Skip to main content
ISTH 2024 Main banner
Back

Poster Networking

Venous Thromboembolism

PB1410 - Plasma tissue factor activity and D-dimer in lung cancer patients predicts venous thromboembolism and poor overall survival

Tuesday, June 25, 2024
13:45 – 14:45 ICT
Room: Exhibition Hall
Background: Among solid tumors, lung cancer (LC) have a high incidence of venous thrombotic events.

Aims: A prospective multicenter trial (NCT02853188, approved by the Independent Ethics Committee IdF) was conducted to determine whether plasma TF activity (TFA) and D-dimer could be useful to predict venous thromboembolism (VTE) and overall survival (OS), in ambulatory LC patients.

Methods: 256 patients with non-small cell lung cancer (NSCLC) and 46 patients with small cell lung cancer (SCLC) were consecutively included in five French hospitals. TFA was measured by a one-stage kinetic chromogenic method, generation of activated factor X (FXa) by the [TF-activated factor VII] complex was measured using a FXa chromogenic substrate. D-dimer were measured using a latex enhanced turbidimetric immunoassay. TFA and D-dimer were quantified at diagnosis before any cancer treatment (V1) and between 8 and 12 weeks after diagnosis (V2). Patients were followed up for two years.

Results: 38 patients experienced VTE within the first year after diagnosis. V1-TFA and V1-D-dimer were significantly (p=0.02) higher in patients who presented VTE within 3 months than in patients without VTE (V1-TFA were 2.02 vs 0.49 ng/mL and V1-D-dimer were 1.42 vs 0.69 μg/mL, respectively). Cut-offs of 1.92 ng/mL for TFA and 1.26 μg/mL for D-dimer could discriminate both groups of patients. In multivariate analysis, V1-TFA >1.92 ng/mL was the only significant predictor of VTE risk at one year (hazard ratio = 2.10, p=0.03). V2-TFA quantified in 251 patients, decreased significantly compared to V1-TFA (0.20 vs 0.56 ng/mL, p < 0.05), but a level of V2-TFA > 0.77 ng/mL could predict VTE in the following 3 months. Median OS was worse for patients with V1-TFA >1.92 ng/mL (14.6 vs 23.8 months) and V1-D-dimer >1.26 μg/mL (13.8 vs 24 months) (p < 0.001).

Conclusion(s): High plasma TFA and D-dimer levels predict occurrence of VTE within the next 3 months and poor survival.