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Cancer-associated venous thromboembolism (VTE) accounts for around 20% of all VTE cases and is a major cause of morbidity and mortality among individuals with cancer. Current guidelines typically recommend direct oral anticoagulants (DOACs) or low-molecular-weight heparin as first-line treatments for cancer-associated VTE. Because DOACs play a key role in preventing and treating cancer-associated VTE, interest in the effectiveness and safety of apixaban and rivaroxaban remains high. However, direct, head-to-head evidence comparing these two drugs in this population is lacking. In this issue, Jingjing Sun and colleagues examine the comparative effectiveness of apixaban and rivaroxaban in preventing recurrent VTE and reducing bleeding risk in individuals with active cancer.
Image Credit: Maksim Goncharenok, Pexels
Citation: (2025) PLoS Medicine Issue Image | Vol. 22(9) October 2025. PLoS Med 22(9): ev22.i09. https://doi.org/10.1371/image.pmed.v22.i09
Published: October 8, 2025
Copyright: © 2025 . This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Cancer-associated venous thromboembolism (VTE) accounts for around 20% of all VTE cases and is a major cause of morbidity and mortality among individuals with cancer. Current guidelines typically recommend direct oral anticoagulants (DOACs) or low-molecular-weight heparin as first-line treatments for cancer-associated VTE. Because DOACs play a key role in preventing and treating cancer-associated VTE, interest in the effectiveness and safety of apixaban and rivaroxaban remains high. However, direct, head-to-head evidence comparing these two drugs in this population is lacking. In this issue, Jingjing Sun and colleagues examine the comparative effectiveness of apixaban and rivaroxaban in preventing recurrent VTE and reducing bleeding risk in individuals with active cancer.
Image Credit: Maksim Goncharenok, Pexels