2146P - Cancer-associated thrombosis clinic: Experience of the Medical Oncology Department of a hospital in Spain

Background

Venous thromboembolism (VTE) in cancer patients is a common complication that requires a multidisciplinary management. In April 2021 we established in the Medical Oncology Department of our hospital a “Cancer-associated thrombosis (CAT) clinic” in order to provide immediate support in prevention and management of VTE to physicians involved in cancer patients’ treatment. The aim of this analysis is to describe the characteristics of patients evaluated, the decisions taken and their results.

Methods

Between May 2021 and April 2023, 124 patients have been evaluated in the “CAT clinic” of the Medical Oncology Department of the Hospital General Universitario Gregorio Marañón (Madrid, Spain) with a mean follow-up of 4.25 months (standard deviation +/- 5.47 months).

Results

The main reason for referral to clinic was VTE treatment (n=120; 96.8%) and the most frequent thrombotic event was pulmonary thromboembolism (n=56; 46.7%). The most common tumors were breast (n=29; 23.4%), lung (n=21; 16.9%) and colon cancer (n=16; 12.9%). Most patients had metastatic disease (n=85; 72.0%), active cancer (n=101; 81.5%) or are receiving antineoplastic therapies (n=95; 76.6%). A modification of anticoagulation therapy was conducted in 99 patients (80.5%): change of anticoagulant drug in 77 patients (most of them from low molecular weight heparins to direct-acting oral anticoagulants [n=51;66.2%]) or change of anticoagulant dose in 49 patients (most of them from therapeutic dose to prophylactic dose in patients with low risk of recurrence and/or high risk of bleeding [n=27;55.1%]). Recurrence of VTE was observed in 8 patients (6.7%) and major bleeding (MB) in 4 patients (3.3%). In particular, 63 patients (52.5%) have received or are receiving apixaban for VTE treatment. No differences were observed between patients receiving apixaban and general population in tumor type, stage, antineoplastic treatment, or thrombotic event. VTE recurrence was seen in 2 patients (3.2%) and MB in 1 patient (1.6%) during apixaban treatment.

Conclusions

The “CAT clinic” has allowed us to adapt the anticoagulant treatment in most of patients, obtaining low complication rates (recurrence/bleeding).

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

L. Ortega Morán: Financial Interests, Personal, Invited Speaker: Leo Pharma, Rovi, Menarini, Servier. J. Soto Alsar: Financial Interests, Personal, Invited Speaker: Merck, Ipsen, Pfizer, Leo Pharma; Financial Interests, Personal, Training: MSD, Angelini, Vifor Pharma, Rovi, Amgen, Pfizer, Roche, Janssen, Sanofi; Non-Financial Interests, Personal, Other: Pfizer, Sanofi. R. Jiménez Rodríguez: Financial Interests, Personal, Invited Speaker: Amgen, Kyowa Kyrin; Financial Interests, Personal, Training: Mylan. C. López Jiménez: Financial Interests, Personal, Invited Speaker: Servier; Financial Interests, Personal, Training: Rovi. R. Martín Lozano: Financial Interests, Personal, Training: Sanofi. G. Torres Perez-Solero: Financial Interests, Personal, Invited Speaker: Adacap, Ipsen, Amgen, Roche, Merck, Servier; Financial Interests, Personal, Advisory Role: Adacap; Financial Interests, Personal, Training: Amgen, Roche, Merck, Lilly, Ipsen, Pfizer, Servier, Sanofi, Rovi, Adacap. M. Martin Jimenez: Financial Interests, Research Grant: Roche, Puma, Novartis; Financial Interests, Advisory Board: AstraZeneca, Amgen, Taiho Oncology, Roche/Genentech, Novartis, PharmaMar, Eli Lilly, Puma, Daiichi Sankyo, Menarini/Stemline, Pfizer; Financial Interests, Invited Speaker: AstraZeneca, Lilly, Amgen, Roche/Genentech, Novartis, Pfizer. A.J. Munoz Martin: Financial Interests, Personal, Advisory Role: Sanofi, Pfizer, BMS, AstraZeneca, MSD, Roche, GSK, Taiho Oncology, Servier, Leo Pharma; Financial Interests, Personal, Speaker’s Bureau: Rovi, Stada, Menarini, Amgen, Merck; Financial Interests, Personal, Research Funding: Rovi, Celgene, Leo Pharma; Financial Interests, Personal, Training: AstraZeneca, Amgen, Merck, Roche. All other authors have declared no conflicts of interest.