{"id":1202,"date":"2023-12-11T18:04:08","date_gmt":"2023-12-11T18:04:08","guid":{"rendered":"https:\/\/oncologytweetorials-ce.com\/?p=1202"},"modified":"2023-12-13T18:08:03","modified_gmt":"2023-12-13T18:08:03","slug":"cat5","status":"publish","type":"post","link":"https:\/\/oncologytweetorials-ce.com\/cat5\/","title":{"rendered":"Cancer Associated Thrombosis: Current and Future Treatment Strategies, Assessing Relative Risk Among Cancer Types"},"content":{"rendered":"\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">2a) The program is intended for <a href=\"https:\/\/twitter.com\/hashtag\/healthcare?src=hash&amp;ref_src=twsrc%5Etfw\">#healthcare<\/a> professionals &amp; supported by an independent educational grant from Anthos Therapeutics. Statement of accreditation &amp; faculty disclosures at <a href=\"https:\/\/t.co\/8oShcATovC\">https:\/\/t.co\/8oShcATovC<\/a>.<\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911913169969578?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">3) The problem <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a> = <a href=\"https:\/\/twitter.com\/hashtag\/cancer?src=hash&amp;ref_src=twsrc%5Etfw\">#cancer<\/a>-associated <a href=\"https:\/\/twitter.com\/hashtag\/thrombosis?src=hash&amp;ref_src=twsrc%5Etfw\">#thrombosis<\/a> is that pts w\/cancer have an \u2b06\ufe0frisk of thrombosis<br>\ud83d\udea820%-30% of all <a href=\"https:\/\/twitter.com\/hashtag\/VTE?src=hash&amp;ref_src=twsrc%5Etfw\">#VTE<\/a> occur in pts with cancer<br>\ud83d\ude91 <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a> is associated w\/\u2b06\ufe0fmorbidity &amp; mortality<br>Great schematic here from fellow faculty <a href=\"https:\/\/twitter.com\/aakonc?ref_src=twsrc%5Etfw\">@aakonc<\/a> , <a href=\"https:\/\/t.co\/gteyliAuDp\">https:\/\/t.co\/gteyliAuDp<\/a> <a href=\"https:\/\/t.co\/PhWqzdNVvw\">pic.twitter.com\/PhWqzdNVvw<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911916424741156?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">5) Evidence \u27a1\ufe0fcancer itself is associated with a state of <a href=\"https:\/\/twitter.com\/hashtag\/hypercoagulability?src=hash&amp;ref_src=twsrc%5Etfw\">#hypercoagulability<\/a>, driven by release of <a href=\"https:\/\/twitter.com\/hashtag\/procoagulant?src=hash&amp;ref_src=twsrc%5Etfw\">#procoagulant<\/a> factors e.g. tissue factor <a href=\"https:\/\/twitter.com\/hashtag\/TF?src=hash&amp;ref_src=twsrc%5Etfw\">#TF<\/a>, from malignant tissue, &amp; by inflammation-driven activation of endothelial cells, <a href=\"https:\/\/twitter.com\/hashtag\/platelets?src=hash&amp;ref_src=twsrc%5Etfw\">#platelets<\/a>, &amp; <a href=\"https:\/\/twitter.com\/hashtag\/leukocytes?src=hash&amp;ref_src=twsrc%5Etfw\">#leukocytes<\/a><a href=\"https:\/\/t.co\/0atQUs2ipP\">https:\/\/t.co\/0atQUs2ipP<\/a> <a href=\"https:\/\/t.co\/I3mtW4ljau\">pic.twitter.com\/I3mtW4ljau<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911920203776223?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">7) Per \ud83d\udd13 <a href=\"https:\/\/t.co\/TfppSeg4km\">https:\/\/t.co\/TfppSeg4km<\/a>, the risk of <a href=\"https:\/\/twitter.com\/hashtag\/VTE?src=hash&amp;ref_src=twsrc%5Etfw\">#VTE<\/a> varies over the natural history of <a href=\"https:\/\/twitter.com\/hashtag\/cancer?src=hash&amp;ref_src=twsrc%5Etfw\">#cancer<\/a>, with the highest risk occurring during hospitalization and following the development of <a href=\"https:\/\/twitter.com\/hashtag\/metastatic?src=hash&amp;ref_src=twsrc%5Etfw\">#metastatic<\/a> disease. <a href=\"https:\/\/t.co\/piLWKFgcoj\">pic.twitter.com\/piLWKFgcoj<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911924368732268?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">9) To that point, <a href=\"https:\/\/twitter.com\/hashtag\/LMWH?src=hash&amp;ref_src=twsrc%5Etfw\">#LMWH<\/a> was the \ud83e\ude99 standard tx of acute <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a> for 15 years, based on <a href=\"https:\/\/twitter.com\/hashtag\/CLOT?src=hash&amp;ref_src=twsrc%5Etfw\">#CLOT<\/a> trial: \u2b07\ufe0f <a href=\"https:\/\/twitter.com\/hashtag\/VTE?src=hash&amp;ref_src=twsrc%5Etfw\">#VTE<\/a> recurrence w\/ <a href=\"https:\/\/twitter.com\/hashtag\/dalteparin?src=hash&amp;ref_src=twsrc%5Etfw\">#dalteparin<\/a> compared to <a href=\"https:\/\/twitter.com\/hashtag\/VKA?src=hash&amp;ref_src=twsrc%5Etfw\">#VKA<\/a>.<br>Since then, dalteparin (w\/ dose \u2b07\ufe0f to 75% after 1 mo) has become the comparator for all major studies<br>\ud83d\udd13 <a href=\"https:\/\/t.co\/THDX0NfdNk\">https:\/\/t.co\/THDX0NfdNk<\/a> <a href=\"https:\/\/t.co\/Fd1W6YWLoj\">pic.twitter.com\/Fd1W6YWLoj<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911928508588385?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">11) These were followed by <a href=\"https:\/\/twitter.com\/hashtag\/CANVAS?src=hash&amp;ref_src=twsrc%5Etfw\">#CANVAS<\/a>, a <a href=\"https:\/\/twitter.com\/hashtag\/pragmatic?src=hash&amp;ref_src=twsrc%5Etfw\">#pragmatic<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/effectiveness?src=hash&amp;ref_src=twsrc%5Etfw\">#effectiveness<\/a> trial of pts w\/ <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a> randomized to <a href=\"https:\/\/twitter.com\/hashtag\/DOAC?src=hash&amp;ref_src=twsrc%5Etfw\">#DOAC<\/a> vs &quot;SOC.&quot;<br>Results:<br>1\u20e3 DOAC noninferior for preventing recurrent VTE<br>2\u20e3 No diff in major \ud83e\ude78 (58.5% of DOAC was <a href=\"https:\/\/twitter.com\/hashtag\/apixaban?src=hash&amp;ref_src=twsrc%5Etfw\">#apixaban<\/a>)<br>3\u20e3 better adherence with DOAC<a href=\"https:\/\/t.co\/arT0KpuZ4O\">https:\/\/t.co\/arT0KpuZ4O<\/a> <a href=\"https:\/\/t.co\/6HilLZDIw1\">pic.twitter.com\/6HilLZDIw1<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911933650788534?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">13a) In <a href=\"https:\/\/twitter.com\/hashtag\/cancer?src=hash&amp;ref_src=twsrc%5Etfw\">#cancer<\/a>, tho, one size rarely fits all. <a href=\"https:\/\/twitter.com\/hashtag\/Gastrointestinal?src=hash&amp;ref_src=twsrc%5Etfw\">#Gastrointestinal<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/GI?src=hash&amp;ref_src=twsrc%5Etfw\">#GI<\/a> tumors are a problem! In <a href=\"https:\/\/twitter.com\/hashtag\/SELECT_D?src=hash&amp;ref_src=twsrc%5Etfw\">#SELECT_D<\/a> (riva vs dalt) the <a href=\"https:\/\/twitter.com\/hashtag\/DSMB?src=hash&amp;ref_src=twsrc%5Etfw\">#DSMB<\/a> advised enrolling no more upper GI malignancies. In <a href=\"https:\/\/twitter.com\/hashtag\/HOKUSAI?src=hash&amp;ref_src=twsrc%5Etfw\">#HOKUSAI<\/a>, major \ud83e\ude78on edox were GI in 22\/32 cases, vs 5\/16 GI with dalteparin.<\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911937966649837?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">14) So how do we currently treat acute <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a>? There are many considerations: <a href=\"https:\/\/t.co\/aWXeP8Yozm\">pic.twitter.com\/aWXeP8Yozm<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911941586411839?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">16) Recurrent <a href=\"https:\/\/twitter.com\/hashtag\/VTE?src=hash&amp;ref_src=twsrc%5Etfw\">#VTE<\/a> in <a href=\"https:\/\/twitter.com\/hashtag\/cancer?src=hash&amp;ref_src=twsrc%5Etfw\">#cancer<\/a>: <a href=\"https:\/\/t.co\/VWvyaOvDou\">pic.twitter.com\/VWvyaOvDou<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911945008890020?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">17b) See how we practice at\ud83d\udd13 <a href=\"https:\/\/t.co\/2mi3v4rwRC\">https:\/\/t.co\/2mi3v4rwRC<\/a>: <a href=\"https:\/\/t.co\/WNLDFGtz2o\">pic.twitter.com\/WNLDFGtz2o<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911948376924507?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">19a) How long to treat?<br>Most <a href=\"https:\/\/twitter.com\/hashtag\/RCT?src=hash&amp;ref_src=twsrc%5Etfw\">#RCT<\/a> for <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a> \ud83d\uded1at 6mos \u27a1\ufe0f guidelines advise only on tx first 6mos after acute VTE<br>\ud83d\udc49 <a href=\"https:\/\/twitter.com\/hashtag\/DALTECAN?src=hash&amp;ref_src=twsrc%5Etfw\">#DALTECAN<\/a>: Ph 4 prospective single arm safety trial of dalteparin over 12mos \u27a1\ufe0flow rate major bleeding\ud83e\ude78<br>(cont)<\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911952080523389?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">19c) Current consensus&#8211;beyond guidelines&#8211;is to continue therapeutic dose anticoagulation in the setting of persistent <a href=\"https:\/\/twitter.com\/hashtag\/cancer?src=hash&amp;ref_src=twsrc%5Etfw\">#cancer<\/a> or continued cancer treatments <a href=\"https:\/\/t.co\/5E423RPlys\">pic.twitter.com\/5E423RPlys<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734911955125547271?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">20b) <a href=\"https:\/\/twitter.com\/hashtag\/EVE?src=hash&amp;ref_src=twsrc%5Etfw\">#EVE<\/a>\u2014presented at ISTH June 2023, NCT03080883<br>At 12 months:<br>\ud83e\ude78MB+CRNMB: 8.9% vs 12.2% (HR 0.72, 95% CI 0.38-1.37)<br>\ud83d\ude91recurrent VTE: 5.0% vs 4.4% (HR 1.00, 95% CI 0.40 \u2013 2.53)<a href=\"https:\/\/twitter.com\/hashtag\/API_CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#API_CAT<\/a>\u2014ongoing <a href=\"https:\/\/t.co\/4an7rnCNHu\">pic.twitter.com\/4an7rnCNHu<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734913531286257697?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">21b) Rationale 2\u20e3 : <a href=\"https:\/\/twitter.com\/hashtag\/FXI?src=hash&amp;ref_src=twsrc%5Etfw\">#FXI<\/a> is a promising \ud83d\udcf7for inhibition of pathologic thrombosis w\/ minimal impairment of physiologic hemostasis \ud83d\udcf7<a href=\"https:\/\/twitter.com\/hashtag\/FXI?src=hash&amp;ref_src=twsrc%5Etfw\">#FXI<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/ASO?src=hash&amp;ref_src=twsrc%5Etfw\">#ASO<\/a> requires 30d lead in to suppress FXI production &amp; \ud83d\udcf7 levels, so not practical for acute VTE treatment<a href=\"https:\/\/t.co\/Igqaf9QnAl\">https:\/\/t.co\/Igqaf9QnAl<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734972610121802078?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">22a) <a href=\"https:\/\/twitter.com\/hashtag\/Abelacimabtrials?src=hash&amp;ref_src=twsrc%5Etfw\">#Abelacimabtrials<\/a> for patients with <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a> are underway and have been designed with the issues in mind&#8211;esp about <a href=\"https:\/\/twitter.com\/hashtag\/intraluminal?src=hash&amp;ref_src=twsrc%5Etfw\">#intraluminal<\/a> tumors&#8211;that we covered above in posts 13a &amp; 13b \u2934\ufe0f<\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734974379006492790?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">22c) Why two RCTs? For some pts with <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a>, <a href=\"https:\/\/twitter.com\/hashtag\/LMWH?src=hash&amp;ref_src=twsrc%5Etfw\">#LMWH<\/a> is the standard &amp; for others <a href=\"https:\/\/twitter.com\/hashtag\/DOACs?src=hash&amp;ref_src=twsrc%5Etfw\">#DOACs<\/a> are the standard. The two concurrent RCTs address both these populations&#8211;with different \ud83e\ude78 risk levels&#8211;with different control arms.<\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734976317513138417?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">23b) It&#39;s c, particularly <a href=\"https:\/\/twitter.com\/hashtag\/intraluminal?src=hash&amp;ref_src=twsrc%5Etfw\">#intraluminal<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/GI?src=hash&amp;ref_src=twsrc%5Etfw\">#GI<\/a> (and <a href=\"https:\/\/twitter.com\/hashtag\/GU?src=hash&amp;ref_src=twsrc%5Etfw\">#GU<\/a>) tumors. Current <a href=\"https:\/\/twitter.com\/hashtag\/SOC?src=hash&amp;ref_src=twsrc%5Etfw\">#SOC<\/a> for <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a> in affected pts is <a href=\"https:\/\/twitter.com\/hashtag\/LMWH?src=hash&amp;ref_src=twsrc%5Etfw\">#LMWH<\/a>.<\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734977852615909748?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">24b) It&#39;s b, interference with thrombosis. By selectively inhibiting the intrinsic pathway at the <a href=\"https:\/\/twitter.com\/hashtag\/FXIa?src=hash&amp;ref_src=twsrc%5Etfw\">#FXIa<\/a> step, physiologic <a href=\"https:\/\/twitter.com\/hashtag\/hemostasis?src=hash&amp;ref_src=twsrc%5Etfw\">#hemostasis<\/a> is not directly impacted, but pathologic <a href=\"https:\/\/twitter.com\/hashtag\/thrombosis?src=hash&amp;ref_src=twsrc%5Etfw\">#thrombosis<\/a> is. For more education on this, \u2714\ufe0fout (&amp; earn more\ud83c\udd93CE\/<a href=\"https:\/\/twitter.com\/hashtag\/CME?src=hash&amp;ref_src=twsrc%5Etfw\">#CME<\/a>) at <a href=\"https:\/\/t.co\/OQZyzk57I2\">https:\/\/t.co\/OQZyzk57I2<\/a><\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734996067022708828?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">25b) The <a href=\"https:\/\/twitter.com\/hashtag\/DMC?src=hash&amp;ref_src=twsrc%5Etfw\">#DMC<\/a> for that study recommended closing it because of an &quot;inferior efficacy&quot; signal for <a href=\"https:\/\/twitter.com\/hashtag\/asundexian?src=hash&amp;ref_src=twsrc%5Etfw\">#asundexian<\/a> compared with the <a href=\"https:\/\/twitter.com\/hashtag\/DOAC?src=hash&amp;ref_src=twsrc%5Etfw\">#DOAC<\/a>. As noted above, in the <a href=\"https:\/\/twitter.com\/hashtag\/ASTER?src=hash&amp;ref_src=twsrc%5Etfw\">#ASTER<\/a> Ph 3 trial for <a href=\"https:\/\/twitter.com\/hashtag\/CAT?src=hash&amp;ref_src=twsrc%5Etfw\">#CAT<\/a>, the <a href=\"https:\/\/twitter.com\/hashtag\/MAb?src=hash&amp;ref_src=twsrc%5Etfw\">#MAb<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/FXI?src=hash&amp;ref_src=twsrc%5Etfw\">#FXI<\/a> inhibitor <a href=\"https:\/\/twitter.com\/hashtag\/abelacimab?src=hash&amp;ref_src=twsrc%5Etfw\">#abelacimab<\/a> is being compared to apixaban.<\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734996287903146137?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<blockquote class=\"twitter-tweet\"><p lang=\"en\" dir=\"ltr\">26) Thanks for joining us! You just earned 0.5hr \ud83c\udd93CE\/<a href=\"https:\/\/twitter.com\/hashtag\/CME?src=hash&amp;ref_src=twsrc%5Etfw\">#CME<\/a>, &amp; you can claim your certificate NOW at <a href=\"https:\/\/t.co\/mtM167V7LD\">https:\/\/t.co\/mtM167V7LD<\/a>. And join expert faculty <a href=\"https:\/\/twitter.com\/connors_md?ref_src=twsrc%5Etfw\">@connors_md<\/a> in FOLLOWING <a href=\"https:\/\/twitter.com\/onc_ce?ref_src=twsrc%5Etfw\">@onc_ce<\/a> for the best <a href=\"https:\/\/twitter.com\/hashtag\/MedEd?src=hash&amp;ref_src=twsrc%5Etfw\">#MedEd<\/a> available wholly by <a href=\"https:\/\/twitter.com\/hashtag\/tweetorial?src=hash&amp;ref_src=twsrc%5Etfw\">#tweetorial<\/a>!<\/p>&mdash; @onc_ce (@onc_ce) <a href=\"https:\/\/twitter.com\/onc_ce\/status\/1734996428013941232?ref_src=twsrc%5Etfw\">December 13, 2023<\/a><\/blockquote> <script async src=\"https:\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"><\/script>\n\n\n\n<iframe\n      id=\"JotFormIFrame-233445072614149\"\n      title=\"cat5 | Oncology CE 2023new\"\n      onload=\"window.parent.scrollTo(0,0)\"\n      allowtransparency=\"true\"\n      allowfullscreen=\"true\"\n      allow=\"geolocation; microphone; camera\"\n      src=\"https:\/\/form.jotform.com\/233445072614149\"\n      frameborder=\"0\"\n      style=\"min-width:100%;max-width:100%;height:1539px;border:none;\"\n      scrolling=\"no\"\n    >\n    <\/iframe>\n    <script type=\"text\/javascript\">\n    var ifr = document.getElementById(\"JotFormIFrame-233445072614149\");\n    if (ifr) {\n      var src = ifr.src;\n      var iframeParams = [];\n      if (window.location.href && window.location.href.indexOf(\"?\") > -1) {\n        iframeParams = iframeParams.concat(window.location.href.substr(window.location.href.indexOf(\"?\") + 1).split('&'));\n      }\n      if (src && src.indexOf(\"?\") > -1) {\n        iframeParams = iframeParams.concat(src.substr(src.indexOf(\"?\") + 1).split(\"&\"));\n        src = src.substr(0, src.indexOf(\"?\"))\n      }\n      iframeParams.push(\"isIframeEmbed=1\");\n      ifr.src = src + \"?\" + iframeParams.join('&');\n    }\n    window.handleIFrameMessage = function(e) {\n      if (typeof e.data === 'object') { return; }\n      var args = e.data.split(\":\");\n      if (args.length > 2) { iframe = document.getElementById(\"JotFormIFrame-\" + args[(args.length - 1)]); } else { iframe = document.getElementById(\"JotFormIFrame\"); }\n      if (!iframe) { return; }\n      switch (args[0]) {\n        case \"scrollIntoView\":\n          iframe.scrollIntoView();\n          break;\n        case \"setHeight\":\n          iframe.style.height = args[1] + \"px\";\n          if (!isNaN(args[1]) && parseInt(iframe.style.minHeight) > parseInt(args[1])) {\n            iframe.style.minHeight = args[1] + \"px\";\n          }\n          break;\n        case \"collapseErrorPage\":\n          if (iframe.clientHeight > window.innerHeight) {\n            iframe.style.height = window.innerHeight + \"px\";\n          }\n          break;\n        case \"reloadPage\":\n          window.location.reload();\n          break;\n        case \"loadScript\":\n          if( !window.isPermitted(e.origin, ['jotform.com', 'jotform.pro']) ) { break; }\n          var src = args[1];\n          if (args.length > 3) {\n              src = args[1] + ':' + args[2];\n          }\n          var script = document.createElement('script');\n          script.src = src;\n          script.type = 'text\/javascript';\n          document.body.appendChild(script);\n          break;\n        case \"exitFullscreen\":\n          if      (window.document.exitFullscreen)        window.document.exitFullscreen();\n          else if (window.document.mozCancelFullScreen)   window.document.mozCancelFullScreen();\n          else if (window.document.mozCancelFullscreen)   window.document.mozCancelFullScreen();\n          else if (window.document.webkitExitFullscreen)  window.document.webkitExitFullscreen();\n          else if (window.document.msExitFullscreen)      window.document.msExitFullscreen();\n          break;\n      }\n      var isJotForm = (e.origin.indexOf(\"jotform\") > -1) ? 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