Muhammed Hajmusa/LinkedIn
Oct 27, 2026, 13:51
Muhammed Hajmusa: ESMO 2026 Highlights the Challenge of Anticoagulation in ROS1-Positive Lung Cancer
Muhammed Hajmusa, Specialist of Medical Oncology at National Center for Cancer Care and Research in Doha, Qatar, shared a post on LinkedIn:
“Our e-poster is up at ESMO 26 in Madrid (2784eP). When a patient with ROS1-positive lung cancer develops a clot, the anticoagulant we choose has to work alongside a TKI.
Many of these TKIs act on the same pathways that clear DOACs and warfarin. No guideline addresses this. So we ran a systematic review. What we found across 46 studies:
- Thrombosis is common. Rates in ROS1 cohorts ranged from 10% to 48%.
- No study has compared anticoagulants in this population. The evidence is case reports and small cohorts.
- Drug labels predict no pharmacokinetic interaction with heparins for any ROS1 TKI. DOAC and warfarin interactions vary by TKI, and the newer agents are largely unstudied.
Until better data exist, the TKI should guide the anticoagulant choice. A prospective ROS1 thrombosis registry is overdue. Thanks go to the team.”
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