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A Study to Evaluate the Efficacy and Safety of Rivaroxaban Venous Thromboembolism (VTE) Prophylaxis in Ambulatory Cancer Participants

Primary Purpose

Neoplasms

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Rivaroxaban
Placebo
Sponsored by
Janssen Research & Development, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Neoplasms focused on measuring Cancer, Rivaroxaban, Venous thromboembolism

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Have histologically confirmed solid malignancy including but not limited to: pancreas, lung, stomach, colon, rectum, bladder, breast, ovary, renal or lymphoma (hematologic), with locally advanced or metastatic disease
  • Have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2
  • Have a Khorana thromboembolic risk Score greater than or equal to (>=) 2
  • Creatinine clearance (CrCl) >= 30 milliliter per minute (mL/min)
  • Plan to initiate systemic cancer therapy within plus or minus (+-) 1 week of receiving the first dose of study drug with the intention of receiving systemic cancer therapy during the double-blind treatment period for an intended duration determined by the treating oncologist according to standard protocols of clinical care

Exclusion Criteria:

  • Diagnosis of primary brain tumors
  • Known history of brain metastases
  • Bleeding diathesis, hemorrhagic lesions, active bleeding, and other conditions with a high risk for bleeding
  • Hematologic malignancies with the exception of lymphoma
  • Platelet count less than (<) 50,000/millimeter^3 (mm^3), Life expectancy of less than or equal to (<=) 6 months

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Rivaroxaban

Placebo

Arm Description

Participants will be administered rivaroxaban 10 milligram (mg) tablet orally once daily for 180 days.

Participants will be administered matching placebo tablet orally once daily for 180 days.

Outcomes

Primary Outcome Measures

Percentage of Participants With Time to First Occurrence of Primary Efficacy Endpoint (Composite and Components)
Percentage of participants with time to the first occurrence of primary efficacy endpoint (composite and components) was reported. The primary efficacy composite endpoint is time to first occurrence of objectively confirmed symptomatic and asymptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal PE, incidental PE, or VTE-related death as adjudicated by an independent blinded Clinical Endpoint Committee (CEC).
Percentage of Participants With Time to the First Occurrence of Major Bleeding Events as Defined by International Society of Thrombosis and Haemostasis (ISTH)
Major bleeding is defined as clinically overt bleeding that is associated with a reduction in hemoglobin of 2 gram per deciliter (g/dL) or more, or a transfusion of 2 or more units of packed red blood cells or whole blood, or occurrence at a critical site defined as intracranial, intra-spinal, intraocular, pericardial, intra-articular, intra-muscular with compartment syndrome, retroperitoneal, or fatal outcome.

Secondary Outcome Measures

Percentage of Participants With Time to the First Occurrence of Symptomatic VTE Events or VTE-Related Deaths
Percentage of participants with time to first occurrence of the composite endpoint of symptomatic VTE events (symptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, or symptomatic non-fatal PE) or VTE related deaths as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Percentage of Participants With All-Cause Mortality
Percentage of participants with all-cause mortality as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported. Overall deaths occurred during observation period (defined by start to end date of the observation period [that is approximately 180 days] are reported here.
Percentage of Participants With Time to the First Occurrence of Fatal or Non-fatal Arterial Thromboembolic Events (ATE)
Percentage of participants with time to first occurrence of fatal/non-fatal ATE (a composite of occurrence of myocardial infarction (MI), stroke [ischemic infarction with or without hemorrhagic conversion or primary hemorrhagic events - intraparenchymal hemorrhage, subdural hematoma or epidural hematoma] or any other ATE recorded) event as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Percentage of Participants With Time to the First Occurrence of Fatal or Non-fatal Visceral VTE
Percentage of participants with time to the first occurrence of fatal or non-fatal visceral VTE as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Percentage of Participants With Time to the First Occurrence of Composite Efficacy Endpoint 1
Percentage of participants with time to first occurrence of composite efficacy endpoint 1 (composite of objectively confirmed symptomatic and asymptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal PE, incidental PE or all-cause mortality) as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Percentage of Participants With Time to First Occurrence of Composite Efficacy Endpoint 2
Percentage of participants with time to first occurrence of composite efficacy endpoint 2 (composite of objectively confirmed symptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal PE or VTE-related deaths) as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Percentage of Participants With Time to First Occurrence of Composite Efficacy Endpoint 3
Percentage of participants with time to first occurrence of composite efficacy endpoint 3 (composite of objectively confirmed symptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, asymptomatic lower extremity proximal DVT, symptomatic non-fatal PE, incidental PE, VTE-related deaths, fatal/non-fatal ATE [MI, stroke {ischemic infarction with or without hemorrhagic conversion or primary hemorrhagic events - intraparenchymal hemorrhage, subdural hematoma or epidural hematoma} or any ATE] or fatal/non-fatal visceral VTE) as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Percentage of Participants With Time to First Occurrence of Composite Efficacy Endpoint 4
Percentage of participants with time to first occurrence of composite efficacy endpoint 4 (composite of objectively confirmed symptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal PE, VTE-related deaths or major bleeding events up to Day 180) as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Percentage of Participants With Time to the First Occurrence of Clinically Relevant Non-major Bleeding
Percentage of participants with time to the first occurrence of clinically relevant non-major bleeding was reported. Clinically relevant non-major bleeding is defined as overt bleeding not meeting the criteria for major bleeding but associated with medical intervention, or unscheduled contact with a physician, or temporary cessation of study treatment, or discomfort such as pain, or impairment of activities of daily life.
Percentage of Participants With Time to the First Occurrence of Minor Bleeding
Percentage of participants with time to the first occurrence of minor bleeding was reported. Minor bleeding (that is, minimal bleeding) is defined as overt bleeding episodes not meeting the criteria for major or clinically relevant non-major bleeding event.
Percentage of Participants With Time to the First Occurrence of Any Bleeding
Percentage of participants with time to the first occurrence of any bleeding event was reported. Any bleeding is defined as a composite of major bleeding, clinically relevant non-major bleeding, or minor bleeding.

Full Information

First Posted
September 18, 2015
Last Updated
August 22, 2019
Sponsor
Janssen Research & Development, LLC
Collaborators
Bayer
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1. Study Identification

Unique Protocol Identification Number
NCT02555878
Brief Title
A Study to Evaluate the Efficacy and Safety of Rivaroxaban Venous Thromboembolism (VTE) Prophylaxis in Ambulatory Cancer Participants
Official Title
Efficacy and Safety of Rivaroxaban Prophylaxis Compared With Placebo in Ambulatory Cancer Patients Initiating Systemic Cancer Therapy and at High Risk for Venous Thromboembolism
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
September 11, 2015 (Actual)
Primary Completion Date
August 24, 2018 (Actual)
Study Completion Date
August 24, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Research & Development, LLC
Collaborators
Bayer

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to demonstrate that rivaroxaban is superior to placebo for reducing the risk of the primary composite outcome as defined by objectively confirmed symptomatic lower extremity proximal deep vein thrombosis (DVT), asymptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal pulmonary embolism (PE), incidental PE, and venous thromboembolism (VTE)-related death in ambulatory adult participants with various cancer types receiving systemic cancer therapy who are at high risk of developing a VTE.
Detailed Description
This is a multicenter, randomized, double-blind, placebo-controlled, parallel-group, superiority study comparing the efficacy and safety of rivaroxaban with placebo for primary prophylaxis of venous thromboembolism (VTE) in ambulatory adult participants, with various cancer types who are scheduled to initiate systemic cancer therapy. The study consists of 3 Phases: Screening Phase (14 Days), double-blind treatment Phase (180 Days) and follow up Phase (30 Days). The duration of participation in the study for each participant is approximately 32 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neoplasms
Keywords
Cancer, Rivaroxaban, Venous thromboembolism

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
841 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Rivaroxaban
Arm Type
Experimental
Arm Description
Participants will be administered rivaroxaban 10 milligram (mg) tablet orally once daily for 180 days.
Arm Title
Placebo
Arm Type
Experimental
Arm Description
Participants will be administered matching placebo tablet orally once daily for 180 days.
Intervention Type
Drug
Intervention Name(s)
Rivaroxaban
Intervention Description
Rivaroxaban 10 milligram (mg) tablet will be administered orally once daily for 180 days.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo tablet will be administered orally once daily for 180 days.
Primary Outcome Measure Information:
Title
Percentage of Participants With Time to First Occurrence of Primary Efficacy Endpoint (Composite and Components)
Description
Percentage of participants with time to the first occurrence of primary efficacy endpoint (composite and components) was reported. The primary efficacy composite endpoint is time to first occurrence of objectively confirmed symptomatic and asymptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal PE, incidental PE, or VTE-related death as adjudicated by an independent blinded Clinical Endpoint Committee (CEC).
Time Frame
Up to Day 180
Title
Percentage of Participants With Time to the First Occurrence of Major Bleeding Events as Defined by International Society of Thrombosis and Haemostasis (ISTH)
Description
Major bleeding is defined as clinically overt bleeding that is associated with a reduction in hemoglobin of 2 gram per deciliter (g/dL) or more, or a transfusion of 2 or more units of packed red blood cells or whole blood, or occurrence at a critical site defined as intracranial, intra-spinal, intraocular, pericardial, intra-articular, intra-muscular with compartment syndrome, retroperitoneal, or fatal outcome.
Time Frame
From first dose of study drug to 2 days after the last dose of the study drug (up to 32 weeks)
Secondary Outcome Measure Information:
Title
Percentage of Participants With Time to the First Occurrence of Symptomatic VTE Events or VTE-Related Deaths
Description
Percentage of participants with time to first occurrence of the composite endpoint of symptomatic VTE events (symptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, or symptomatic non-fatal PE) or VTE related deaths as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Time Frame
Up to Day 180
Title
Percentage of Participants With All-Cause Mortality
Description
Percentage of participants with all-cause mortality as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported. Overall deaths occurred during observation period (defined by start to end date of the observation period [that is approximately 180 days] are reported here.
Time Frame
Up to Day 180
Title
Percentage of Participants With Time to the First Occurrence of Fatal or Non-fatal Arterial Thromboembolic Events (ATE)
Description
Percentage of participants with time to first occurrence of fatal/non-fatal ATE (a composite of occurrence of myocardial infarction (MI), stroke [ischemic infarction with or without hemorrhagic conversion or primary hemorrhagic events - intraparenchymal hemorrhage, subdural hematoma or epidural hematoma] or any other ATE recorded) event as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Time Frame
Up to Day 180
Title
Percentage of Participants With Time to the First Occurrence of Fatal or Non-fatal Visceral VTE
Description
Percentage of participants with time to the first occurrence of fatal or non-fatal visceral VTE as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Time Frame
Up to Day 180
Title
Percentage of Participants With Time to the First Occurrence of Composite Efficacy Endpoint 1
Description
Percentage of participants with time to first occurrence of composite efficacy endpoint 1 (composite of objectively confirmed symptomatic and asymptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal PE, incidental PE or all-cause mortality) as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Time Frame
Up to Day 180
Title
Percentage of Participants With Time to First Occurrence of Composite Efficacy Endpoint 2
Description
Percentage of participants with time to first occurrence of composite efficacy endpoint 2 (composite of objectively confirmed symptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal PE or VTE-related deaths) as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Time Frame
Up to Day 180
Title
Percentage of Participants With Time to First Occurrence of Composite Efficacy Endpoint 3
Description
Percentage of participants with time to first occurrence of composite efficacy endpoint 3 (composite of objectively confirmed symptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, asymptomatic lower extremity proximal DVT, symptomatic non-fatal PE, incidental PE, VTE-related deaths, fatal/non-fatal ATE [MI, stroke {ischemic infarction with or without hemorrhagic conversion or primary hemorrhagic events - intraparenchymal hemorrhage, subdural hematoma or epidural hematoma} or any ATE] or fatal/non-fatal visceral VTE) as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Time Frame
Up to Day 180
Title
Percentage of Participants With Time to First Occurrence of Composite Efficacy Endpoint 4
Description
Percentage of participants with time to first occurrence of composite efficacy endpoint 4 (composite of objectively confirmed symptomatic lower extremity proximal DVT, symptomatic lower extremity distal DVT, symptomatic upper extremity DVT, symptomatic non-fatal PE, VTE-related deaths or major bleeding events up to Day 180) as adjudicated by an independent blinded CEC up-to-Day 180 observation period was reported.
Time Frame
Up to Day 180
Title
Percentage of Participants With Time to the First Occurrence of Clinically Relevant Non-major Bleeding
Description
Percentage of participants with time to the first occurrence of clinically relevant non-major bleeding was reported. Clinically relevant non-major bleeding is defined as overt bleeding not meeting the criteria for major bleeding but associated with medical intervention, or unscheduled contact with a physician, or temporary cessation of study treatment, or discomfort such as pain, or impairment of activities of daily life.
Time Frame
From first dose of study drug to 2 days after the last dose of the study drug (up to 32 weeks)
Title
Percentage of Participants With Time to the First Occurrence of Minor Bleeding
Description
Percentage of participants with time to the first occurrence of minor bleeding was reported. Minor bleeding (that is, minimal bleeding) is defined as overt bleeding episodes not meeting the criteria for major or clinically relevant non-major bleeding event.
Time Frame
From first dose of study drug to 2 days after the last dose of the study drug (up to 32 weeks)
Title
Percentage of Participants With Time to the First Occurrence of Any Bleeding
Description
Percentage of participants with time to the first occurrence of any bleeding event was reported. Any bleeding is defined as a composite of major bleeding, clinically relevant non-major bleeding, or minor bleeding.
Time Frame
From first dose of study drug to 2 days after the last dose of the study drug (up to 32 weeks)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have histologically confirmed solid malignancy including but not limited to: pancreas, lung, stomach, colon, rectum, bladder, breast, ovary, renal or lymphoma (hematologic), with locally advanced or metastatic disease Have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0-2 Have a Khorana thromboembolic risk Score greater than or equal to (>=) 2 Creatinine clearance (CrCl) >= 30 milliliter per minute (mL/min) Plan to initiate systemic cancer therapy within plus or minus (+-) 1 week of receiving the first dose of study drug with the intention of receiving systemic cancer therapy during the double-blind treatment period for an intended duration determined by the treating oncologist according to standard protocols of clinical care Exclusion Criteria: Diagnosis of primary brain tumors Known history of brain metastases Bleeding diathesis, hemorrhagic lesions, active bleeding, and other conditions with a high risk for bleeding Hematologic malignancies with the exception of lymphoma Platelet count less than (<) 50,000/millimeter^3 (mm^3), Life expectancy of less than or equal to (<=) 6 months
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Research & Development, LLC Clinical Trial
Organizational Affiliation
Janssen Research & Development, LLC
Official's Role
Study Director
Facility Information:
City
Phoenix
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Arizona
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Tucson
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Arizona
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Little Rock
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Arkansas
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Los Angeles
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California
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Martinez
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Santa Barbara
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Torrance
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Upland
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Denver
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Norwich
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Connecticut
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Gainesville
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Miami Shores
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Miami
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New Port Richey
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Atlanta
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Georgia
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Evanston
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Illinois
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Joliet
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Illinois
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Peoria
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Illinois
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Rockford
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Illinois
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Skokie
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Urbana
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Anderson
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Indiana
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Cedar Rapids
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Iowa
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Brewer
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Maine
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Baltimore
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Silver Spring
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Boston
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Massachusetts
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Detroit
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Michigan
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Rochester
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Saint Cloud
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Kansas City
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Grand Island
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Las Vegas
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Lebanon
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New Hampshire
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Albany
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New York
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Bronx
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East Syracuse
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New York
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New York
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New York
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Rochester
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New York
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Charlotte
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North Carolina
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High Point
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Cleveland
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Eugene
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Portland
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Erie
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Charleston
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Greenville
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North Charleston
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Rapid City
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South Dakota
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Nashville
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Abilene
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Austin
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Beaumont
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Bedford
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Dallas
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Denton
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Flower Mound
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Garland
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Houston
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Paris
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San Antonio
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Sugar Land
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Temple
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The Woodlands
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Tyler
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Waco
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Roanoke
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Virginia
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Winchester
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Virginia
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Green Bay
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Wisconsin
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Weston
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Amberloup
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Belgium
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Bonheiden
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Belgium
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Brussel
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Belgium
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Bruxelles
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Belgium
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Edegem
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Belgium
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Laken (brussel)
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Belgium
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Turnhout
Country
Belgium
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Wilrijk
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Belgium
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Barretos
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Brazil
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Caxias do Sul
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Brazil
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Curitiba
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Brazil
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Itajai
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Brazil
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Lajeado
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Brazil
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Londrina
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Brazil
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Mogi das Cruzes
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Brazil
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Porto Alegre, Rs
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Brazil
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Porto Alegre
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Brazil
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Rio de Janeiro
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Brazil
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Santo André
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Brazil
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Sao Jose do Rio Preto
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Brazil
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Sao Paulo
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Brazil
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Sorocaba
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Brazil
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São Paulo
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Brazil
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Plovdiv N/a
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Bulgaria
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Plovdiv
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Bulgaria
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Sofia
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Bulgaria
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Toronto
State/Province
Ontario
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Canada
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Saint-Jerome
State/Province
Quebec
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Canada
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Quebec
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Canada
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Benesov Nad Cernou
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Czechia
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Brno
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Czechia
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Jindrichuv Hradec
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Czechia
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Kladno
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Czechia
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Liberec
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Czechia
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Novy Jicin
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Czechia
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Olomouc
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Czechia
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Pardubice
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Czechia
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Praha 4
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Czechia
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Praha 5
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Czechia
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Tabor
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Czechia
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Angers Cedex 9
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France
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Angers
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France
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Avignon Cedex 9
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France
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Dijon Cedex
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France
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Hyers
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France
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Le Mans Cedex 2
Country
France
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Le Mans cedex 9
Country
France
City
Paris
Country
France
City
Rennes Cedex
Country
France
City
Saint Herblain
Country
France
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Valenciennes
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France
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Berlin
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Germany
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Brandenburg
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Germany
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Dortmund
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Germany
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Dresden
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Germany
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Esslingen
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Germany
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Gauting
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Germany
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Hamburg
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Germany
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Hannover
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Germany
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Herne
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Germany
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Kiel
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Germany
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Koeln
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Germany
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Leipzig
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Germany
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Luebeck
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Germany
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Magdeburg
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Germany
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Merseburg
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Germany
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Minden
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Germany
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München
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Germany
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Paderborn
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Germany
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Recklinghausen
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Germany
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Weiden
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Germany
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Arkhangelsk
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Russian Federation
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Chelyabinsk
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Russian Federation
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Kursk
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Russian Federation
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Moscow
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Russian Federation
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Novosibirsk
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Russian Federation
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Omsk
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Russian Federation
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Saint Petersburg
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Russian Federation
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St Petersburg
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Russian Federation
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Tomsk
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Russian Federation
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Yaroslavi
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Russian Federation
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Bournemouth
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United Kingdom
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Cheltenham
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United Kingdom
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Dundee
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United Kingdom
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London
Country
United Kingdom
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Manchester
Country
United Kingdom
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Plymouth
Country
United Kingdom
City
Swindon
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
34807979
Citation
Khorana AA, Barnard J, Wun T, Vijapurkar U, Damaraju CV, Moore KT, Wildgoose P, McCrae KR. Biomarker signatures in cancer patients with and without venous thromboembolism events: a substudy of CASSINI. Blood Adv. 2022 Feb 22;6(4):1212-1221. doi: 10.1182/bloodadvances.2021005710.
Results Reference
derived
PubMed Identifier
33337539
Citation
Rutjes AW, Porreca E, Candeloro M, Valeriani E, Di Nisio M. Primary prophylaxis for venous thromboembolism in ambulatory cancer patients receiving chemotherapy. Cochrane Database Syst Rev. 2020 Dec 18;12(12):CD008500. doi: 10.1002/14651858.CD008500.pub5.
Results Reference
derived
PubMed Identifier
32663379
Citation
Vadhan-Raj S, McNamara MG, Venerito M, Riess H, O'Reilly EM, Overman MJ, Zhou X, Vijapurkar U, Kaul S, Wildgoose P, Khorana AA. Rivaroxaban thromboprophylaxis in ambulatory patients with pancreatic cancer: Results from a pre-specified subgroup analysis of the randomized CASSINI study. Cancer Med. 2020 Sep;9(17):6196-6204. doi: 10.1002/cam4.3269. Epub 2020 Jul 14.
Results Reference
derived
PubMed Identifier
30786186
Citation
Khorana AA, Soff GA, Kakkar AK, Vadhan-Raj S, Riess H, Wun T, Streiff MB, Garcia DA, Liebman HA, Belani CP, O'Reilly EM, Patel JN, Yimer HA, Wildgoose P, Burton P, Vijapurkar U, Kaul S, Eikelboom J, McBane R, Bauer KA, Kuderer NM, Lyman GH; CASSINI Investigators. Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients with Cancer. N Engl J Med. 2019 Feb 21;380(8):720-728. doi: 10.1056/NEJMoa1814630.
Results Reference
derived
PubMed Identifier
28933799
Citation
Khorana AA, Vadhan-Raj S, Kuderer NM, Wun T, Liebman H, Soff G, Belani C, O'Reilly EM, McBane R, Eikelboom J, Damaraju CV, Beyers K, Dietrich F, Kakkar AK, Riess H, Peixoto RD, Lyman GH. Rivaroxaban for Preventing Venous Thromboembolism in High-Risk Ambulatory Patients with Cancer: Rationale and Design of the CASSINI Trial. Rationale and Design of the CASSINI Trial. Thromb Haemost. 2017 Nov 1;117(11):2135-2145. doi: 10.1160/TH17-03-0171. Epub 2017 Sep 21.
Results Reference
derived

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A Study to Evaluate the Efficacy and Safety of Rivaroxaban Venous Thromboembolism (VTE) Prophylaxis in Ambulatory Cancer Participants

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