Apixaban in Preventing Secondary Cancer Related Venous Thrombosis in Cancer Patients Who Have Completed Anticoagulation Therapy

Inclusion Criteria

• •Confirmed acute index (original venous thrombotic) event: lower extremity or upper extremity (jugular, innominate, subclavian, axillary, brachial) DVT, PE, splanchnic (hepatic, portal, splenic, mesenteric, renal, gonadal), or cerebral vein thrombosis for which the patient has received \>= 180 days (but =\< 365 days) of anticoagulant therapy prior to registration; the date, imaging modality, and location of index event will be required; the date of initiation and specific type of anticoagulants used will also be required
• •Active cancer defined as metastatic disease and/or any evidence of cancer on cross-sectional or positron emission tomography (PET) imaging, cancer related surgery, chemotherapy or radiation therapy within the past 6 months; Note: non-melanoma skin cancer does not meet the cancer requirement
• •Life expectancy \>= 6 months
• •Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0, 1, or 2
• •Hemoglobin \>= 8 g/dL obtained =\< 30 days prior to registration
• •Platelet count \>= 50,000/mm\^3 obtained =\< 30 days prior to registration
• •Alanine aminotransferase (ALT) or aspartate transaminase (AST) =\< 3 x upper limit of normal (ULN) obtained =\< 30 days prior to registration
• •Calculated creatinine clearance must be \>= 30 ml/min using the Cockcroft-Gault formula obtained =\< 30 days prior to registration
• •Negative serum or urine pregnancy test done =\< 7 days prior to registration, for women of childbearing potential only;
• •* Note: a woman of childbearing potential (WOCBP) is defined as any female who has experienced menarche and who has not undergone surgical sterilization (hysterectomy or bilateral oophorectomy) and is not postmenopausal; menopause is defined as 12 months of amenorrhea in a woman over age 45 years in the absence of other biological or physiological causes
• •Ability to provide informed written consent
• •Willing to undergo monthly follow-up assessment, either in person at the enrolling institution or by telephone
• •Current use of thienopyridine therapy (clopidogrel, prasugrel, or ticagrelor) that will be continued on study
• •Severe liver disease (known cirrhosis Childs Pugh class B or C), or active hepatitis
• •Documented venous thromboembolism while on therapeutic anticoagulation ("anticoagulation failure")
• •Mechanical heart valve
• •Documented hemorrhagic tendencies (e.g., hemophilia)
• •Bacterial endocarditis
• •Any of the following conditions:
• •* Intracranial bleeding =\< 6 months prior to randomization
• •* Intraocular bleeding =\< 6 months prior to randomization
• •* Gastrointestinal bleeding and/or endoscopically proven ulcer =\< 6 months prior to randomization
• •* Head trauma or major trauma =\< 1 month prior to randomization
• •* Neurosurgery =\< 2 weeks prior to randomization
• •* Major surgery =\< 1 week prior to randomization
• •* Gross hematuria at the time of randomization