Long-term survival outcomes after biomarker-guided thromboprophylaxis in cancer: extended follow-up of the TARGET-TP randomised trial
- Author(s)
- Rogers, J; Michael, M; Tie, J; Solomon, BJ; Harris, S; Underhill, C; Wolfe, R; Burbury, K; Alexander, M;
- Journal Title
- Journal of the National Cancer Institute
- Publication Type
- Online publication before print
- 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.
- Department(s)
- Pharmacy; Medical Oncology; Haematology
- Publisher's Version
- https://doi.org/10.1093/jnci/djag065
- Open Access at Publisher's Site
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Creation Date: 2026-03-31 11:33:32
Last Modified: 2026-03-31 11:33:37