Risk of venous thromboembolism in patients receiving neoadjuvant chemotherapy for ovarian cancer.

Abstract

6073 Background: To identify the incidence of newly occurring venous thromboembolism (VTE) in patients with ovarian cancer receiving neoadjuvant chemotherapy (NACT). Methods: Using our prospectively maintained ovarian cancer database, we identified all ovarian cancer patients who received NACT at our institution from 4/15-9/18. VTE events included clinically diagnosed deep venous thrombosis (DVT) or pulmonary embolism (PE). Patients who presented with VTE prior to induction of NACT or patients on anticoagulation therapy prior to diagnosis were excluded. The incidence of newly occurring thrombotic events were categorized according to treatment phases, defined as 1) NACT prior to interval debulking surgery (IDS); 2) intraoperative and 30-day post-IDS; and 3) adjuvant chemotherapy. Results: 290 patients underwent NACT during the study period. Thirty-eight patients (13%) who presented with VTE, 12 (4%) on anticoagulation at presentation, and 4 (1.4%) seeking only a second opinion were excluded from analysis. Of the 236 evaluable patients, the overall rate of VTE during all treatment phases was 15% (35/236). In treatment phase I, 11% (27/236) of patients experienced VTE during NACT. In phase II, an additional 2.5% (6/236) developed VTE in the intraoperative and 30-day postoperative period. In phase III, an additional 0.8% (2/236) experienced a thrombotic event >30 days postoperatively. Sevety-seven percent (27/35) of VTE events occured during phase I. Conclusions: Patients receiving NACT for advanced ovarian cancer are at high risk for the development of clinically detectable thromboembolic events. The highest rate of new VTE events was seen during induction of NACT, a phase of treatment traditionally without any prophylactic anticoagulation. Further research regarding the timing of thromboprophylaxis for this patient population is warranted. [Table: see text]

Ovarian clear cell cancer associated with Trousseau syndrome: A case report and literature review

“…Previous reports have shown that early-onset VTE events are associated with surgery and chemotherapy during treatment of malignant diseases. [14] But, Chavan et al revealed that neoadjuvant chemotherapy was not associated with thromboembolism, and the current combination of commonly used chemotherapeutic agents for ovarian cancer had a minimal risk of thromboembolic events. [15] So how to balance the advantages of neoadjuvant chemotherapy and surgery in OCCC with cerebral infarction and the risks associated with treatment remains to be explored.…”

Niraparib-Related Pulmonary Embolism During Ovarian Cancer Therapy

“…There are several reports of PE occurring after operation or during chemotherapy in patients with ovarian cancer. 3,4 However, con rmed by publicly available niraparib-related treatment adverse events, there have been no reports of PE caused by the use of niraparib in patients with advanced high-grade serous ovarian cancer. Thus, knowledge of the occurrence of PE after the use of niraparib may assist other clinicians in managing this rare but potentially serious toxic effect.…”