Cancer

Prostate cancer therapies appear compatible with anticoagulants despite theoretical interaction risks

March 11, 2026

A large, population‑based analysis from Canada reported no meaningful rise in thrombosis or bleeding among prostate cancer patients who received DOACs alongside enzalutamide, apalutamide, or abiraterone. The retrospective study included 2,997 individuals treated in Ontario and Alberta between 2012 and 2023. Although enzalutamide and apalutamide are theoretically expected to reduce DOAC activity via CYP induction—and abiraterone could, in contrast, raise bleeding risk through enzyme inhibition—the study observed no meaningful differences in real‑world outcomes. In the enzalutamide/apalutamide group, the pooled hazard ratio for thrombosis was 0.83 (95% confidence interval [CI], 0.36–1.93), and for abiraterone, the pooled hazard ratio for bleeding was 1.16 (95% CI, 0.10–13.99).

Clinical takeaway: Current evidence suggests these combinations don’t elevate clotting or bleeding risks; clinicians can feel more confident selecting anticoagulants while continuing to monitor for individual drug–drug interaction concerns.

Source:

Wang TF, et al. (2026, March 15). Cancer. Risks of thrombosis and hemorrhage in concurrent use of anticoagulants and potential interacting prostate cancer agents. https://pubmed.ncbi.nlm.nih.gov/41797435/