Risk of venous thromboembolism in ovarian cancer patients receiving neoadjuvant chemotherapy

Başaran, Derman; Boerner, Thomas; Suhner, Jessa; Sassine, Dib; Liu, Ying; Grisham, Rachel N.; Tew, William P.; Gardner, Ginger J.; Zivanovic, Oliver; Sonoda, Yukio; Roche, Kara Long; Dennis, S.; Abu‐Rustum, Nadeem R.; Soff, Gerald A.; Jewell, Elizabeth L.

doi:10.1016/j.ygyno.2021.07.030

Cited by 19 publications

(8 citation statements)

References 26 publications

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“…Those patients would have potentially benefited from thromboprophylaxis. The original Khorana score 30 remains a widely known method for cancer patients receiving chemotherapy but has not been validated for many cancers and has shown poor predictability in female cancers such as ovarian 31 and endometrial cancers 32 . However, a combination with hypercoagulability marker carries potential.…”

Section: Discussionmentioning

confidence: 99%

“…Analysis of biological variation is crucial for estimating critical differences, which corresponds with a threshold suggestive of a statistically significant difference between two consecutive results of a laboratory parameter in the same subject. 25 The original Khorana score 30 remains a widely known method for cancer patients receiving chemotherapy but has not been validated for many cancers and has shown poor predictability in female cancers such as ovarian 31 and endometrial cancers. 32 However, a combination with hypercoagulability marker carries potential.…”

Section: Hypercoagulability By Teg Is Related To Khorana Risk Assessmentmentioning

confidence: 99%

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Assessing hypercoagulability and VTE risk using thromboelastography and Khorana score in women with cancers receiving chemotherapy

Tera,

Suh,

Fainchtein

et al. 2024

American J Hematol

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Venous thromboembolism (VTE) is a common occurrence in cancer and chemotherapy increases thrombosis risk. Current risk assessment models such as the Khorana score (KS) and its modifications have limitations in female cancers. We assessed the coagulation profile of a group of women cancer patients under chemotherapy using thromboelastography (TEG) to determine if this can inform VTE risk assessment. Cancer patients who planned to receive chemotherapy were recruited. Baseline demographics, cancer data, BMI, Khorana Score (KS), and VTE risk factors were recorded and patients were followed for 6 months, for any thrombotic events. A total of 36 patients aged 35–85 (18 breast, 11 endometrial, 7 ovarian cancer) were evaluated. Hypercoagulability was detected in 63% of patients post‐chemo cycle 1 and 75% post‐cycle 2, with a significant increase in MA (maximum amplitude) and CI (clotting index), reduction in R (reaction time), K (clot kinetics), and LY30 (lysis time after 30 min of MA). KS showed only 7% of patients were high risk, 23% were low, and 70% were intermediate risk. MA and CI significantly increased in patients with intermediate and high‐risk KS when compared with the low‐risk patients and MA was positively correlated with KS. Five patients developed actual VTE; 100% of the tested ones were hypercoagulable either post‐cycle 1 or 2 and 80% were KS intermediate risk. TEG is a hypercoagulability marker and TEG‐MA and CI can potentially assess VTE risk. Larger studies are needed to assess the utility of TEG as an adjuvant to KS to better predict VTE in specific female cancers.

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Section: Discussionmentioning

confidence: 99%

Section: Hypercoagulability By Teg Is Related To Khorana Risk Assessmentmentioning

confidence: 99%

Assessing hypercoagulability and VTE risk using thromboelastography and Khorana score in women with cancers receiving chemotherapy

Tera,

Suh,

Fainchtein

et al. 2024

American J Hematol

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“…Expanding the trial sample size, increasing the number of patients included, and including a control group could make the findings of similar future studies more convincing. In addition, clinicians cannot ignore the issue that OC patients treated with NACT are at extremely high risk of thromboembolic events, especially those with advanced metastatic disease, and increased screening or the use of prophylactic anticoagulation are effective means of preventing associated AEs (Basaran et al, 2021). Notably, the OV21/PETROC study provided RCT data supporting that women undergoing NACT followed by optimal tumor reduction surgery would benefit from chemotherapy with intraperitoneal injections of carboplatin, informing the choice of follow-up treatment after NACT and optimal tumor reduction surgery in the clinic (Provencher et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Targeted therapy and immunotherapy: Diamonds in the rough in the treatment of epithelial ovarian cancer

Huang

Shan

et al. 2023

Front. Pharmacol.

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Currently, for ovarian cancer, which has the highest mortality rate among all gynecological cancers, the standard treatment protocol is initial tumor cytoreductive surgery followed by platinum-based combination chemotherapy. Although the survival rate after standard treatment has improved, the therapeutic effect of traditional chemotherapy is very limited due to problems such as resistance to platinum-based drugs and recurrence. With the advent of the precision medicine era, molecular targeted therapy has gradually entered clinicians’ view, and individualized precision therapy has been realized, surpassing the limitations of traditional therapy. The detection of genetic mutations affecting treatment, especially breast cancer susceptibility gene (BRCA) mutations and mutations of other homologous recombination repair defect (HRD) genes, can guide the targeted drug treatment of patients, effectively improve the treatment effect and achieve a better patient prognosis. This article reviews different sites and pathways of targeted therapy, including angiogenesis, cell cycle and DNA repair, and immune and metabolic pathways, and the latest research progress from preclinical and clinical trials related to ovarian cancer therapy.

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“…There are several reports of PE occurring after operation or during chemotherapy in patients with ovarian cancer (11)(12)(13). However, confirmed by publicly available niraparib treatmentrelated adverse events, there have been no reports of PE caused by the use of niraparib in patients with advanced high-grade serous ovarian cancer.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Niraparib-Related Pulmonary Embolism During the Treatment of BRCA Mutant Advanced Ovarian Cancer

2022

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Niraparib, an oral, potent, highly selective poly (ADP-ribose) polymerase (PARP) inhibitor, has promising clinical benefit for maintenance treatment of patients with ovarian cancer in partial response to platinum-based chemotherapy, especially in patients with BRCA mutation. In publicly available niraparib treatment-related adverse events, gastrointestinal disorders and hematological toxicities were most commonly reported with manageable safety profile. Herein, we first describe a severe and never-reported pulmonary embolism (PE) associated with the use of niraparib in a patient with BRCA mutation advanced high-grade serous ovarian cancer and received anticoagulant therapy after PE. There have been no reports of PE caused by the use of niraparib in patients with advanced high-grade serous ovarian cancer; knowledge of the occurrence of PE after the use of niraparib may assist other clinicians in managing this rare but potentially serious toxic effect.

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Risk of venous thromboembolism in ovarian cancer patients receiving neoadjuvant chemotherapy

Cited by 19 publications

References 26 publications

Assessing hypercoagulability and VTE risk using thromboelastography and Khorana score in women with cancers receiving chemotherapy

Assessing hypercoagulability and VTE risk using thromboelastography and Khorana score in women with cancers receiving chemotherapy

Targeted therapy and immunotherapy: Diamonds in the rough in the treatment of epithelial ovarian cancer

Case Report: Niraparib-Related Pulmonary Embolism During the Treatment of BRCA Mutant Advanced Ovarian Cancer

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