Oops, you're using an old version of your browser so some of the features on this page may not be displaying properly.

MINIMAL Requirements: Google Chrome 24+Mozilla Firefox 20+Internet Explorer 11Opera 15–18Apple Safari 7SeaMonkey 2.15-2.23

ePoster Display

1692P - Thromboprophylaxis in high-risk oncology patients: Is it a safe and effective clinical decision-intervention?

Date

16 Sep 2021

Session

ePoster Display

Presenters

Nikolaos Tsoukalas

Citation

Annals of Oncology (2021) 32 (suppl_5): S1175-S1198. 10.1016/annonc/annonc714

Authors

N.G. Tsoukalas, A.N. Christopoulou, E. Timotheadou, A. Koumarianou, I. Athanasiadis, S. Peroukidis, G.F. Samelis, A. Psyrri, N. Kapodistrias, A. Nikolakopoulos, S. Demiri, C. Andreadis, A. Ardavanis, I. Sgouros, A. Bokas, V. Barbounis, N. Kentepozidis, D. Mavroudis, P. Papakotoulas, I. Boukovinas

Author affiliations

  • (hesmo, Http://www.hesmo.gr/en), On behalf of the Hellenic Society of Medical Oncology, 11475 - Athens/GR
More

Abstract 1692P

Background

Cancer-associated thrombosis (CAT) is a negative prognostic factor for survival during cancer treatment, accounting for 20% of total thrombosis. Attention should be devoted to CAT prophylaxis, since cancer patients are more vulnerable for bleeding and drug-drug interactions.

Methods

HeSMO conducted a prospective observational study (ACT4CAT), to record the clinical practice for thromboprophylaxis in ambulatory patients with high thrombotic active cancer. Patients were enrolled after signing informed consent.

Results

From 19 oncology departments, 628 patients were enrolled while 394 (62.7%) completed the study. 541 (86.1%, age: 65.4±12.4 years, BMI: 26.2±5.2 kg/m2) finished second visit (3-4 cycles of treatment) and their characteristics are depicted in the table. 78.1% had metastatic disease and 84.5% were treated with highly thrombogenic agents (HTAs), such as platinum (53.4%), antimetabolites (51.9%), and immunotherapy (11.8%). Notably, 53.8% of these agents had the potential to interact with direct oral anticoagulants (DOACs). Regarding clinical setting: 61.1% & 18.0% patients were at 1st and 2nd line, respectively & 9.2%, 3.1% in adjuvant & neoadjuvant setting. 59.5% had Khorana score ≥2. Anticoagulation agents administered: 90.7% tinzaparin, 5.2% fondaparinux, 2.0% bemiparin, 1.3% enoxaparin and rivaroxaban, apixaban by 0.4%, for 5.5±3.7 months duration. 68.6% of patients received intermediate dose regardless of clinical setting (1st, 2nd, adjuvant & neoadjuvant: 67.5%, 73.9%, 42.2% & 66.7% respectively, p=0.0028). 13 patients (2.4%) experienced thrombotic events. 11 minor bleeding events reported (2.0%). Table: 1692P

Neoplasms Incidence% GenderF, % Age≥65, % BMI ≥30,% Metastatic% Khorana score≥2, % HTAs%
Pancreatic 27.0 41.4 52.1 13.0 76.7 100.0 90.4
Lung 26.6 22.6 59.0 21.5 88.4 58.3 88.0
Colorectal 10.7 34.7 58.6 6.9 83.0 19.0 96.6
Gastric 6.7 19.4 69.4 13.9 69.7 97.2 83.3
Ovarian 4.8 100.0 57.7 19.2 76.0 65.4 88.0
Bladder 4.4 17.4 79.2 16.7 72.7 37.5 91.3
Breast 4.3 95.7 21.7 13.0 71.4 13.0 65.2
Prostate 4.1 0.0 90.9 18.2 100.0 18.2 28.6
Testicular 2.2 0.0 0.0 8.3 0.0 25.0 58.3
Uterine 1.3 100.0 57.1 71.4 100.0 71.4 71.4
Renal 1.3 14.3 85.7 57.1 85.7 14.3 71.4
Sarcomas 1.1 50.0 66.7 50.0 66.7 0.0 33.3
Head & neck 0.9 50.0 60.0 0.0 33.3 0.0 100.0
Cervical 0.9 100.0 0.0 0.0 80.0 80.0 100.0
Others 3.7 22.2 35.0 30.0 52.9 0.0 85.0

Conclusions

CAT can negatively affect prognosis in patients with active cancer. Apart from Khorana score, high thrombotic risk tumors, metastasis, HTAs, along with bleeding risk and drug-drug interactions, also influence the clinical decision for thromboprophylaxis. Intermediate anticoagulation doses as thromboprophylaxis are safe and effective in active cancer.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Hellenic Society of Medical Oncology.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

This site uses cookies. Some of these cookies are essential, while others help us improve your experience by providing insights into how the site is being used.

For more detailed information on the cookies we use, please check our Privacy Policy.

Customise settings
  • Necessary cookies enable core functionality. The website cannot function properly without these cookies, and you can only disable them by changing your browser preferences.