Cancer-associated thrombosis: enhanced awareness and pathophysiologic complexity

Falanga, Anna; Marchetti, Marina

doi:10.1016/j.jtha.2023.02.029

Cited by 21 publications

(13 citation statements)

References 48 publications

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“…Therefore, it is crucial to increase our awareness of VTE and ATE. For VTE prediction, it is important to improve the Risk Assessment Methods (RAMs) by including old and novel biomarkers to better identify cancer outpatients with a high risk of VTE and taking into account cancer itself and cancer treatment-associated thrombotic risk [ 6 ]. For ATE prediction, we do not have scores yet, but it is mandatory to assess the “arterial thrombotic risk” in cancer patients at baseline, with careful identification of the common risk factors [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is also largely documented that thrombotic risk is related to the type of primary tumor, the burden of metastatic disease, and the thrombogenic effect of oncologic treatments, with the highest 1-year VTE incidence observed in metastatic disease. Moreover, there are novel VTE risk factors, such as the mutations in JAK2 (V617F), MET, and KRAS genes in myeloproliferative and solid neoplasms, that may have a strong clinical impact [ 6 , 7 , 8 ]. On the contrary, the incidence of arterial thromboembolism (ATE) in cancer patients has only recently become a widely investigated issue, even though the association between ATE and VTE has long been hypothesized [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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The Conundrum of Cancer-Associated Thrombosis: Lesson Learned from Two Intriguing Cases and Literature Review

Laurino,

Russi,

Omer

et al. 2024

Diseases

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The correlation between cancer and venous thromboembolism (VTE) is solid, whereas the knowledge about cancer-related arterial thromboembolism (ATE) still needs a deeper investigation to clarify its pathogenesis. We describe two cases that represent useful hints for a comprehensive review of the thrombotic issue. A 75-year-old man with advanced rectal cancer treated with fluoropyrimidines suffered two catheter-related VTE events managed according to current guidelines. There was no indication for “extended” anticoagulant therapy for him, but during antithrombotic wash-out and fluoropyrimidines plus panitumumab regimen, he suffered a massive right coronary artery (RCA) thrombosis. Another patient with no cardiovascular (CV) risk factors and affected by advanced bladder cancer was treated with a platinum-containing regimen and suffered an acute inferior myocardial infarction 2 days after chemotherapy administration. He was successfully treated with primary Percutaneous Transluminal Coronary Angioplasty of RCA, discontinuing platinum-based therapy. Our observations raise the issue of cancer-associated thrombosis (CAT) complexity and the potential correlation between arterial and venous thrombotic events. Moreover, physicians should be aware of the thrombotic risk associated with anticancer therapies, suggesting that an appropriate prophylaxis should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Conundrum of Cancer-Associated Thrombosis: Lesson Learned from Two Intriguing Cases and Literature Review

Laurino,

Russi,

Omer

et al. 2024

Diseases

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“…The European Society for Medical Oncology (ESMO) 2010 practical guidelines proposed the Khrorana model to identify ambulatory cancer patients who are clinically at high risk for VTE [5]. The new 2023 ESMO guideline suggested the use of the same Khrorana model, but also the Vienna-CATS and COMPASS-CAT methods [6].…”

Section: Guideline Recommendationsmentioning

confidence: 99%

Novel Insights in Venous Thromboembolism Risk Assessment Methods in Ambulatory Cancer Patients: From the Guidelines to Clinical Practice

Drăgan,

Drăgan

2024

Cancers

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Many cancer patients will experience venous thromboembolism (VTE) at some stage, with the highest rate in the initial period following diagnosis. Novel cancer therapies may further enhance the risk. VTE in a cancer setting is associated with poor prognostic, a decreased quality of life, and high healthcare costs. If thromboprophylaxis in hospitalized cancer patients and perioperative settings is widely accepted in clinical practice and supported by the guidelines, it is not the same situation in ambulatory cancer patient settings. The guidelines do not recommend primary thromboprophylaxis, except in high-risk cases. However, nowadays, risk stratification is still challenging, although many tools have been developed. The Khrorana score remains the most used method, but it has many limits. This narrative review aims to present the current relevant knowledge of VTE risk assessment in ambulatory cancer patients, starting from the guideline recommendations and continuing with the specific risk assessment methods and machine learning models approaches. Biomarkers, genetic, and clinical features were tested alone or in groups. Old and new models used in VTE risk assessment are exposed, underlining their clinical utility. Imaging and biomolecular approaches to VTE screening of outpatients with cancer are also presented, which could help clinical decisions.

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“…Cancer-associated thrombosis (CAT) stands out as a common complication of malignant tumors, affecting up to approximately 20% of individuals, according to relevant studies[ 4 , 5 ]. The risk of CAT is multifaceted, lacking a singular predictive risk factor or biomarker for its occurrence[ 6 , 7 ]. The correlation between venous thrombosis and malignancy was initially suggested by Baptiste Builaud, and later confirmed 44 years afterward by the French physician Armand Trousseau[ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Research progress on venous thrombosis development in patients with malignant tumors

Wang,

Chen,

Deng

et al. 2024

World J Clin Cases

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The coexistence of venous thromboembolism (VTE) within patients with cancer, known as cancer-associated thrombosis (CAT), stands as a prominent cause of mortality in this population. Over recent years, the incidence of VTE has demonstrated a steady increase across diverse tumor types, influenced by several factors such as patient management, tumor-specific risks, and treatment-related aspects. Furthermore, mutations in specific genes have been identified as potential contributors to increased CAT occurrence in particular cancer subtypes. We conducted an extensive review encompassing pivotal historical and ongoing studies on CAT. This review elucidates the risks, mechanisms, reliable markers, and risk assessment methodologies that can significantly guide effective interventions in clinical practice.

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Cancer-associated thrombosis: enhanced awareness and pathophysiologic complexity

Cited by 21 publications

References 48 publications

The Conundrum of Cancer-Associated Thrombosis: Lesson Learned from Two Intriguing Cases and Literature Review

The Conundrum of Cancer-Associated Thrombosis: Lesson Learned from Two Intriguing Cases and Literature Review

Novel Insights in Venous Thromboembolism Risk Assessment Methods in Ambulatory Cancer Patients: From the Guidelines to Clinical Practice

Research progress on venous thrombosis development in patients with malignant tumors

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