1360 - Retrospective study of radiological findings of pulmonary embolisms (PE) in patients (pts) with advanced non-small cell lung cancer (NSCLC)

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Supportive Care
Non-Small-Cell Lung Cancer, Metastatic
Presenter Enrica Capelletto
Authors E. Capelletto1, S. Novello1, F. Solitro2, L. Focaraccio1, M. Giaj Levra1, S.G. Rapetti1, T. Vavala3, J. Menis4, A. Veltri2, G. Scagliotti1
  • 1Department Of Clinical And Biological Sciences - Thoracic Oncology Unit, Azienda Ospedaliero-Universitaria ASOU San Luigi Gonzaga, 10043 - Orbassano/IT
  • 2Department Of Radiology, Azienda Ospedaliero-Universitaria ASOU San Luigi Gonzaga, Orbassano, ITALY, 10043 - Orbassano/IT
  • 3Medical Oncology, Azienda Ospedaliero-Universitaria ASOU San Luigi Gonzaga, 10043 - Orbassano/IT
  • 4Department Of Medical Oncology, University Hospital Santa Maria della Misericordia, 33100 - Udine/IT

Abstract

Introduction

Venous thromboembolism (VTE) is one of the leading cause of death for cancer pts, with an incidence of 1 event per 110-120 patients, mainly within the first year from diagnosis. Cancer pts with VTE show a 2.2-fold increase in mortality and lung cancer is the second tumor type with the highest incidence of VTE. Considering that chemotherapy is associated with a 6 times increased risk of VTE and that biological agents, especially antiangiogenetic compounds, cause an additional risk, the aim of the study is to evaluate, with a radiological retrospective evaluation, the real incidence of PE in selected cohorts of advanced NSCLC patients and the impact of PE on survival.

Materials and methods

This retrospective monocentric study enrolled 141 advanced NSCLC pts, diagnosed between June 2007 and June 2008 (cohort 1), and between January 2010 and December 2010 (cohort 2). Pts were mostly men, with a median age of 63 years, performance status of 0 and a prevalence of comorbidities predisposing to VTE of 42.0% and 70.0% in first and second cohort, respectively. 74.1% and 43.3% of pts received biological agents in first and second cohort; 39.5% and 21.7% antiangiogenetic agents.

Results

Retrospective review of 460 contrast-enhanced multidetector computed tomography studies showed a prevalence of PE of 13.6% in the first cohort and of 15.0% in the second one. Survival analysis didn't show any statistically significant differences in terms of OS and TTP in the first cohort. In the second cohort, Kaplan Meier curves showed a significantly difference in terms of TTP in favor of pts who never developed PE, p-value = 0.003. Similar results were observed considering as stratification factors the use of biological agents, p-value = 0.007, and of antiangiogenic agents, p-value = 0.010.

Conclusion

The higher incidence of PE in the second cohort, despite a lower exposure to biological and antiangiogenic agents, could be related to a greater thrombogenic action of these drugs, but also a higher prevalence of comorbidities predisposing to VTE. Descriptive analysis was confirmed by survival data, underlining the need of further studies to clarify the role of predisposing factors for PE.

Disclosure

All authors have declared no conflicts of interest.