1648P - Association between circulating tumor cell count and thrombosis in pancreatic cancer

Background

Cancer patients have a risk up to nine times higher of suffering from venous thromboembolism (VTE) compared to those without cancer, which makes VTE the second preventable cause of mortality in cancer patients. Pancreatic carcinoma is a high thrombotic risk tumor, being its incidence of thrombosis of up to 30% in outpatient patients. It has been suggested that circulating tumor cells (CTC) may be related to thrombosis, as they can alter blood coagulation and due to their pro-inflammatory and pro-coagulant properties.

Methods

We conducted an observational, prospective, cohort study in a two Spanish centers. CTC were isolated from a blood sample of newly diagnosed patients of pancreas carcinoma before starting chemotherapy treatment. CTC count was determined by using Isoflux® technology followed by counting via confocal microscopy. Patients were followed up according to routine practice. Clinical and analytical data were collected up to death. We analyzed the relation between CTC and VTE, and between CTC and VTE scores.

Results

This analysis included a total of 63 patients newly diagnosed before chemotherapy was given. 39 (61,9%) patients were metastatic, 16 (25,4%) locally advanced and 8 (12,7%) borderline tumors. Median follow up was 11,63 months. 25 episodes of VTE occurred in 23 patients during follow up (11 pulmonary embolism, 5 deep vein thrombosis, 6 visceral thrombosis, 3 catheter-related thrombosis). Median value of CTC was 397 (range 33-21697). For a cut off of CTC 500, we found no relation between CTC and VTE (p=0,298). However, when we analyzed CTC>500 and VTE excluding visceral and catheter-related thrombosis, it was found to be associated (p=0.006, p=0.002 in those metastatic). We found no relation between CTC and thrombosis scores (Khorana, Viena, Protech, Conko nor CAT).

Conclusions

This study shows that CTC detection before first-line chemotherapy could be a predictor marker for VTE.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Fundacion Investigación Biomedica Gregorio Marañon.

Funding

Fundación Investigación Biomedica Gregorio Marañon.

Disclosure

P. García Alfonso: Financial Interests, Personal, Advisory Board: Amgen. M. Martin Jimenez: Financial Interests, Personal, Advisory Board: AstraZeneca, Lilly, Roche/Genentech, Daiichi Sankyo, Menarini-Stemline; Financial Interests, Personal, Invited Speaker: Pfizer, AstraZeneca, Lilly, Novartis, Roche/Genentech; Financial Interests, Institutional, Research Grant: Novartis, Roche, Puma; Non-Financial Interests, Member of Board of Directors: TRIO; Non-Financial Interests, Leadership Role: GEICAM; Non-Financial Interests, Member: ASCO; Non-Financial Interests, Advisory Board: Seom. All other authors have declared no conflicts of interest.