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Multicenter Study
. 2023 Oct;25(10):3021-3031.
doi: 10.1007/s12094-023-03171-z. Epub 2023 Apr 10.

Immune checkpoint inhibitor-associated thrombosis in patients with bladder and kidney cancer: a study of the Spanish Society of Medical Oncology (SEOM) thrombosis and cancer group

Manuel Sánchez Cánovas  1   2 , David Fernández Garay  3   4 , Evdochia Adoamnei  5 , Esperanza Guirao García  3   6 , Javier López Robles  3   6 , Diego Cacho Lavin  3   7 , Eva Martínez de Castro  3   7 , Begoña Campos Balea  3   8 , Alberto Garrido Fernández  3   9 , Isaura Fernández Pérez  3   9 , Asia Ferrández Arias  3   10 , Noelia Suarez  3   10 , Teresa Quintanar Verduguez  3   10 , Miriam Lobo de Mena  3   11 , Laura Rodríguez  3   12 , David Gutierrez  3   12 , Ana Manuela Martín Fernández de Soiginie  3   12 , Silvia García Adrián  3   13 , Ana Isabel Ferrer Pérez  3   14 , María Jesús Delgado Heredia  3   15 , Amelia Muñoz Lerma  3   16 , Raquel Luque  3   16 , Manuel Mazariegos Rubí  3   17 , Ana Belen Rúperez Blanco  3   17 , Ignacio García Escobar  3   17 , Jaime Mendiola  18 , Andrés Jesús Muñoz Martín  3   19
Affiliations
Multicenter Study

Immune checkpoint inhibitor-associated thrombosis in patients with bladder and kidney cancer: a study of the Spanish Society of Medical Oncology (SEOM) thrombosis and cancer group

Manuel Sánchez Cánovas et al. Clin Transl Oncol. 2023 Oct.

Abstract

Purpose: Both venous and arterial thrombotic events (VTE/AT) can be associated with immune checkpoint inhibitors (ICI). However, there is a paucity of information apropos 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). Individuals with kidney or bladder cancer who initiated ICI between 01/01/2015 and 12/31/2020 were recruited. Minimum follow-up was 6 months (except in cases of demise). The primary objective was to calculate the incidence of ICI-associated VTE/AT and secondary objectives included to analyze their impact on survival and identify variables predictive of VTE/AT.

Results: 210 patients with kidney cancer were enrolled. The incidence of VTE/AT during follow-up (median 13 months) was 5.7%. Median overall survival (OS) was relatively lower among subjects with VTE/AT (16 months, 95% CI 0.01-34.2 vs. 27 months, 95% CI 22.6-31.4; p = 0.43). Multivariate analysis failed to reveal predictive variables for developing VTE/ AT. 197 patients with bladder were enrolled. There was a 9.1% incidence rate of VTE/AT during follow-up (median 8 months). Median OS was somewhat higher in patients with VTE/AT (28 months, 95% CI 18.4-37.6 vs 25 months, 95% CI 20.7-29.3; p = 0.821). Serum albumin levels < 3.5 g/dl were predictive of VTE/ AT (p < 0.05).

Conclusions: There appears to be no association between developing VTE/AT and ICI use in patients with renal or bladder cancer. Serum albumin levels are a predictive factor in individuals with bladder cancer.

Keywords: Bladder cancer; Cancer-related thrombosis; Immune checkpoint inhibitors; Kidney cancer.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest related to the development of this research project.

Figures

Fig. 1
Fig. 1
Survival analysis: A Kaplan–Meier curve comparing OS (since initiation ICI) of kidney cancer patients treated with ICI who developed VTE/ AT versus those who did not; B landmark analysis at 3 months after initiation ICI; C landmark analysis at 6 months after initiation ICI; D landmark analysis at 9 months after initiation ICI
Fig. 2
Fig. 2
Survival analysis: A Kaplan–Meier curve comparing OS (since initiation ICI) of bladder cancer patients treated with ICI who developed VTE/AT versus those who did not; B landmark analysis at 3 months after initiation ICI; C landmark analysis at 6 months after initiation ICI; D landmark analysis at 9 months after initiation ICI
See this image and copyright information in PMC

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