PB1439 - Incidence of venous and arterial thromboembolic events in patients with cancer receiving systemic anti-cancer therapies: results from a prospective cohort study

Tuesday, June 25, 2024

13:45 – 14:45 ICT

Room: Exhibition Hall

Presenting Author(s)

Cornelia Englisch, MD

PhD Student
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria

Co-Author(s)

Florian Moik

Physician
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Graz, Steiermark, Austria
Daniel Steiner

PhD student
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
NV

Nikola Vladic

PhD Student
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
AS

Angelika M. Starzer

Physician
Division of Oncology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
AB

Anna Berghoff

Professor
Division of Oncology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
MP

Matthias Preusser

Professor
Division of Oncology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
Ingrid Pabinger

Professor
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria
Cihan Ay, MD

Professor
Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna
Vienna, Wien, Austria

Background: Cancer is associated with an increased risk of venous thromboembolism (VTE) and arterial thromboembolic events (ATE), which is in part attributable to systemic cancer therapies. Immune checkpoint inhibitors (ICIs) have changed the treatment landscape in oncology but their impact on thrombosis risk is still debated.

Aims: We assessed VTE and ATE risk in a single-center prospective cohort study of patients with cancer initiating systemic anti-cancer therapies and compared the risk of thrombotic complications between patients receiving different types of therapy.

Methods: All-cause mortality was considered a competing event and thus, competing risk analyses were performed.

Results: In total, 739 patients (median age: 61 years [interquartile range, IQR: 52-69], 49% women) were included, comprising 389 (52.6%) patients with newly diagnosed cancer and 350 (47.4%) patients with recurrent or progressive disease. Of 696 patients with solid tumors, 455 (65.4%) had metastatic disease at study inclusion. After study inclusion, systemic treatment with chemotherapy alone was initiated in 351 (47.5%), with combined chemotherapy and ICI therapy in 130 (17.6%), with ICI therapy alone in 115 (15.6%), with targeted therapy and chemotherapy in 91 (12.3%), with targeted therapy alone in 40 (5.4%), and with targeted therapy and ICI therapy in 12 (1.6%) patients. During a median follow-up time of 16 months (IQR: 9-28), 60 (8.1%) patients were diagnosed with VTE and 13 (1.8%) with ATE. The 12-month cumulative VTE incidence was highest in patients receiving chemotherapy (11.5%, 95% confidence interval [CI]: 7.8-15.3), while the 12-month cumulative ATE incidence was the highest in patients receiving ICI therapy (2.9%, 95% CI: 0.0-6.2; table and figure 1).

Conclusion(s): In our single-center prospective cohort study, patients with cancer receiving systemic anti-cancer therapies had a substantial thrombosis risk. The incidences differed between patients receiving different types of antineoplastic therapies and thus, further analyses considering other risk factors are needed in the future.