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Poster session 07

2147P - Thrombotic recurrence and bleeding complications in non-small cell lung carcinoma (NSCLC) patients with venous thromboembolism (VTE)

Date

21 Oct 2023

Session

Poster session 07

Topics

Supportive Care and Symptom Management

Tumour Site

Non-Small Cell Lung Cancer

Presenters

Irene Gonzalez Caraballo

Citation

Annals of Oncology (2023) 34 (suppl_2): S1080-S1134. 10.1016/S0923-7534(23)01268-1

Authors

I. Gonzalez Caraballo1, M.A. Cañete Muñoz1, V. Velasco Durantez2, M.E. Guirao García3, P. Martinez del Prado4, E. Segui Solis5, R. Porta-Balanya6, M. Covela7, G. Benitez Lopez8, M. Lobo de Mena9, M.S. Moyano10, H. Huertas11, E. Martinez de Castro12, E.M. Brozos Vazquez13, T. Quintanar Verduguez14, M. Biosca Gomez de Tejada15, L. Ortega Morán1, A. Carmona-Bayonas16, P. Jimenez Fonseca2, A.J. Munoz Martin1

Author affiliations

  • 1 Medical Oncology, Hospital General Universitario Gregorio Maranon, 28007 - Madrid/ES
  • 2 Medical Oncology, Hospital Universitario Central de Asturias, 33006 - Oviedo/ES
  • 3 C/gil Pérez Número 8, Hospital General Universitario Morales Meseguer, 30008 - Murcia/ES
  • 4 Medical Oncology, Hospital Universitario de Basurto, 48013 - Bilbao/ES
  • 5 Medical Oncology, Hospital Clinic y Provincial de Barcelona, 08036 - Barcelona/ES
  • 6 Medical Oncology, ICO Girona - Institut Català d'Oncologia Girona, 17007 - Girona/ES
  • 7 Medical Oncology, Hospital Xeral Calde of Lugo, 27004 - Lugo/ES
  • 8 Médical Oncology, Hosp. Universitario Materno Infantil De Canarias, 35016 - Las Palmas/ES
  • 9 Medical Oncology Department, FIHGUV - Fundación de Investigación Hospital General Universitario de Valencia, 46014 - Valencia/ES
  • 10 Medical Oncology, Hospital de Jerez, 11407 - Jerez de la Frontera/ES
  • 11 Medical Oncology Dept., Hospital Clinico Universitario San Carlos, 28040 - Madrid/ES
  • 12 Oncologist, HUMV - Hospital Universitario Marques de Valdecilla, 39008 - Santander/ES
  • 13 Medical Oncology Department, CHUAC - Complexo Hospitalario Universitario A Coruña, 15006 - A Coruña/ES
  • 14 Medical Oncology, Hospital General Universitario de Elche, 03203 - Elche/ES
  • 15 Internal Medicina, Vall d'Hebron, 08023 - Barcelona/ES
  • 16 Medical Oncology, Hospital General Universitario Morales Meseguer, 30008 - Murcia/ES

Resources

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Abstract 2147P

Background

VTE management in cancer patients, particularly those with NSCLC, poses unique challenges due to increased bleeding and recurrence risk during anticoagulation. This study is investigating the characteristics of NSCLC patients who experience thrombotic event while assessing thrombotic recurrence, bleeding pattern, and their association with prognosis.

Methods

From the international, multicenter, prospective TESEO registry of the Spanish Society of Medical Oncology (SEOM), we selected consecutive patients diagnosed with NSCLC and VTE between June 2018 and April 2023. Demographic, thrombotic event and anticoagulant treatment were analyzed.

Results

A total of 562 patients with NSCLC and VTE were assessed (Table, clinical characteristics). Deep vein thrombosis (DVT) occurred in 22.2% (n=125), pulmonary embolism (PE) in 69.5% (n=391), and catheter-associated thrombosis (CAT) in 2.1% (n=12). Most events (59.7%, n=336) were symptomatic, 46.2% (n=260) occurring within three months of cancer diagnosis. Post-anticoagulant treatment, arterial thrombosis appeared in 0.8% (n=5) and VTE recurrence in 6.0% (n=34), with 52.9% (n=18) being PE, 20.5% (n=7) DVT and 2.9% (n=1) CAT. Bleeding complications included clinically relevant bleeding in 3.3% (n=19), minor bleeding in the same percentage, and major bleeding in 1.4% (n=8). Thrombotic recurrence (p=0.24) and bleeding (p=0.12) were not associated with worse prognosis. Males had a higher risk of thrombotic recurrence (RR 1.05, 95% CI 1.01-1.09, p=0.024). Platinum analogs and KRAS mutation were also associated with a higher recurrence risk (p=0.019 and p=0.004, respectively). Table: 2147P

Baseline characteristics

N=562 (100%)
Sex
Male 363 (64.5)
Age
> 65 304 (54)
ECOG
0-1 383 (68.1)
Comorbidities
Hypertension 231 (41.1)
Dislipemia 233 (41.4)
Smoking habit 455 (80.9)
COPD 126 (22.4)
Previous VTE 38 (6.7)
TNM Stage
Resectable 23 (4.0)
Locally advanced 91 (16.1)
Metastatic 448 (79.9)
Histology
Adenocarcinoma 442 (78.6)
Squamous cell carcinoma 98 (17.4)
Neuroendocrine 3 (0.5)
Other 19 (3.3)
Antineoplastic treatment at the moment of VTE
Surgery 76 (13.5)
Radiotherapy 187 (33.2)
Quimiotherapy 224 (39.8)
Inmunotherapy 120 (21.3)

Conclusions

Our study confirms a higher incidence of thrombotic recurrence than bleeding in patients with NSCLC. Thrombotic recurrence and bleeding complications were not associated with worse prognosis. Male patients, platinum analogs, and KRAS mutation were associated with higher risk of thrombotic recurrence.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

E.M. Brozos Vazquez: Financial Interests, Institutional, Speaker, Consultant, Advisor, Public Speaking: Leo Pharma, Rovi, Roche, Kyowa Kirin, Merck, Pierre Fabre, Amgen, Sanofi; Financial Interests, Institutional, Speaker, Consultant, Advisor: Bayer, Servier; Financial Interests, Speaker, Consultant, Advisor: Pfizer. T. Quintanar Verduguez: Financial Interests, Institutional, Advisory Role: Lilly; Financial Interests, Institutional, Speaker, Consultant, Advisor: Lilly, AstraZeneca, Rovi, Novartis, Roche; Financial Interests, Institutional, Advisory Board: Novartis, Daiichi. M. Biosca Gomez de Tejada: Financial Interests, Institutional, Advisory Role, Speaker: Rovi; Financial Interests, Institutional, Advisory Board, Speaker: Sanofi, Leo Pharma; Financial Interests, Advisory Board: Bristol Myers. L. Ortega Morán: Financial Interests, Institutional, Invited Speaker: Rovi, Leo Pharma, Menarini, Servier. A.J. Munoz Martin: Financial Interests, Institutional, Speaker’s Bureau, Research Funding: Rovi; Financial Interests, Institutional, Speaker’s Bureau: Stada, Menarin; Financial Interests, Institutional, Speaker’s Bureau, Travel, accommodation: Amgen, Merck; Financial Interests, Institutional, Research Funding: Celgene, Leo Pharma; Financial Interests, Institutional, Other, Travel, accommodation: AstraZeneca, Roche. All other authors have declared no conflicts of interest.

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