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Multicenter Study
. 2022 Oct;24(10):2010-2020.
doi: 10.1007/s12094-022-02860-5. Epub 2022 Jun 6.

Immune checkpoint inhibitors-associated thrombosis in patients with lung cancer and melanoma: a study of the Spanish society of medical oncology (SEOM) thrombosis and cancer group

Manuel Sánchez Cánovas  1   2 , David Fernández Garay  3   4 , Laura Ortega Moran  3   5 , Jaime Rubio Pérez  3   6 , Carlos Miguel Guirao Rubio  3   7 , Miriam Lobo de Mena  3   8 , Berta Obispo Portero  3   9 , Jesús Brenes Castro  3   10 , Yolanda Lage  3   11 , Diego Cacho Lavin  3   12 , Ana Belen Rupérez Blanco  3   13 , Ana Manuela Martín Fernández de Soignie  3   14 , Jonatan Zacarías Benoit Perejón  3   4 , Laura Jiménez Colomo  3   10 , Noel Blaya Boluda  3   15 , Javier Bosque Moreno  3   7 , Teresa Quintanar Verduguez  3   7 , Carmen Rosa Garrido  3   16 , Roberto Martín Huertas  3   17 , Carme Font I Puig  3   17 , Andrés Jesús Muñoz Martín  3   5
Affiliations
Multicenter Study

Immune checkpoint inhibitors-associated thrombosis in patients with lung cancer and melanoma: a study of the Spanish society of medical oncology (SEOM) thrombosis and cancer group

Manuel Sánchez Cánovas et al. Clin Transl Oncol. 2022 Oct.

Abstract

Purpose: Immune Checkpoint Inhibitors (ICI) can be associated with thrombotic events, both venous and arterial (VTE/AT). However, there is a paucity of information regarding patients in routine clinical practice.

Methods/patients: Retrospective, multicenter study promoted by the Thrombosis and Cancer Section of the Spanish Society of Medical Oncology (SEOM). Patients with melanoma and lung cancer who initiated ICI between 01/01/2015 and 31/12/2019 were recruited. Minimum follow-up was 6 months (unless it was not possible because of death). The primary objective was to calculate the incidence of ICI-associated VTE/AT and the secondary objectives included to analyze its impact on survival and to identify predictor variables for VTE/AT.

Results: 665 patients with lung cancer were enrolled. The incidence of VTE/AT during follow-up was 8.4%. Median overall survival (OS) was lower in the VTE/AT group (12 months 95% CI 4.84-19.16 vs. 19 months 95% CI 16.11-21.9; p = 0.0049). Neutrophil/lymphocyte ratio (NLR) and anemia upon initiation of IT, as well as a history of thrombosis between cancer diagnosis and the start of ICI, were predictive variables for developing of VTE/AT (p < 0.05). 291 patients with melanoma were enrolled. There was a 5.8% incidence rate of VTE/AT during follow-up. Median OS was lower in the VTE/AT group (10 months 95% CI 0.0-20.27 vs. 29 months 95% CI 19.58-36.42; p = 0.034). NLR and lactate dehydrogenase (LDH) at the beginning of ICI were predictor variables for VTE/AT (p < 0.05).

Conclusions: ICI increases the risk of VTE/AT in patients with lung cancer and melanoma, which impact OS.

Keywords: Cancer related thrombosis; Immune Checkpoint Inhibitors; Lung cancer; Melanoma.

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Conflict of interest statement

The authors have not conflicts of interest related to the development of this research project.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curve comparing OS of lung cancer patients treated with ICI who developed VTE/AT vs. those who did not
Fig. 2
Fig. 2
Kaplan–Meier curve comparing OS of melanoma cancer patients treated with ICI who developed VTE/AT vs. those who did not
See this image and copyright information in PMC

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