Abstract 1554P
Background
PaC is one of the most fatal cancers and cancer associated thrombosis (CAT) is a leading cause of death in these pts. 5-year survival rate for PaC is estimated around 8%. PaC induces a prothrombotic and hypercoagulable state. LMWHs are attributed to various non anticoagulant effects and could enhance the anti-tumor effect of therapy.
Methods
PaCT (Pancreatic Cancer & Tinzaparin) is a retrospective observational study aiming to collect data regarding progression free survival (PFS) in active advanced PaC pts who received thromboprophylaxis with tinzaparin, as suggested by SCC ISTH guidance, during chemotherapy. Primary end point is the impact of LMWHs in PFS compared to PFS with chemotherapy only; secondary are efficacy and safety of anticoagulation.
Results
We report intermediate results. 127 PaC pts, 87% with advanced or metastatic disease, treated with highly thrombogenic agents and receiving thromboprophylaxis were enrolled. 54% males, median age 66.1±9.9 years, BMI 25.3±4.0 Kg/m2. A sub-cohort of 68 pts, all with advanced or metastatic disease at 1st line treatment with nab-paclitaxel + gemcitabine who received tinzaparin [10,348±1,418 Anti-Xa IU, OD, median duration 7.8, IQR: 5.4-11.8mo] had median PFS 7.8 months (mo) (IQR: 5.4-11.8mo). PFS in 2 studies in pts with same characteristics, apart use of thromboprophylaxis, was [patients/median PFS]: 431/5.5mo, 75/5.2 and in a recent meta-analysis of 21 studies median PFS was 5.4 mo. Comparing[FC1] in our sub-cohort. PFS of pts receiving tinzaparin was 44% higher than in patients without such protection (p<0.05). During follow up period of 16.7±9.9 mo of 68 pts, no thrombotic events were recorded while 2 clinically relevant non major bleeding events occurred.
Conclusions
PFS in advanced PaC pts undergoing chemotherapy seems to positively impacted by anticoagulation. Thromboprophylaxis with tinzaparin in treatment doses is an efficient and safe approach.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Karamouzis Michalis.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.