Long-term survival outcomes after biomarker-guided thromboprophylaxis in cancer: extended follow-up of the TARGET-TP randomised trial.
rct · Level II
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- Record sourced from PubMed, PMID 41795841.
- Also identified by DOI 10.1093/jnci/djag065.
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Abstract
Thromboembolism (TE) is a major cause of early mortality in cancer. TARGET-TP randomised high-risk patients with lung or gastrointestinal cancers, identified using a d-dimer/fibrinogen model, to enoxaparin or no thromboprophylaxis; low-risk patients were observed. Thromboprophylaxis reduced TE and 6-month mortality. This study reports extended overall survival (OS) and progression-free survival (PFS) to 36 months. Among high-risk patients, thromboprophylaxis improved OS at 6 and 12 months, with convergence thereafter; no PFS differences were observed. Adjustment for on-study TE attenuated the OS effect, consistent with thrombosis-specific risk reduction. These findings describe the duration and extent of survival benefit achievable with biomarker-guided thromboprophylaxis and highlight that TARGET-TP is the first trial to demonstrate a survival advantage, likely driven by cohort enrichment for thrombotic risk. The improved risk-benefit profile supports real-world evaluation of d-dimer/fibrinogen-guided thromboprophylaxis in lung and gastrointestinal cancers, with validation of the model warranted in additional tumour groups.