https://orcid.org/0000-0002-8426-3398
Key Points
The addition of rosuvastatin to enoxaparin following ovarian cancer surgery does not impact number of circulating TF+EV
Rosuvastatin did not alter markers of thromboinflammation after ovarian cancer surgery including C reactive protein or D-dimer
Venous thromboembolism is frequent in ovarian cancer especially after surgery. Elaboration of tissue factor bearing extracellular vesicles (TF+EV) has been linked to thrombosis in cancer and hypercoagulability of surgery. Rosuvastatin can reduce the generation of EV and decrease VTE risk in non-cancer populations. The use of rosuvastatin to mitigate post-surgical thrombosis by lowering TF+EV following ovarian cancer surgery has not been investigated. In a pilot phase 2 trial in women undergoing ovarian cancer, women were randomized to enoxaparin 40 mg daily for 30 days with or without rosuvastatin 40 mg daily (administered from days 15- 60). Women who elected to forgo randomization received enoxaparin 40 mg daily for 30 days per standard of care. Total EV and TF+EV were assessed at baseline, day 30, and day 60. Bilateral lower extremity ultrasound was performed on day 30 and 60. A total of 24 women enrolled in the trial, 15 underwent randomization and 7 women were randomized to enoxaparin with rosuvastatin (17 received enoxaparin alone). There were no statistical differences observed in circulating TF+EV with the addition of rosuvastatin to enoxaparin at day 30 or day 60. Similarly, there were no differences in C-reactive protein or D-dimer between groups. There were no lower extremity deep vein thrombosis identified on screening ultrasounds, although portal vein thrombosis was diagnosed in enoxaparin-only arm. No major hemorrhages were observed. The addition of rosuvastatin to enoxaparin following ovarian cancer surgery does not appear to impact number of circulating TF+EV nor alter markers of thromboinflammation.
