Dr med Florian Moik from the Medical University of Vienna, Department of Medicine I, Division of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Vienna, Austria speaks about the Incidence, Risk Factors, And Outcomes Of Venous And Arterial Thromboembolism In Immune Checkpoint Inhibitor Therapy.
Link to Article:
https://ashpublications.org/blood/article/137/12/1669/469619/Incidence-risk-factors-and-outcomes-of-venous-and
Points to Remember:
* Patients taking immune checkpoint inhibitors for cancer are at a higher risk of developing VTE/ATE.
* VTE caused by immune checkpoint inhibitors has a poor prognosis and is difficult to predict.
Synopsis:
Immune checkpoint inhibitors are currently associated with a risk of venous thromboembolism (VTE) and arterial thromboembolism (ATE). The aim of this study was to quantify the risk of VTE/ATE in cancer patients taking immune checkpoint inhibitors, look into the clinical implications, and look into possible clinical risk factors. Patients treated with immune checkpoint inhibitors at the Medical University of Vienna from 2015 to 2018 (n = 672; most common entities: 30.4 percent melanoma, 24.1 percent non-small cell lung cancer; 86 percent stage IV disease) were classified using in-house pharmacy records. To check for VTE and/or ATE, a retrospective chart analysis was done. In a competing-risk analysis, cumulative incidences and between-group discrepancies were calculated. Multistate modeling was used to investigate the effect of VTE/ATE on mortality. There were 47 VTEs and 9 ATEs observed over an 8.5-month follow-up period. VTE and ATE incidences were 12.9 percent (95 percent confidence interval [CI], 8.2-18.5) and 1.8 percent, respectively (95 percent CI, 0.7-3.6). The presence of VTE was linked to a higher risk of death (transition hazard ratio, 3.09; 95 percent CI, 2.07-4.60). VTE history predicted VTE occurrence (subdistribution hazard ratio [SHR], 3.69; 95 percent confidence interval [CI], 2.00-6.81), and distant metastasis was unrelated to VTE danger (SHR, 1.71; 95 percent CI, 0.62-4.73). There was no correlation between VTE and Eastern Cooperative Oncology Group success status, Charlson comorbidity index, or Khorana score, and VTE rates were similar across tumor types and checkpoint inhibitors. Finally, patients with cancer who are taking immune checkpoint inhibitors are at a higher risk of thromboembolism, especially VTE. Furthermore, VTE was linked to an increased risk of death.