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. 2020 Aug:78:41-49.
doi: 10.1016/j.ejim.2020.05.031. Epub 2020 May 29.

A snapshot of cancer-associated thromboembolic disease in 2018-2019: First data from the TESEO prospective registry

Alberto Carmona-Bayonas  1 , David Gómez  2 , Eva Martínez de Castro  3 , Pedro Pérez Segura  4 , José Muñoz Langa  5 , Paula Jimenez-Fonseca  6 , Manuel Sánchez Cánovas  1 , Laura Ortega Moran  7 , Ignacio García Escobar  8 , Ana Belén Rupérez Blanco  9 , Isaura Fernández Pérez  10 , Purificación Martínez de Prado  11 , Rut Porta I Balanyà  12 , Teresa Quintanar Verduguez  13 , Álvaro Rodríguez-Lescure  13 , Andrés Muñoz  14
Affiliations

A snapshot of cancer-associated thromboembolic disease in 2018-2019: First data from the TESEO prospective registry

Alberto Carmona-Bayonas et al. Eur J Intern Med. 2020 Aug.

Abstract

Background: The ever-growing complexity of cancer-associated thrombosis (CAT), with new antineoplastic drugs and anticoagulants, distinctive characteristics, and decisions with low levels of evidence, justifies this registry.

Method: TESEO is a prospective registry promoted by the Spanish Society of Medical Oncology to which 34 centers contribute cases. It seeks to provide an epidemiological description of CAT in Spain.

Results: Participants (N=939) with CAT diagnosed between July 2018 and December 2019 were recruited. Most subjects had advanced colon (21.4%), non-small cell lung (19.2%), and breast (11.1%) cancers, treated with dual-agent chemotherapy (28.4%), monochemotherapy (14.4%), or immune checkpoint inhibitors (3.6%). Half (51%) were unsuspected events, albeit only 57.1% were truly asymptomatic. Pulmonary embolism (PE) was recorded in 571 (58.3%); in 120/571 (21.0%), there was a concurrent deep venous thromboembolism (VTE). Most initially received low molecular weight heparin (89.7%). Suspected and unsuspected VTE had an OS rate of 9.9 (95% CI, 7.3-non-computable) and 14.4 months (95% CI, 12.6-non-computable) (p=0.00038). Six-month survival was 80.9%, 55.9%, and 55.5% for unsuspected PE, unsuspected PE admitted for another reason, and suspected PE, respectively (p<0.0001). The 12-month cumulative incidence of venous rethrombosis was 7.1% (95% CI, 4.7-10.2) in stage IV vs 3.0% (95% CI, 0.9-7.1) in stages I-III. The 12-month cumulative incidence of major/clinically relevant bleeding was 9.6% (95% CI, 6.1-14.0) in the presence of risk factors.

Conclusion: CAT continues to be a relevant problem in the era of immunotherapy and targeted therapies. The initial TESEO data highlight the evolution of CAT, with new agents and thrombotic risk factors.

Keywords: Cancer; Heparin; Pulmonary embolism; Registry; Thrombosis.

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Conflict of interest statement

Declaration of Competing Interest ACB: consulting/advisory role: Roche, Rovi, Sanofi, LeoPharma, Pfizer, Esteve; travel grants: Ipsen, Roche, Novartis. DG: None. EMC: Consultant or Advisory Role: Pfizer, Amgen. Speaking: Roche, Pfizer, Amgen, Sanofi, LeoPharma, Rovi, Celgene. Travel, Accommodations: Roche, Pfizer, Celgene, Sanofi. PPS: Consultant or Advisory Role: Novartis, BMS, Merck. Travel, Accommodations: MSD, Merck. JML: Consultant or Advisory Role: LEO Pharma. Speaking: Sanofi, LeoPharma. Travel, Accommodations: LeoPharma. PJF: consulting/advisory role: Roche, Bristol, Mylan, Rovi, Sanofi, LeoPharma; travel grants: Ipsen. All outside of the scope of this work. MSC: Consultant or Advisory Role: KyowaKirin. Research Funding: LeoPharma. Financial support for educational programs: Angelini, Sanofi, Rovi, LeoPharma, Servier. Remunerations for authorship: KyowaKirin, Mylan. Travel, Accommodations: Sanofi, MSD, Esteve, Amgen, Servier, Angelini, Leo Pharma. LOM: Consultant or Advisory Role: Sanofi. Speaking: Amgen, Sanofi, LeoPharma. Travel, Accommodations: Roche, Amgen, Sanofi, LeoPharma. IGE: Consultant or Advisory Role: Sanofi, Leo Pharma. Speaking: Roche, Sanofi, Leo Pharma. Grant support: Leo Pharma. ABRB: Travel, Accommodation: Roche, Novartis, Lilly, BMS, Merck, Leo Pharma, MSD, Sanofi. IFP: Speaking: Roche, Pfizer, Novartis. Amgem. Travel, Accommodations (SEOM, SABC): Roche, Novartis. PMP: Speaking: Roche, ROVi, Sanofi, Pfizer, LeoPharma. Travel, Accommodations: Roche, Pfizer, Novartis, Sanofi, Leo Pharma, Rovi, Pierre Fabre. RPB: none. TQ: Consultant or Advisory Role: Tesaro. Speaking: Roche, Pfizer, Novartis, Teva, Rovi, Kiowa Kirin. Travel, Accommodations: Roche. ARL: Consultant or Advisory Role: Roche, Pfizer, Novartis, Lilly, Mylan. Speaking: Roche, Pfizer, Novartis, Lilly, Kern, A-Z, Mylan, Eisai. Travel, Accommodations (ASCO, SABCS): Roche, Novartis. AM: consulting, lectures and advisory board: Sanofi, Celgene, Astra-Zeneca, Roche, Leo Pharma, Servier, Pfizer, Bristol-Myers Squibb, Daiichi Sankyo, Bayer, Halozyme, Amgen, Rovi, Merck Sharp & Dohme and Lilly. Research funding: Sanofi, LEO Pharma, Celgene. Travel, Acccommodations: Roche, Merck Serono, Amgen, Celgene. All outside of the scope of this work.

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