What is the clinical evidence from this study?

Study design: Cohort. Population: Malignancies (n=936). Intervention: Cisplatin-based chemotherapy. Primary outcome: Thromboembolic events (TEEs).

What question did this study set out to answer?

To determine the incidence, timing, and risk factors of thromboembolic events in patients undergoing cisplatin-based chemotherapy across various malignancies.

November 20, 2009Blood

Cisplatin-Based Chemotherapy Is Associated with An Unacceptably High Incidence of Thromboembolic Events: A Large Retrospective Analysis.

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Key result

Cisplatin-based chemotherapy was associated with an 18.3% incidence of thromboembolic events across various primary cancers, with most events occurring within 90 days of treatment initiation.

Key Points

To determine the incidence, timing, and risk factors of thromboembolic events in patients undergoing cisplatin-based chemotherapy across various malignancies.
Retrospective cohort analysis of adult patients (N=936) treated with cisplatin-based chemotherapy for various malignancies at Memorial Sloan Kettering Cancer Center in 2008.
Identified cisplatin-associated thromboembolic events (TEEs)—including deep vein thrombosis, pulmonary embolism, and arterial thrombosis—occurring between the first dose and 4 weeks post-treatment using imaging, laboratory markers, and electronic records.
Overall, 171 of 936 patients (18.3%) experienced a TEE, with 85.4% (146/171) of events occurring within 90 days of initiating treatment.
Events comprised deep vein thrombosis alone (50.3%), pulmonary embolism alone (26.3%), combined DVT and PE (12.9%), arterial TEEs (7.6%), and mixed DVT and arterial events (2.9%).
TEE incidence was highest in pancreatic cancer (38.2%), gastric cancer (31.2%), metastatic disease (22.2%), and combination regimens containing gemcitabine (27.3%) or bevacizumab (24.6%).

Study Design

Type

Cohort (n=936)

Multicenter

Structured PICO

Population

936 adult patients with various malignancies receiving cisplatin-based chemotherapy, followed for at least 4 weeks after the last dose.

Exposure

Cisplatin-based chemotherapy

Outcome

Incidence of thromboembolic events (TEEs) occurring between the time of the first dose of cisplatin administration and 4 weeks after the last dosesafety

Cisplatin-based chemotherapy is associated with a high (18.3%) incidence of thromboembolic events, suggesting that prophylactic anticoagulation may be advisable in this population.

Limitations

Incidences reported may represent an under-estimate of the real incidence of TEEs since some patients with TEE may have been missed because of lack of adequate documentation.
Retrospective analysis
Potential under-estimation of real incidence due to missed cases from lack of adequate documentation

Discussion

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Implication

High thromboembolic risk observed with cisplatin; leaves open whether prophylaxis improves outcomes in prospective trials.

Cite This Study

Moore et al. (2009) conducted a cohort in Malignancies (n=936). Cisplatin-based chemotherapy was evaluated on Thromboembolic events (TEEs). Cisplatin-based chemotherapy was associated with an 18.3% incidence of thromboembolic events across various primary cancers, with most events occurring within 90 days of treatment initiation.

synapsesocial.com/papers/6a746ffce2936089dd0323bf https://doi.org/10.1182/blood.v114.22.456.456

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Cisplatin-Based Chemotherapy Is Associated with An Unacceptably High Incidence of Thromboembolic Events: A Large Retrospective Analysis.

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Cisplatin-Based Chemotherapy Is Associated with An Unacceptably High Incidence of Thromboembolic Events: A Large Retrospective Analysis.

Key Points

Study Design

Structured PICO

Limitations

Discussion

Implication

Cite This Study

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