Transition of management strategies and long-term outcomes in cancer-associated venous thromboembolism from the warfarin era to the direct oral anticoagulant era

•There have been still limited data on the transition of management strategies and clinical outcomes after introduction of direct oral anticoagulant (DOAC) for cancer-associated venous thromboembolism (VTE) in the real-world clinical practice.•In the current historical comparison of cancer-associated VTE between the 2 large real-world registries, there was a striking change in the treatment strategies with decreased risks of recurrent VTE and major bleeding in the DOAC era (COMAAND VTE Registry-2) compared with those in the warfarin era (COMAAND VTE Registry-1).•The risks of recurrent VTE has decreased significantly with the transition to the DOAC era, while there seemed to be unmet needs of clinically relevant nonmajor bleeding, DOAC-related gastrointestinal bleeding, and home treatment for pulmonary embolism patients with cancer.