Effect of concomitant chemotherapy on edoxaban plasma concentration in patients with colorectal cancer.

PURPOSE: Direct oral anticoagulants are a treatment option for cancer-associated venous thromboembolism (VTE). In patients receiving chemotherapy for cancer, there may be pharmacokinetic drug-drug interaction between anti-cancer agents and direct oral anticoagulants. However, there are no data available in patients with colorectal cancer (CRC). In this study, we investigated edoxaban plasma concentration in patients with CRC receiving chemotherapy.

METHODS

The study included patients with unresectable or metastatic CRC undergoing systemic chemotherapy and simultaneously receiving anticoagulant therapy with edoxaban for VTE or atrial fibrillation. Blood sampling was performed prior to chemotherapy and after 24 h and 48 h depending on the chemotherapy regimen.

RESULTS

Data of 21 and 26 patients were analyzed for edoxaban plasma concentration and safety, respectively. Edoxaban plasma concentration was not statistically different before and after 24 h and 48 h between patients receiving treatment with a chemotherapy regimen, cytotoxic drug, and a molecular targeted drug. One patient had major bleeding requiring transfusion; however, edoxaban plasma concentration was not elevated before and 24 h after chemotherapy (19.98 and 9.63 ng/ml, respectively).

CONCLUSION

In patients with CRC, edoxaban plasma concentration did not change after chemotherapy, implying that drug-drug interaction between edoxaban and anti-cancer agents was minimal.