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Poster display session

2699 - Factors influencing the use of thromboprophylaxis in cancer outpatients: CAT AXIS, a case-vignette study on clinical practice.

Date

10 Sep 2017

Session

Poster display session

Topics

Supportive Care and Symptom Management

Presenters

Florian Scotté

Citation

Annals of Oncology (2017) 28 (suppl_5): v543-v567. 10.1093/annonc/mdx388

Authors

F. Scotté1, I. Elalamy2, D. Mayeur3, G. Meyer4

Author affiliations

  • 1 Medical Oncology And Supportive Care Unit, Foch Hospital, 92 - Suresnes/FR
  • 2 Biological Hematology, Inserm U938, Paris, France, Tenon University Hospital,, Paris/FR
  • 3 Medical Oncology, Centre Hospitalier de Versailles - Hopital Andre Mignot, 78157 - Le Chesnay/FR
  • 4 Pneumology, Hopital European George Pompidou, 75015 - Paris/FR
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Resources

Abstract 2699

Background

Data on long-term venous thromboembolism (VTE) prophylaxis in cancer outpatients remain scarce. In the absence of consistent treatment guidelines, our objective was to describe clinical practice and to identify factors influencing the use of thromboprophylaxis.

Methods

CAT AXIS was a multicenter cross-sectional study based on the completion of physician-profile questionnaires and the assessment of 10 e-mailed credible clinical scenarios of lung, colon and breast cancer by each of participants using the case-vignettes validated method.

Results

A total of 224 physicians participated allowing the completion and the analysis of 2,085 case vignettes corresponding to 765, 703 and 617 fictive clinical scenarios on lung, colon and breast cancers, respectively. The overall rate of thromboprophylaxis was 680/2085 (32.6%) among participants with a comparable proportion for the three types of cancer. Low-molecular-weight heparin (LMWH) was the most frequently used, by 92.7%, 93.8% and 83.9% of participants for lung, colon and breast cancer, respectively; treatment duration of ≥ 3 months was prescribed by 74.4% of participants. Multivariate analysis of factors influencing thromboprophylaxis based on patient’s characteristics is summarized in Table.rnTable:

1562P Factors influencing the prescription of thromboprophylaxis

rnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn
rnLung cancerColon cancerBreast cancer
OR [95% CI]pOR [95% CI]pOR [95% CI]p
ECOG index score: 3 vs 0-23.3 [2.4; 4.6]

Conclusions

In the absence of clear guidance, the use of thromboprophylaxis remains low and rather empiric even though the selection of LMWH by the majority of participants and treatment duration seems appropriate based on available data to date. ECOG index, metastatic malignancy, chemotherapy and history of thrombosis were significantly associated with the decision to use thromboprophylaxis in most situations.

Clinical trial identification

Legal entity responsible for the study

Guy Meyer

Funding

Leo Pharma

Disclosure

F. Scotté: Roche, Vifor, MSD, TEVA, Norgine, Prostrakan, Leo pharma, Janssen, Hospira, Boehringer, Sanofi, AMGEN, Pierre Fabre Oncologie, TESARO D. Mayeur: Leo Pharma, Pfizer G. Meyer: Investigator (uncompensated) in clinical trials for: Daiichi Sankyo; Bayer; Sanofi Aventis; Leo Pharm; BMS-Pfizer, Daiichi Sankyo; Boehringer-Ingelheim, Bayer All other authors have declared no conflicts of interest.

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