Predictors of active cancer thromboembolic outcomes: validation of the Khorana score among patients with lung cancer: comment

Noble, Simon; Alikhan, Raza; Robbins, Alexandria J.; Macbeth, Fergus; Hood, Kerenza

doi:10.1111/jth.13594

Cited by 27 publications

(34 citation statements)

References 3 publications

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“…However, our current findings in lung cancer are consistent with other recent studies in lung cancer that have failed to validate an association of the risk score with VTE occurrence in patients with lung cancer . Furthermore, the VTE‐RS represents a significant independent predictor of early all‐cause mortality in patients with cancer receiving chemotherapy even after adjustment for other major prognostic factors, confirming prospectively in this large real‐world study our prior results and those of other studies . This is of clinical interest because, to the best of our knowledge, there have been no prospective, global, real‐world cohort studies comprehensively confirming risk factors for VTE or early mortality in patients with lung cancer.…”

Section: Discussionsupporting

confidence: 91%

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Predictors of Venous Thromboembolism and Early Mortality in Lung Cancer: Results from a Global Prospective Study (CANTARISK)

et al. 2017

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Multiple risk factors for both venous thromboembolism (VTE) and early mortality in patients with lung cancer receiving systemic chemotherapy should guide best practice by better informing clinical evaluation and treatment decision-making. The Khorana risk score is of value in assessing the risk of early all-cause mortality along with other clinical parameters in patients with lung cancer receiving systemic therapy. Further study is needed to fully evaluate the validity of the risk score in predicting the risk of VTE in the modern era of lung cancer therapy.

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Section: Discussionsupporting

confidence: 91%

“…Although validated across a range of solid tumors, the risk score has not previously been independently validated for VTE in patients with lung cancer. In fact, in the era of targeted therapies, other authors have been unable to demonstrate a significant association of the risk score with VTE in patients with lung cancer .…”

Section: Introductionmentioning

confidence: 99%

Predictors of Venous Thromboembolism and Early Mortality in Lung Cancer: Results from a Global Prospective Study (CANTARISK)

et al. 2017

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“…Furthermore, in a multicenter cohort of cancer patients, the KRS was not able to discriminate between patients with and without VTE; however, the addition of other biomarkers increased its predictive value [ 25 ]. Similar to the SAVE-ONCO and FRAGMATIC studies, in our study, VTE events occurred more often in the intermediate-risk KRS group than in the high-risk KRS group [ 26 – 29 ].…”

Section: Discussionsupporting

confidence: 85%

Prediction of venous thromboembolism in newly diagnosed patients treated for lymphoid malignancies: validation of the Khorana Risk Score

et al. 2017

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The utility of the venous thromboembolism (VTE) risk assessment model known as the Khorana Risk Score (KRS) in patients with lymphoid malignancies receiving outpatient chemotherapy is not defined. We evaluated the association of the KRS with VTE in patients treated for diffuse large B cell lymphoma (DLBCL) or Hodgkin lymphoma (HL). Retrospective analyses were performed in 428 patients, 241 of whom were newly diagnosed with DLBCL and 187 of whom had HL. During the initial therapy, 64 (15%) patients developed VTE and 56 died during follow-up. More VTE events occurred in patients with DLBCL than in patients with HL. According to the KRS, 364 (85%) and 64 (15%) patients were considered to be at intermediate risk and high risk of VTE development, respectively. The high-risk KRS patients were more often diagnosed with HL than DLBCL (19 vs. 10%, P = 0.0143). The KRS did not discriminate between high- and intermediate-risk patients with respect to VTE occurrence (17 vs. 15%, P = 0.5868). In our patients, the KRS did not adequately predict VTE (positive predictive value 15%, negative predictive value 82% and C statistic 0.51). In the multivariate analysis, bulky disease (OR 2.34; 95% CI 1.62–3.36, P < 0.0001), poor prognostic disease (OR 1.32; 95% CI 1.01–1.74, P = 0.049) and DLBCL histological subtype (OR 1.61; 95% CI 1.17–2.19, P = 0.003) were all significantly associated with the VTE development. In this cohort of patients with lymphoid malignancies, the KRS did not adequately stratify or predict VTE events in patients at a higher risk of VTE. This finding suggests the need for the development of a disease-specific VTE assessment model.

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“…We appreciate the thoughtful response to our article ‘Predictors of active cancer thromboembolic outcomes: validation of the Khorana score among patients with lung cancer’ from Noble et al . . We are encouraged that our results are similar to those of the presented analysis of the pivotal FRAGMATIC study .…”

supporting

confidence: 86%

Predictors of active cancer thromboembolic outcomes: validation of the Khorana score among patients with lung cancer: reply

Mansfield

Tafur

2017

Journal of Thrombosis and Haemostasis

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Predictors of active cancer thromboembolic outcomes: validation of the Khorana score among patients with lung cancer: comment

Cited by 27 publications

References 3 publications

Predictors of Venous Thromboembolism and Early Mortality in Lung Cancer: Results from a Global Prospective Study (CANTARISK)

Predictors of Venous Thromboembolism and Early Mortality in Lung Cancer: Results from a Global Prospective Study (CANTARISK)

Prediction of venous thromboembolism in newly diagnosed patients treated for lymphoid malignancies: validation of the Khorana Risk Score

Predictors of active cancer thromboembolic outcomes: validation of the Khorana score among patients with lung cancer: reply

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