Cancer-associated thrombosis: pathogenesis, risk factors, and treatment. A review

Cover Page

Cite item

Full Text

Abstract

Cancer-associated thrombosis (CAT) is one of the most frequent and dangerous complications of malignancies, ranking 2nd among the causes of death in cancer patients. The article presents an overview of current data on the pathogenesis of thrombosis in cancer patients, including the key role of tumor cells, inflammatory cytokines, neutrophil extracellular traps, and dysregulation of hemostasis. CAT epidemiology, individual (age, comorbidities, mobility) and tumor-dependent (location, stage, histology) risk factors, as well as the effect of various types of anticancer therapy, including chemotherapy, surgery, and the use of central venous catheters, are considered. Particular attention is paid to modern approaches to the prevention and treatment of CAT, including direct oral anticoagulants, their advantages over low molecular weight heparins, and data from large randomized trials (CARAVAGGIO and API-CAT). The review includes an analysis of international and Russian clinical guidelines (ASCO, NCCN, RUSSCO), focusing on the need for an individual approach, considering the clinical situation, the risk of bleeding, and drug interactions. The presented data emphasize the importance of timely detection of CAT and rational choice of therapy to reduce the risk of complications and improve the prognosis in cancer patients. The presented data emphasize the importance of timely detection of CAT and rational choice of therapy to reduce the risk of complications and improve the prognosis in cancer patients. In addition, a reduced dose of apixaban (2.5 mg twice daily) after 6 months of therapy was found to be effective in preventing the recurrence of venous thromboembolism and reducing the incidence of clinically significant bleeding compared to the full dose.

About the authors

Airat I. Bilyalov

Loginov Moscow Clinical Scientific Center

Author for correspondence.
Email: BilyalovAir@yandex.ru
ORCID iD: 0000-0002-8888-8395

Cand. Sci. (Med.), Oncologist

Russian Federation, Moscow

Alfia I. Nesterova

Segal Republican Clinical Oncological Dispensary; Kazan (Volga Region) Federal University; Kazan State Medical Academy – a branch of the Russian Medical Academy of Continuous Professional Education

Email: BilyalovAir@yandex.ru
ORCID iD: 0000-0003-4249-5518

Cand. Sci. (Med.), Oncologist, Head of Department

Russian Federation, Kazan; Kazan; Kazan

Natalia A. Bodunova

Loginov Moscow Clinical Scientific Center

Email: BilyalovAir@yandex.ru
ORCID iD: 0000-0002-3119-7673

Cand. Sci. (Med.)

Russian Federation, Moscow

Sergey V. Zinchenko

Segal Republican Clinical Oncological Dispensary; Kazan (Volga Region) Federal University

Email: BilyalovAir@yandex.ru
ORCID iD: 0000-0002-9306-3507

D. Sci. (Med.), Oncologist; Head of Department

Russian Federation, Kazan; Kazan

References

  1. Prandoni P, Falanga A, Piccioli A. Cancer and venous thromboembolism. Lancet Oncol. 2005;6(6):401-10. doi: 10.1016/S1470-2045(05)70207-2
  2. Noble S, Pasi J. Epidemiology and pathophysiology of cancer-associated thrombosis. Br J Cancer. 2010;102(Suppl. 1):S2-9. doi: 10.1038/sj.bjc.6605599
  3. Levi M. Cancer-related coagulopathies. Thromb Res. 2014;133(Suppl. 2):S70-5. doi: 10.1016/S0049-3848(14)50012-6
  4. Eichinger S. Cancer associated thrombosis: Risk factors and outcomes. Thromb Res. 2016;140(Suppl. 1):S12-7. doi: 10.1016/S0049-3848(16)30092-5
  5. Blom JW, Doggen CJ, Osanto S, Rosendaal FR. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA. 2005;293(6):715-22. doi: 10.1001/jama.293.6.715
  6. Heit JA, Silverstein MD, Mohr DN, et al. Risk factors for deep vein thrombosis and pulmonary embolism: A population-based case-control study. Arch Intern Med. 2000;160(6):809-15. doi: 10.1001/archinte.160.6.809
  7. Navi BB, Reiner AS, Kamel H, et al. Risk of arterial thromboembolism in patients with cancer. J Am Coll Cardiol. 2017;70(8):926-38. doi: 10.1016/j.jacc.2017.06.047
  8. Fuchs TA, Brill A, Wagner DD. Neutrophil extracellular trap (NET) impact on deep vein thrombosis. Arterioscler Thromb Vasc Biol. 2012;32(8):1777-83. doi: 10.1161/ATVBAHA.111.242859
  9. Naess IA, Christiansen SC, Romundstad P, et al. Incidence and mortality of venous thrombosis: A population-based study. J Thromb Haemost. 2007;5(4):692-9. doi: 10.1111/j.1538-7836.2007.02450.x
  10. Connolly GC, Francis CW. Cancer-associated thrombosis. Hematology Am Soc Hematol Educ Program. 2013;2013:684-91. doi: 10.1182/asheducation-2013.1.684
  11. Agnelli G, Verso M. Management of venous thromboembolism in patients with cancer. J Thromb Haemost. 2011;9(Suppl. 1):316-24. doi: 10.1111/j.1538-7836.2011.04346
  12. Robertson L, Yeoh SE, Broderick C, et al. Effect of testing for cancer on cancer- or venous thromboembolism (VTE)-related mortality and morbidity in people with unprovoked VTE. Cochrane Database Syst Rev. 2018;11(11):CD010837. doi: 10.1002/14651858.CD010837.pub4
  13. Rigdon EE. Trousseau's syndrome and acute arterial thrombosis. Cardiovasc Surg. 2000;8(3):214-8. doi: 10.1016/s0967-2109(00)00004-1
  14. Litvinov RI, Weisel JW. Blood clot contraction: Mechanisms, pathophysiology, and disease. Res Pract Thromb Haemost. 2023;7(1):100023. doi: 10.1016/j.rpth.2022.100023
  15. Tuzovic M, Herrmann J, Iliescu C, et al. Arterial thrombosis in patients with cancer. Curr Treat Options Cardiovasc Med. 2018;20(5):40. doi: 10.1007/s11936-018-0635-x
  16. Mi Y, Yan S, Lu Y, et al. Venous thromboembolism has the same risk factors as atherosclerosis: A PRISMA-compliant systemic review and meta-analysis. Medicine (Baltimore). 2016;95(32):e4495. doi: 10.1097/MD.0000000000004495
  17. Levi M. Management of cancer-associated disseminated intravascular coagulation. Thromb Res. 2016;140(Suppl. 1):S66-70. doi: 10.1016/S0049-3848(16)30101-3
  18. Kwaan HC, Gordon LI. Thrombotic microangiopathy in the cancer patient. Acta Haematol. 2001;106(1-2):52-6. doi: 10.1159/000046589
  19. Wada H, Matsumoto T, Suzuki K, et al. Differences and similarities between disseminated intravascular coagulation and thrombotic microangiopathy. Thromb J. 2018;16:14. doi: 10.1186/s12959-018-0168-2
  20. Sallah S, Wan JY, Nguyen NP, et al. Disseminated intravascular coagulation in solid tumors: Clinical and pathologic study. Thromb Haemost. 2001;86(3):828-33. PMID: 11583315
  21. Barbui T, Falanga A. Disseminated intravascular coagulation in acute leukemia. Semin Thromb Hemost. 2001;27(6):593-604. doi: 10.1055/s-2001-18865
  22. Yeh KH, Cheng AL. Gastric cancer associated with acute disseminated intravascular coagulation: successful initial treatment with weekly 24-hour infusion of high-dose 5-fluorouracil and leucovorin. Br J Haematol. 1998;100(4):769-72. doi: 10.1046/j.1365-2141.1998.00613.x
  23. Amer MH. Cancer-associated thrombosis: Clinical presentation and survival. Cancer Manag Res. 2013;5:165-78. doi: 10.2147/CMAR.S47094
  24. Silverstein MD, Heit JA, Mohr DN, et al. Trends in the incidence of deep vein thrombosis and pulmonary embolism: A 25-year population-based study. Arch Intern Med. 1998;158(6):585-93. doi: 10.1001/archinte.158.6.585
  25. Tsai AW, Cushman M, Rosamond WD, et al. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Arch Intern Med. 2002;162(10):1182-9. doi: 10.1001/archinte.162.10.1182
  26. Khorana AA, Francis CW, Culakova E, et al. Thromboembolism in hospitalized neutropenic cancer patients. J Clin Oncol. 2006;24(3):484-90. doi: 10.1200/JCO.2005.03.8877
  27. Vergati M, Della-Morte D, Ferroni P, et al. Increased risk of chemotherapy-associated venous thromboembolism in elderly patients with cancer. Rejuvenation Res. 2013;16(3):224-31. doi: 10.1089/rej.2013.1409
  28. Previtali E, Bucciarelli P, Passamonti SM, Martinelli I. Risk factors for venous and arterial thrombosis. Blood Transfus. 2011;9(2):120-38. doi: 10.2450/2010.0066-10
  29. Leeming JP, Diamond JP, Trigg R, et al. Ocular penetration of topical ciprofloxacin and norfloxacin drops and their effect upon eyelid flora. Br J Ophthalmol. 1994;78(7):546-8. doi: 10.1136/bjo.78.7.546
  30. Nakamura O, Segawa H, Tanaka H, et al. rCBF in brain tumours as measured by xenon enhanced CT. Neurol Res. 1987;9(1):24-9. doi: 10.1080/01616412.1987.11739767
  31. Chew HK, Wun T, Harvey D, et al. Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intern Med. 2006;166(4):458-64. doi: 10.1001/archinte.166.4.458
  32. Khorana AA, Francis CW, Culakova E, et al. Frequency, risk factors, and trends for venous thromboembolism among hospitalized cancer patients. Cancer. 2007;110(10):2339-46. doi: 10.1002/cncr.23062
  33. Stein PD, Beemath A, Meyers FA, et al. Incidence of venous thromboembolism in patients hospitalized with cancer. Am J Med. 2006;119(1):60-8. doi: 10.1016/j.amjmed.2005.06.058
  34. Colling ME, Tourdot BE, Kanthi Y. Inflammation, infection and venous thromboembolism. Circ Res. 2021;128(12):2017-36. doi: 10.1161/CIRCRESAHA.121.318225
  35. Al Diab AI. Cancer-related venous thromboembolism: Insight into underestimated risk factors. Hematol Oncol Stem Cell Ther. 2010;3(4):191-5. doi: 10.5144/1658-3876.2010.191
  36. Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol. 2007;44(2):62-9. doi: 10.1053/j.seminhematol.2007.02.004
  37. Agnelli G, Bolis G, Capussotti L, et al. A clinical outcome-based prospective study on venous thromboembolism after cancer surgery: The @RISTOS project. Ann Surg. 2006;243(1):89-95. doi: 10.1097/01.sla.0000193959.44677.48
  38. Connolly GC, Khorana AA. Emerging risk stratification approaches to cancer-associated thrombosis: Risk factors, biomarkers and a risk score. Thromb Res. 2010;125(Suppl. 2):S1-7. doi: 10.1016/S0049-3848(10)00227-6
  39. Horsted F, West J, Grainge MJ. Risk of venous thromboembolism in patients with cancer: A systematic review and meta-analysis. PLoS Med. 2012;9(7):e1001275. doi: 10.1371/journal.pmed.1001275
  40. Haddad TC, Greeno EW. Chemotherapy-induced thrombosis. Thromb Res. 2006;118(5):555-68. doi: 10.1016/j.thromres.2005.10.015
  41. Yhim HY, Jang MJ, Kwak JY, et al.; Korean Venous Thromboembolism Working Party. The incidence, risk factors, and prognosis of recurrent venous thromboembolism (VTE) in patients with advanced solid cancers receiving anticoagulation therapy after the diagnosis of index VTE. Thromb Res. 2013;131(4):e133-40. doi: 10.1016/j.thromres.2013.01.025
  42. Cronin-Fenton DP, Søndergaard F, Pedersen LA, et al. Hospitalisation for venous thromboembolism in cancer patients and the general population: A population-based cohort study in Denmark, 1997–2006. Br J Cancer. 2010;103(7):947-53. doi: 10.1038/sj.bjc.6605883
  43. Metcalf RL, Fry DJ, Swindell R, et al. Thrombosis in ovarian cancer: A case control study. Br J Cancer. 2014;110(5):1118-24. doi: 10.1038/bjc.2014.3
  44. Blom JW, Osanto S, Rosendaal FR. The risk of a venous thrombotic event in lung cancer patients: Higher risk for adenocarcinoma than squamous cell carcinoma. J Thromb Haemost. 2004;2(10):1760-5. doi: 10.1111/j.1538-7836.2004.00928.x
  45. Caine GJ, Stonelake PS, Lip GY, Kehoe ST. The hypercoagulable state of malignancy: Pathogenesis and current debate. Neoplasia. 2002;4(6):465-73. doi: 10.1038/sj.neo.7900263
  46. Alcalay A, Wun T, Khatri V, et al. Venous thromboembolism in patients with colorectal cancer: Incidence and effect on survival. J Clin Oncol. 2006;24(7):1112-8. doi: 10.1200/JCO.2005.04.2150
  47. Ahlbrecht J, Dickmann B, Ay C, et al. Tumor grade is associated with venous thromboembolism in patients with cancer: Results from the Vienna Cancer and Thrombosis Study. J Clin Oncol. 2012;30(31):3870-5. doi: 10.1200/JCO.2011.40.1810
  48. Cortecchia V, Buli P, Brunocilla E, et al. Therapeutic evaluation of aztreonam in the treatment of infections of the urinary tract in another 800 patients. G Ital Chemioter. 1985;32(2):449-51 (in Italian). PMID: 3914434
  49. Khorana AA, Dalal M, Lin J, Connolly GC. Incidence and predictors of venous thromboembolism (VTE) among ambulatory high-risk cancer patients undergoing chemotherapy in the United States. Cancer. 2013;119(3):648-55. doi: 10.1002/cncr.27772
  50. Khorana AA, Kuderer NM, Culakova E, et al. Development and validation of a predictive model for chemotherapy-associated thrombosis. Blood. 2008;111(10):4902-7. doi: 10.1182/blood-2007-10-116327
  51. Rogers MA, Levine DA, Blumberg N, et al. Triggers of hospitalization for venous thromboembolism. Circulation. 2012;125(17):2092-9. doi: 10.1161/CIRCULATIONAHA.111.084467
  52. Doll DC, List AF, Greco FA, et al. Acute vascular ischemic events after cisplatin-based combination chemotherapy for germ-cell tumors of the testis. Ann Intern Med. 1986;105(1):48-51. doi: 10.7326/0003-4819-105-1-48
  53. Cunningham D, Starling N, Rao S, et al. Capecitabine and oxaliplatin for advanced esophagogastric cancer. N Engl J Med. 2008;358(1):36-46. doi: 10.1056/NEJMoa073149
  54. Heit JA. Epidemiology of venous thromboembolism. Nat Rev Cardiol. 2015;12(8):464-74. doi: 10.1038/nrcardio.2015.83
  55. Wall C, Moore J, Thachil J. Catheter-related thrombosis: A practical approach. J Intensive Care Soc. 2016;17(2):160-7. doi: 10.1177/1751143715618683
  56. Verso M, Agnelli G. Venous thromboembolism associated with long-term use of central venous catheters in cancer patients. J Clin Oncol. 2003;21(19):3665-75. doi: 10.1200/JCO.2003.08.008
  57. Falanga A, Marchetti M, Russo L. The mechanisms of cancer-associated thrombosis. Thromb Res. 2015;135(Suppl. 1):S8-11. doi: 10.1016/S0049-3848(15)50432-5
  58. Moik F, Ay C. Hemostasis and cancer: Impact of haemostatic biomarkers for the prediction of clinical outcomes in patients with cancer. J Thromb Haemost. 2022;20(12):2733-45. doi: 10.1111/jth.15880
  59. Bluff JE, Brown NJ, Reed MW, Staton CA. Tissue factor, angiogenesis and tumour progression. Breast Cancer Res. 2008;10(2):204. doi: 10.1186/bcr1871
  60. Falanga A, Russo L, Milesi V, Vignoli A. Mechanisms and risk factors of thrombosis in cancer. Crit Rev Oncol Hematol. 2017;118:79-83. doi: 10.1016/j.critrevonc.2017.08.003
  61. Riedl J, Preusser M, Nazari PM, et al. Podoplanin expression in primary brain tumors induces platelet aggregation and increases risk of venous thromboembolism. Blood. 2017;129(13):1831-9. doi: 10.1182/blood-2016-06-720714
  62. Akinbo DB, Ajayi OI. Thrombotic pathogenesis and laboratory diagnosis in cancer patients, an update. Int J Gen Med. 2023;16:259-72. doi: 10.2147/IJGM.S385772
  63. Rosell A, Martinod K, Mackman N, Thålin C. Neutrophil extracellular traps and cancer-associated thrombosis. Thromb Res. 2022;213(Suppl. 1):S35-41. doi: 10.1016/j.thromres.2021.12.018
  64. Girardi L, Wang TF, Ageno W, Carrier M. Updates in the incidence, pathogenesis, and management of cancer and venous thromboembolism. Arterioscler Thromb Vasc Biol. 2023;43(6):824-31. doi: 10.1161/ATVBAHA.123.318779
  65. Goffinet AM, Hemmendinger LM, Caviness VS. Autoradiographic study of beta 1-adrenergic receptor development in the mouse forebrain. Brain Res. 1986;389(1-2):187-91. doi: 10.1016/0165-3806(86)90186-0
  66. Büller HR, Décousus H, Grosso MA, et al. Edoxaban versus warfarin for the treatment of symptomatic venous thromboembolism. N Engl J Med. 2013;369(15):1406-15. doi: 10.1056/NEJMoa1306638
  67. Frere C, Farge D, Schrag D, et al. Direct oral anticoagulant versus low molecular weight heparin for the treatment of cancer-associated venous thromboembolism: 2022 Updated systematic review and meta-analysis of randomized controlled trials. J Hematol Oncol. 2022;15(1):69. doi: 10.1186/s13045-022-01289-1
  68. Agnelli G, Becattini C, Meyer G, et al. Apixaban for the treatment of venous thromboembolism associated with cancer. N Engl J Med. 2020;382(17):1599-607. doi: 10.1056/NEJMoa1915103
  69. Raskob GE, van Es N, Verhamme P, et al. Edoxaban for the treatment of cancer-associated venous thromboembolism. N Engl J Med. 2018;378(7):615-24. doi: 10.1056/NEJMoa1711948
  70. Young AM, Marshall A, Thirlwall J, et al. Comparison of an oral factor Xa inhibitor with low molecular weight heparin in patients with cancer with venous thromboembolism: Results of a randomized trial (SELECT-D). J Clin Oncol. 2018;36(20):2017-23. doi: 10.1200/JCO.2018.78.8034
  71. McBane RD, Wysokinski WE, Le-Rademacher JG, et al. Apixaban and dalteparin in active malignancy-associated venous thromboembolism: The ADAM VTE trial. J Thromb Haemost. 2020;18(2):411-21. doi: 10.1111/jth.14662
  72. Key NS, Khorana AA, Kuderer NM, et al. Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO guideline update. J Clin Oncol. 2023;41(16):3063-71. doi: 10.1200/JCO.23.00294
  73. Venous thromboembolic diseases: Diagnosis, management and thrombophilia testing. Available at: https://www.nice.org.uk/guidance/ng158. Accessed: 05.06.2025.
  74. Streiff MB, Holmstrom B, Angelini D, et al. Cancer-associated venous thromboembolic disease, version 2.2024, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2024;22(7):483-506. doi: 10.6004/jnccn.2024.0046
  75. Lyman GH, Carrier M, Ay C, et al. American Society of Hematology 2021 Guidelines for management of venous thromboembolism: prevention and treatment in patients with cancer. Blood Adv. 2021;5(4):927-74. doi: 10.1182/bloodadvances.2020003442
  76. Farge D, Frere C, Connors JM, et al. 2022 International Clinical Practice Guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer, including patients with COVID-19. Lancet Oncol. 2022;23(7):e334-47. doi: 10.1016/S1470-2045(22)00160-7
  77. Сомонова О.В., Антух Э.А., Варданян А.В., и др. Тромбоэмболические осложнения. Практические рекомендации RUSSCO, часть 2. Злокачественные опухоли. 2024;14(3s2):202-15 [Somonova OV, Antukh EA, Vardanian AV, et al. Tromboembolicheskie oslozhneniia. Prakticheskie rekomendatsii RUSSCO, chast' 2. Malignant Tumors. 2024;14(3s2):202-15 (in Russian)]. doi: 10.18027/2224-5057-2024-14-3s2-2-12
  78. Селиверстов Е.И., Лобастов К.В., Илюхин Е.А., и др. Профилактика, диагностика и лечение тромбоза глубоких вен. Рекомендации российских экспертов. Флебология. 2023;17(3):152-296 [Seliverstov EI, Lobastov KV, Ilyukhin EA, et al. Prevention, diagnostics and treatment of deep vein thrombosis. Russian Experts Consensus. Journal of Venous Disorders. 2023;17(3):152-296 (in Russian)]. doi: 10.17116/flebo202317031152
  79. Mahé I, Carrier M, Mayeur D, et al. Extended reduced-dose apixaban for cancer-associated venous thromboembolism. N Engl J Med. 2025;392(14):1363-73. doi: 10.1056/NEJMoa2416112

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Virchow's triad.

Download (107KB)
Indexing metadata
3. Fig. 2. Etiology of cancer-associated thrombosis.

Download (116KB)
Indexing metadata
4. Fig. 3. RUSSCO’s recommendations for the treatment of VTE and prevention of recurrence in patients older than 18 years diagnosed with cancer [77].

Download (255KB)
Indexing metadata

Copyright (c) 2025 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 


Согласие на обработку персональных данных с помощью сервиса «Яндекс.Метрика»

1. Я (далее – «Пользователь» или «Субъект персональных данных»), осуществляя использование сайта https://journals.rcsi.science/ (далее – «Сайт»), подтверждая свою полную дееспособность даю согласие на обработку персональных данных с использованием средств автоматизации Оператору - федеральному государственному бюджетному учреждению «Российский центр научной информации» (РЦНИ), далее – «Оператор», расположенному по адресу: 119991, г. Москва, Ленинский просп., д.32А, со следующими условиями.

2. Категории обрабатываемых данных: файлы «cookies» (куки-файлы). Файлы «cookie» – это небольшой текстовый файл, который веб-сервер может хранить в браузере Пользователя. Данные файлы веб-сервер загружает на устройство Пользователя при посещении им Сайта. При каждом следующем посещении Пользователем Сайта «cookie» файлы отправляются на Сайт Оператора. Данные файлы позволяют Сайту распознавать устройство Пользователя. Содержимое такого файла может как относиться, так и не относиться к персональным данным, в зависимости от того, содержит ли такой файл персональные данные или содержит обезличенные технические данные.

3. Цель обработки персональных данных: анализ пользовательской активности с помощью сервиса «Яндекс.Метрика».

4. Категории субъектов персональных данных: все Пользователи Сайта, которые дали согласие на обработку файлов «cookie».

5. Способы обработки: сбор, запись, систематизация, накопление, хранение, уточнение (обновление, изменение), извлечение, использование, передача (доступ, предоставление), блокирование, удаление, уничтожение персональных данных.

6. Срок обработки и хранения: до получения от Субъекта персональных данных требования о прекращении обработки/отзыва согласия.

7. Способ отзыва: заявление об отзыве в письменном виде путём его направления на адрес электронной почты Оператора: info@rcsi.science или путем письменного обращения по юридическому адресу: 119991, г. Москва, Ленинский просп., д.32А

8. Субъект персональных данных вправе запретить своему оборудованию прием этих данных или ограничить прием этих данных. При отказе от получения таких данных или при ограничении приема данных некоторые функции Сайта могут работать некорректно. Субъект персональных данных обязуется сам настроить свое оборудование таким способом, чтобы оно обеспечивало адекватный его желаниям режим работы и уровень защиты данных файлов «cookie», Оператор не предоставляет технологических и правовых консультаций на темы подобного характера.

9. Порядок уничтожения персональных данных при достижении цели их обработки или при наступлении иных законных оснований определяется Оператором в соответствии с законодательством Российской Федерации.

10. Я согласен/согласна квалифицировать в качестве своей простой электронной подписи под настоящим Согласием и под Политикой обработки персональных данных выполнение мною следующего действия на сайте: https://journals.rcsi.science/ нажатие мною на интерфейсе с текстом: «Сайт использует сервис «Яндекс.Метрика» (который использует файлы «cookie») на элемент с текстом «Принять и продолжить».