Key result
Lung cancer is associated with a high incidence of venous thromboembolism, driven by risk factors like adenocarcinoma and chemotherapy, though predictive biomarkers and optimal prophylaxis remain unclear.
Why the study?
Lung cancer is among malignancies with the highest rates of VTE, but the responsible mechanisms are not understood, no predictive biomarker is recognized, and further trials are needed to assess antithrombotic prophylaxis.
Does antithrombotic prophylaxis prevent venous thromboembolism in lung cancer patients?
Does antithrombotic prophylaxis prevent venous thromboembolism in lung cancer patients?
Lung cancer patients are at high risk for VTE, but the mechanisms are poorly understood and further trials are needed to establish the benefit of routine antithrombotic prophylaxis.
Antithrombotic prophylaxis should not yet be routine in lung cancer; leaves open optimal strategies and biomarker-guided trials.
Venous thromboembolism (VTE) is a common complication of malignancies and epidemiological studies suggest that lung cancer belonged to the group of malignancies with the highest incidence rates of VTE. Risk factors for VTE in lung cancer patients are adenocarcinoma, NSCLC in comparison with SCLC, advanced disease, pneumonectomy, chemotherapy including antiangiogenic therapy. Other risk factors are pretreatment platelet counts and increased release of TF-positive microparticles. Elevated D-dimer levels do not necessarily indicate an increased risk of VTE but have been shown to be predictive for a worse clinical outcome in lung cancer patients. Mechanisms responsible for the increase in venous thrombosis in patients with lung cancer are not understood. Currently no biomarker is recognized as a predictor for VTE in lung cancer patients. Although several clinical trials have reported the efficacy of antithrombotic prophylaxis in patients with lung cancer who are receiving chemotherapy, further trials are needed to assess the clinical benefit since these patients are at an increased risk of developing a thromboembolism.
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Vitale et al. (2019) conducted a review in Venous thromboembolism and lung cancer. Lung cancer is associated with a high incidence of venous thromboembolism, driven by risk factors like adenocarcinoma and chemotherapy, though predictive biomarkers and optimal prophylaxis remain unclear.
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