静脉血栓栓塞（VTE）是癌症的一种常见并发症，癌症相关性血栓形成（CAT）的管理因出血和再发VTE风险增加而具有挑战性。最近的试验显示，与低分子肝素相比，直接口服抗凝剂（DOACs）治疗CAT具有可接受的疗效和安全性。虽然DOACs为CAT提供了一种有效和便捷的治疗选择，但需要评估与抗肿瘤治疗的药物相互作用（DDI）风险，这在临床实践中使用DOACs时存在障碍。为了支持对CAT患者使用DOAC进行治疗的评估，本综述提供了关于单个DOACs（阿哌沙班、达比加群、依多沙班和利伐沙班）与抗肿瘤治疗的兼容性的综合概述。我们使用多个数据源，评估了与p-糖蛋白和细胞色素P450有关的100种广泛使用的抗肿瘤药物的作用，这两种都对于DOACs的转运和排泄重要。这使我们能够评估400个“DOAC-抗肿瘤药物”对的相互作用可能性（不可能、潜在或可能），最终为每个对的同时使用适当性提供临床建议。在评估的对中，约12％存在潜在或可能的DDI。对于几乎所有抗肿瘤药物，至少有一种DOAC被认为与其兼容。Thieme保留所有权利。

Venous thromboembolism (VTE) is a frequent complication of cancer, and management of cancer-associated thrombosis (CAT) is challenging due to increased risks of bleeding and recurrent VTE. Recent trials have shown an acceptable efficacy and safety of direct oral anticoagulants (DOACs) in the treatment of CAT compared to low-molecular weight heparin. Although DOACs provide an effective and convenient treatment option in CAT, the need to assess the risk of drug-drug interactions (DDI) with antineoplastic therapies poses a barrier to their use in clinical practice. With the aim of supporting the assessment of CAT patients for treatment with DOAC, this review provides a comprehensive overview of the compatibility of antineoplastic therapies with the individual DOACs (apixaban, dabigatran, edoxaban, and rivaroxaban). Using several data sources, we characterized 100 widely used antineoplastic agents with regard to their effect on p-glycoprotein and cytochrome P450, both important in the transport and elimination of DOACs. This enabled us to evaluate 400 "DOAC-antineoplastic agent"-pairs regarding their likelihood to interact (unlikely, potential, or likely), ultimately leading to clinical recommendations on the appropriateness of concomitant use for each pair. A potential or likely DDI was identified for 12% of the evaluated pairs. For nearly all antineoplastic agents, at least one DOAC was considered compatible.Thieme. All rights reserved.