Algorithm for the treatment of cancer-associated VTE. *High risk factors for bleeding include thrombocytopenia (platelet count is <50 × 10⁹/L), renal dysfunction (creatinine clearance of 30-50 mL/min by the Cockcroft–Gault formula), liver dysfunction, presence of hemorrhagic lesion, recent major hemorrhage, or use of antiplatelet agent. **Combined P-glycoprotein and strong cytochrome P450 3A4 inducers and inhibitors interact significantly with rivaroxaban and apixaban. These combinations should be avoided. P-glycoprotein inducers should be avoided with edoxaban, whereas a reduced dose (edoxaban 30 mg once daily) should be used with concomitant P-glycoprotein inhibitors. ^§Based on the current published data, edoxaban and rivaroxaban have the highest quality of evidence for use in CAT, although additional studies with apixaban are underway. Adapted from Carrier et al⁴⁶  with permission.