Oral Apixaban (Eliquis) Versus Enoxaparin (Lovenox) for Thromboprophylaxis in Women With Suspected Pelvic Malignancy

Exclusion Criteria

• •Malignancy or mass that is non-gynecologic in origin (mass/tumor of origin other than reproductive organ such as rectal, abdominal, breast)
• •Positive pregnancy test on day of surgery,
• •Known history of Venous (Thromboembolism) VTE prior to diagnosis (DVT or Pulmonary Embolism (PE)) due to increased underlying risk of new event
• •Concomitant NSAIDS or other anticoagulant/antiplatelet therapy including Acetylsalicylic Acid (Aspirin) (ASA) \>81mg/day,
• •Selective serotonin re uptake inhibitor (SSRIs) and Serotonin-nor-epinephrine re uptake inhibitor (SNRIs) (common anti-depressant therapies),
• •Uncontrolled severe hypertension (systolic \>200 mmHg or diastolic \>120 mmHg),
• •With prosthetic heart valves,
• •Active bleeding condition (not limited to: thrombocytopenia, haemophilias, potential bleeding lesions, recent trauma or surgery, recent stroke, confirmed intracranial or intraspinal bleeding),
• •Known or documented bleeding disorders not limited to: anti-phospholipid syndrome, homozygotes for Factor V Leiden deficiency, antithrombin III deficiency, protein C deficiency, Protein S deficiency, hyperhomocysteinemia, systemic lupus erythematous, or Prothrombin G2020 gene mutation,
• •Significant renal disease as defined by creatinine clearance less than 30 mL/min,
• •Significant liver disease as defined as Aspartate Transaminase (AST) or Alanine Transaminase (ALT) twice than normal,
• •Concomitant use of dual strong inhibitors or inducers (CYP3A4, P-gp)
• •Protein C deficiency (increased risk of skin necrosis do those on injectable anticoagulation),
• •Documented allergy to apixaban and/or enoxaparin,
• •Patient's deemed otherwise clinically unfit for clinical trial per Investigator's discretion