of venous thromboembolism: Prevention and treatment in patients with cancer. Blood Advances, 5(4), 927–974.
O’Rorke, M. A., Murray, L. J., Hughes, C. M., Cantwell, M. M., & Cardwell, C. R. (2015). The effect of warfarin therapy on breast, colorectal, lung, and prostate cancer survival: A population-based cohort study using the Clinical Practice Research Datalink. Cancer Causes & Control, 26, 355–366.
Ortel, T. L., Neumann, I., Ageno, W., Beyer-Westendorf, J., Coppens, M., Darius, H., ... & Schulman, S. (2020). Warfarin and the prevention of venous thromboembolism. New England Journal of Medicine, 373, 1222–1230.
Paolino, M., Choidas, A., Wallner, S., Pranjic, B., Uribesalgo, I., Loeser, S., ... & Penninger, J. M. (2014). The E3 ligase Cbl-b and TAM receptors regulate cancer metastasis via natural killer cells. Nature, 507(7493), 508–512.
Parker, J., Crawley, D., Garmo, H., Lindahl, B., Styrke, J., Adolfsson, J., ... & Beckmann, K. (2020). Use of warfarin or direct oral anticoagulants and risk of prostate cancer in PCBaSe: A nationwide case-control study. Frontiers in Oncology, 10, 571838.
Tanaka, M., & Siemann, D. W. (2021). Therapeutic targeting of the Gas6/Axl signaling pathway in cancer. International Journal of Molecular Sciences, 22(18), 9953.
Zacharski, L. R., Henderson, W. G., Rickles, F. R., Forman, W. B., Cornell Jr, C. J., Forcier, A. J., ... & Kwaan, H. C. (1981). Warfarin and survival in small-cell lung cancer. Cancer, 48(5), 875–883.
Zacharski, L. R., Henderson, W. G., Rickles, F. R., Forman, W. B., Cornell Jr, C. J., Forcier, A. J., ... & Kwaan, H. C. (1984). Effect of warfarin anticoagulation on survival in carcinoma of the lung, colon, head and neck, and prostate: Final report of VA Cooperative Study #75. Cancer, 53(10), 2046–2052.
Zaki, H. A., Alkahlout, B. H., Basharat, K., Elsayed, W. A. E., Abdelrahim, M. G., Al-Marri, N. D. R., ... & Shaban, E. (2023). Low-molecular-weight heparin versus warfarin in adult cancer patients as a precision medicine for thrombosis: A systematic review and meta-analysis. Cureus, 15(7).
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