Risk assessment models of cancer-associated thrombosis - Potentials and perspectives

Patients with cancer are at increased risk of venous thromboembolism (VTE). Risk assessment models can help identifying high-risk populations that might benefit from primary thromboprophylaxis. Currently, the Khorana score is suggested to select patients for primary thromboprophylaxis. However, risk stratification with the Khorana-score remains imperfect, which led to the development of subsequent clinical risk assessment models (PROTECHT-, CONKO-, ONKOTEV-, TiCat-, COMPASS-CAT-score). Further, recently, a simplified, personalized risk prediction tool for cancer-associated VTE, incorporating cancer type and D-Dimer levels has been proposed by Pabinger et al. (CATSCORE). Also, novel models have been designed specifically for specific tumour types, such as lung cancer (ROADMAP-CAT), gynaecological cancer (THROMBOGYN), lymphoma (THROLY), or multiple myeloma (SAVED-; IMPEDE VTE-score). In the present narrative review, we comprehensively summarize available data on currently available risk assessment models for VTE in patients with cancer, provide a critical discussion on their clinical utility, and give an outlook towards future developments.