Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Cochrane on Heparin Impact in People with Cancer

Cochrane; 2017 Sep 11; Akl, Kahale, et al

Heparin does not appear to impact 1- and 2-year mortality in people with cancer, according to a Cochrane review of 18 trials involving nearly 9,600 individuals. Studies included patients mainly with small cell lung cancer, non-small cell lung cancer, and pancreatic cancer. Among the findings:

  • The impact on blood thinners is uncertain, or small at best.
  • Injectable blood thinners reduce the risk of blood clots by about half.
  • They appear to increase the risk of major bleeding by 4 more per 1,000, and minor bleeding by 17 more per 1,000.
  • Quality of life impact is not certain.

The decision to start heparin therapy should balance the benefits and downsides, and should include patient values/preferences, the reviewers noted.


Akl E, Kahale L, Hakoum M, et al. Parenteral anticoagulation in ambulatory patients with cancer. Cochrane Database of Systematic Reviews. 2017, Issue 9. Art. No.: CD006652. doi:10.1002/14651858.CD006652.pub5.