Immune checkpoint inhibitors-associated thrombosis in patients with lung cancer and melanoma: a study of the Spanish society of medical oncology (SEOM) thrombosis and cancer group

• Manuel Sánchez Cánovas ^[12] ; David Fernández Garay ^[1] ; Laura Ortega Moran ^[2] ; Jaime Rubio Pérez ^[3] ; Carlos Miguel Guirao Rubio ^[4] ; Miriam Lobo de Mena ^[5] ; Berta Obispo Portero ^[6] ; Jesús Brenes Castro ^[13] ; Yolanda Lage ^[7] ; Diego Cacho Lavin ^[8] ; Ana Belen Rupérez Blanco ^[9] ; Ana Manuela Martín Fernández de Soignie ^[10] ; Jonatan Zacarías Benoit Perejón ^[1] ; Laura Jiménez Colomo ^[13] ; Noel Blaya Boluda ^[12] ; Javier Bosque Moreno ^[4] ; Teresa Quintanar Verduguez ^[4] ; Carmen Rosa Garrido ^[1] ; Roberto Martín Huertas ^[11] ; Carme Font i Puig ^[11] ; Andrés Jesús Muñoz Martín ^[2]
  1. [1] Hospital Universitario de Jaén

     Hospital Universitario de Jaén

     Jaén, España

     
  2. [2] Hospital General Universitario Gregorio Marañón

     Hospital General Universitario Gregorio Marañón

     Madrid, España

     
  3. [3] Fundación Jiménez Díaz

     Fundación Jiménez Díaz

     Madrid, España

     
  4. [4] Hospital General Universitario de Elche

     Hospital General Universitario de Elche

     Elche, España

     
  5. [5] Hospital General Universitario de Valencia

     Hospital General Universitario de Valencia

     Valencia, España

     
  6. [6] Hospital Infanta Leonor

     Hospital Infanta Leonor

     Madrid, España

     
  7. [7] Hospital Ramón y Cajal

     Hospital Ramón y Cajal

     Madrid, España

     
  8. [8] Hospital Universitario Marqués de Valdecilla

     Hospital Universitario Marqués de Valdecilla

     Santander, España

     
  9. [9] Complejo Hospitalario de Toledo

     Complejo Hospitalario de Toledo

     Toledo, España

     
  10. [10] Hospital de Fuenlabrada

      Hospital de Fuenlabrada

      Fuenlabrada, España

      
  11. [11] Hospital Clinic Barcelona

      Hospital Clinic Barcelona

      Barcelona, España

      
  12. [12] Departamento de Hematología y Oncología Médica, Hospital Universitario José María Morales Meseguer, Murcia, España
  13. [13] Instituto Catalán de Oncología, L’Hospitalet de Llobregat, Barcelona, España

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• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 24, Nº. 10 (October), 2022, págs. 2010-2020
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Purpose Immune Checkpoint Inhibitors (ICI) can be associated with thrombotic events, both venous and arterial (VTE/AT). However, there is a paucity of information regarding patients in routine clinical practice.

    Methods/patients Retrospective, multicenter study promoted by the Thrombosis and Cancer Section of the Spanish Society of Medical Oncology (SEOM). Patients with melanoma and lung cancer who initiated ICI between 01/01/2015 and 31/12/2019 were recruited. Minimum follow-up was 6 months (unless it was not possible because of death). The primary objective was to calculate the incidence of ICI-associated VTE/AT and the secondary objectives included to analyze its impact on survival and to identify predictor variables for VTE/AT.

    Results 665 patients with lung cancer were enrolled. The incidence of VTE/AT during follow-up was 8.4%. Median overall survival (OS) was lower in the VTE/AT group (12 months 95% CI 4.84–19.16 vs. 19 months 95% CI 16.11–21.9; p = 0.0049). Neutrophil/lymphocyte ratio (NLR) and anemia upon initiation of IT, as well as a history of thrombosis between cancer diagnosis and the start of ICI, were predictive variables for developing of VTE/AT (p < 0.05). 291 patients with melanoma were enrolled. There was a 5.8% incidence rate of VTE/AT during follow-up. Median OS was lower in the VTE/AT group (10 months 95% CI 0.0–20.27 vs. 29 months 95% CI 19.58–36.42; p = 0.034). NLR and lactate dehydrogenase (LDH) at the beginning of ICI were predictor variables for VTE/AT (p < 0.05).

    Conclusions ICI increases the risk of VTE/AT in patients with lung cancer and melanoma, which impact OS.