Abstract 1589P
Background
VTE is considered one of the main causes of death and morbidity in cancer patients. Khorana score (KS) is the gold-standard to predict VTE risk in this population. PDAC is considered among the most prothrombotic malignancies. However, information about the timing of VTE diagnosis and its prognostic impact are currently scarce.
Methods
All pancreatic cancer patients treated between 2019 and 2021 in Hospital General Universitario Gregorio Marañón, Madrid, Spain were analyzed. We reviewed the medical history of all patients to collect demographics, treatment characteristics and clinical outcomes. Patients were classified based on KS. Occurrence of VTE was evaluated from diagnosis through end of follow-up or death.
Results
A total of 197 patients (p) were included (Table, clinical characteristics ), 54 p (27.4%) were diagnosed with VTE. 14.5% (n=8) were deep vein thrombosis, 34.5% (n= 19) pulmonary embolism and 49.0% (n=27) visceral vein thrombosis. 36 p had metastatic disease (n=35, 66.6%), 12 locally advanced (22.2%) and 6 were resectable (11.1%). Most of them occurred in the first three months of diagnosis (74%, n=40). Early appearance of VTE (less than 3 months from cancer diagnosis) was associated with worse prognosis, median overall survival (mOS) VTE < 3 months 8.5 months (HR 1.65, 95% CI 1.11-2.46; p=0.014), mOS VTE >3 months 12.8 months (HR 0.78, 95% CI 0.39-1.54; p= 0.5) and mOS patients without VTE diagnosis 11.4 months (95% CI 10.1-15.4). 31.9% p were classified as high-risk and 64.9% as intermediate-risk based on KS. 35 p (27.3%) of the intermediate category developed a VTE and 19 (30.1%) in the high-risk category, showing no statistically significant association (chi2 test p-value = 0.9). Table: 1589P
Clinical characteristics
| n=197 (100) | |
| Sex Female Male. | 98 (49.7) 99 (50.3) |
| Age (years) < 65 ≥ 65 | 69 (35.0) 128 (65.0) |
| ECOG 0 1 2 3 | 29 (14.7) 134 (68.0) 27 (13.7) 7 (3.6) |
| Disease status Resectable Locally advanced Metastasic | 41 (20.8) 54 (27.4) 102 (51.8) |
| Tumor location Pancreatic head Body/tail region Unknown | 119 (60.4) 73 (37.1) 5 (2.5) |
Conclusions
Only early-onset VTE impacts in OS of PDAC patients, it may identify a more aggressive cancer phenotype. KS did not predict VTE in our population, being necessary better risk assessment models in clinical practice.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
I. Gonzalez Caraballo: Financial Interests, Personal, Training: Mylan. R. Martín Lozano: Financial Interests, Personal, Training: Novartis, Sanofi, BMS, Merck, Roche, Viartis. R. Jiménez Rodríguez: Financial Interests, Institutional, Training: Mylan; Financial Interests, Personal, Training: BMS, Merck. M.A. Cañete Muñoz: Financial Interests, Personal, Training: Vifor Pharma. M. Palma: Financial Interests, Personal, Training: Grunenthal. M.T. De Toro Carmena: Financial Interests, Personal, Training: Merck, Amgen, MSD, Novartis, Roche, Sanofi, Otsuka, Pierre Fabre. B.I. Morón: Financial Interests, Personal and Institutional, Speaker’s Bureau: MSD, Merk, Angellini; Financial Interests, Personal and Institutional, Other, Travel grants: MSD; Financial Interests, Personal, Travel grants: Amgen, Roche, Novartis, Pierre-Fabre. V.C. Tirado Anula: Financial Interests, Personal, Invited Speaker: Ipsen; Financial Interests, Personal, Training: MSD, Pierre Fabre. J. Soto Alsar: Non-Financial Interests, Personal, Invited Speaker, Family: Sanofi, Pfizer; Financial Interests, Personal, Invited Speaker: Merck, Ipsen; Financial Interests, Personal, Training: MSD, Angelini, Vifor Pharma, Rovi, Amgen, Pfizer, Roche, Sanofi. M. Bringas Beranek: Financial Interests, Personal, Training: Roche, Lilly. C. López Jiménez: Financial Interests, Personal, Training: Mylan, ROVI, Sanofi. A. Gutiérrez Ortiz de la Tabla: Financial Interests, Personal, Training: MSD, Rovi, Sanofi. D.S. Juliao Caamaño: Financial Interests, Personal, Training: MSD, Rovi, Sanofi. L. Ortega Morán: Financial Interests, Personal, Invited Speaker: Sanofi, LEO-Pharma. M. Martin Jimenez: Financial Interests, Personal, Advisory Board: AstraZeneca, Lilly, Roche/Genentech, Daiichi Sankyo; Financial Interests, Personal, Invited Speaker: Pfizer, AstraZeneca, Lilly, Novartis, Roche/Genentech; Financial Interests, Institutional, Research Grant: Novartis, Roche, Puma; Non-financial Interests, Invited Speaker: Trio; Non-financial interests, Leadership role: Geicam. A.J. Munoz Martin: Financial Interests, Institutional, Advisory Board, Research Funding: Celgene, Sanofi, LEO Pharma; Financial Interests, Institutional, Advisory Board: Pfizer-BMS, Daiichi Sankyo, Incyte, AstraZeneca, MSD, Lilly; Financial Interests, Institutional, Advisory Board, Travel, Accommodations: Roche; Financial Interests, Personal and Institutional, Speaker’s Bureau: Rovi, Bayer, Servier, Menarini, Stada; Financial Interests, Institutional, Training: Celgene, Merck Serono, Amgen. All other authors have declared no conflicts of interest.