1826P Thrombosis incidence in cancer patients treated with antiangiogenic therapy

Abstract

Methods: Patients treated with an immune checkpoint inhibitor at the Medical University of Vienna from 2015-2018 have been identified using the in-house pharmacy records (n¼580; most frequent entities: 35.6% melanoma, 29.3% lungcancer; 89% stage-IV-disease). A retrospective chart-review was performed to screen for VTE and/or ATE. Cumulative incidences and between-group differences were analysed within a competing-risk framework. Multi-state modelling was applied to study the impact of VTE/ATE on clinical outcomes (mortality & progression of disease).Results: Over a median follow-up of 8.0 months, 39 VTE and 7 ATE were observed. Cumulative incidences of VTE and ATE were 12.9% [95%CI: 7.7-19.5)] and 1.9% [0.7-4.0]. Occurrence of VTE was associated with increased mortality (transition hazardratio (THR): 3.16 [95%CI: 2.06-4.86]) and an increase in risk of early disease progression (THR: 3.51 [95%CI: 2.25-5.48]). Disease-stage (all VTE occurred in stage IV tumors) and history of ) predicted VTE occurrence. No association of VTE with ECOG performance-status, Charlson-Comorbidity-Index or the Khorana-score was observed, and rates of VTE were comparable among subgroups of tumour types and checkpoint-inhibitory agents.Conclusions: Patients with cancer under immune checkpoint inhibitor therapy are at high risk of thromboembolism, especially VTE. Clinical predictors of VTE were advanced disease and history of VTE. Furthermore, VTE occurrence under immunotherapy was associated with increased risk of mortality and disease progression.Legal entity responsible for the study: The authors.

Do Antiangiogenics Promote Clot Instability? Data from the TESEO Prospective Registry and Caravaggio Clinical Trial

“…However, thromboembolism is not a common side effect in clinical trials, patients are not generally asked specifically about them, and half of all cases are asymptomatic. Therefore, it is likely that VTE are underdiagnosed (23).…”

“…Therefore, it is likely that VTEs are underdiagnosed. 23 Our study differs from those analyses as it does examine the relative frequency of PEs across subjects who have had any VTE and, consequently, makes it possible to probe into the qualitative characteristics of the events in a broad, prospective cohort. Mainly, we have found that exposure to antiangiogenics was associated with a marked increase in the proportion of PE over DVT.…”