Key result
Baseline VTE in lung cancer is linked to ~429% higher risk of subsequent VTE during therapy.
Why the study?
Real-world data on venous thromboembolism incidence and outcomes in patients with lung cancer were limited and needed clarification.
What is the incidence of VTE, bleeding, and death in patients with lung cancer, and how does baseline VTE affect these outcomes?
Cohort (n=2,377)
What is the incidence of VTE, bleeding, and death in patients with lung cancer, and how does baseline VTE affect these outcomes?
Hazard Ratio: 5.29
p-value: p=<0.001
In patients with lung cancer, the presence of VTE at baseline is associated with a significantly increased risk of subsequent VTE, bleeding, and all-cause mortality, highlighting the importance of VTE screening at cancer diagnosis.
Baseline VTE in lung cancer signals higher subsequent VTE, bleeding, and death risk; supports screening at diagnosis but leaves practice change open.
Introduction This subanalysis aimed to provide real-world data on venous thromboembolism (VTE) from patients with lung cancer in the Cancer-VTE Registry. Methods The primary outcome was the number of baseline VTE events in patients with lung cancer. The 1-year cumulative incidences of symptomatic VTE; composite VTE (symptomatic and incidental VTE requiring treatment); bleeding; cerebral infarction, transient ischemic attack, and systemic embolic events; and all-cause death were calculated. Clinical trial registration: UMIN000024942. Results The study enrolled a total of 2377 patients with lung cancer; of these, 119 (5.0%) had VTE (six [0.3%], symptomatic, and 113 [4.8%], asymptomatic) and 14 (0.6%) had pulmonary embolism at baseline. During the follow-up period (mean, 337.7 d), the incidence was 0.6% for symptomatic VTE, 1.8% for composite VTE, 1.5% for bleeding events, 1.3% for cerebral infarction, transient ischemic attack, and systemic embolism, and 19.1% for all-cause death. Composite VTE frequency did not vary by anticancer drug type. Patients with (versus without) VTE at baseline had higher hazard ratios (HRs) for composite VTE (unadjusted HR: 5.29; Gray test p < 0.001) and symptomatic VTE (unadjusted HR: 4.89; Gray test p = 0.007). Patients with VTE at baseline had higher HRs for bleeding events (unadjusted HR: 3.27; Gray test p = 0.010) and all-cause death (unadjusted HR: 2.73; log-rank test p < 0.001) than patients without. In multivariable analysis, patients with baseline VTE prevalence and Eastern Cooperative Oncology Group Performance Status of 2 had increased composite VTE risk during cancer therapy. There were no other risk factors for composite VTE. Conclusions Our findings emphasize the importance of VTE screening at cancer diagnosis.
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Awano et al. (2022) conducted a cohort in Lung cancer (n=2,377). Baseline venous thromboembolism (VTE) vs. No baseline VTE was evaluated on Composite VTE (symptomatic and incidental VTE requiring treatment) (HR 5.29, p=<0.001). Baseline venous thromboembolism in patients with lung cancer was associated with a significantly increased risk of subsequent composite VTE during cancer therapy (unadjusted HR 5.29; P<0.001).
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