Abstract 1590P
Background
Venous thromboembolic events (VTE) are frequent during cancer and increase with age. Their preventions by anticoagulants in older patients with cancer has not been established and very few data exist in older frail subjects. The primary Objective: To compare the risk of VTE in older patients with cancer treated or not treated with preventive anticoagulant therapy. The secondary objectives are to assess the bleeding risk in both groups and to identify risk factors of VTE.
Methods
The ANTIGONE study is a French multicenter, observational longitudinal study nested in the ELCAPA cohort study. The population included patients aged 70 and over with recent diagnosis of cancer referred to a geriatrician for a standardized geriatric assessment before the decision on cancer therapy, between 2015 and 2020. Patients with curative anticoagulant treatments were not included. Besides geriatric and oncological characteristics, initiation, dose and duration of preventive anticoagulant therapy were collected at baseline and over one-year follow-up. Main endpoint was the onset of VTE (deep vein thrombosis and pulmonary embolism).
Results
The ANTIGONE study comprised 1702 subjects. At baseline, mean age of the population was 82 years (SD=5.8), with 58.6 % of women (n=997), 26% of subjects had cognitive impairment and 25% had recent falls. Main cancers were solid gynecologic (33%), digestive (26%), urologic (17%), pulmonary (10%) tumors and 53% of patients had metastasis at baseline. Mean comorbidity score CIRSG was 10.6 (5.0), mean disability scores were 5.5/6 for activities of daily living and 5.8/8 for instrumental activities of daily living. Mean number of drugs taken by patient was 5.3 (3.1) per day. In this elderly frail population, at baseline 11.6% (n=198) subjects were treated with low-molecular-weight heparin to prevent VTE. The follow up of the ANTIGONE study is ongoing and the final results will be available in 2023.
Conclusions
In this unique very old and frail population with a recent cancer, a preventive treatment of VTE has been initiated in 12% of subjects. The follow up of at 1 year will determine the benefit–risk ratio of preventive low-molecular-weight heparin in this population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Gérond'if.
Funding
Leo Pharma.
Disclosure
O. Hanon: Financial Interests, Personal, Invited Speaker: Leo Pharma. N. Spiess: Financial Interests, Personal, Full or part-time Employment: Leo Pharma. I. Elalamy: Financial Interests, Personal, Invited Speaker: Leo Pharma. All other authors have declared no conflicts of interest.