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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