Treatment and Prevention of Cancer-Associated Thrombosis in Frail Patients: Tailored Management

Scotté, Florian; Leroy, P.; Chastenet, Mathilde; Aumont, Laure; Benatar, Vidal; Elalamy, Ismaı̈l

doi:10.3390/cancers11010048

Cited by 18 publications

(10 citation statements)

References 75 publications

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“…The switch from LMWHs to oral anticoagulation between 6 and 12 months was firstly related to the doctor's decision, then to the patient's preference. This is consistent with previous observations in France on the management of the anticoagulant treatment in CAT patients, which is based on physician's decision with a case-by-case approach [18,19].…”

Section: Discussionsupporting

confidence: 92%

Long-Term Treatment of Cancer-Associated Thrombosis (CAT) Beyond 6 Months in the Medical Practice: USCAT, a 432-Patient Retrospective Non-Interventional Study

Mahé

Plaisance

Chapelle

et al. 2020

Cancers

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Background: extended anticoagulant therapy beyond the initial 6 months is suggested in patients with cancer-associated thrombosis (CAT) and active cancer. Few data are available on patient management and outcomes on the period between 6 and 12 months after the venous thromboembolism (VTE) event. Objectives: our objective was to document patient management and outcomes beyond 6 months and up to 12 months in CAT patients initially treated for 6 months with tinzaparin. Methods: adult CAT patients with a cancer still alive at the end of an initial 6-month treatment period were eligible to participate in this retrospective non-interventional French multicenter study. Results: a total of 432 patients aged 66.5 ± 12.7 years were available to participate in this study. Out of the patients included in the study, the anticoagulant treatment was maintained in 348 of 422 documented patients (82.5%) while it was discontinued in 74 (17.5%) patients (before the end or at the end of the initial 6-month treatment period). Between 6 and 12 months, 24 patients (5.7%) experienced VTE recurrence, while 21 (5.1%) patients had clinically relevant bleeding, 11 patients (2.7%) had major bleeding and 96 patients (22.3%) died, mostly from cancer. VTE recurrence was more frequent in patients with lung (14.3%) and colorectal cancer (6.0%) while major bleeding was more frequent in patients with colorectal cancer (6.0%). Conclusion: clinical outcomes were consistent with previous observations and variable according to the type of cancer. Further clinical research is required to orient the management of patients with CAT beyond 6 months based on cancer-specific treatment strategies.

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Section: Discussionsupporting

confidence: 92%

Long-Term Treatment of Cancer-Associated Thrombosis (CAT) Beyond 6 Months in the Medical Practice: USCAT, a 432-Patient Retrospective Non-Interventional Study

Mahé

Plaisance

Chapelle

et al. 2020

Cancers

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“…Cancer patients commonly require antiplatelet or anticoagulant medications for thrombosis treatment or prophylaxis, but long-term use of antiplatelet agents increases risk of bleeding and gastrointestinal side effects and is not recommended for most patients [ 53 , 54 ]. However, even when cancer patients are treated with an anticoagulant, they remain at high risk for recurrent thrombosis [ 55 , 56 ].…”

Section: Discussionmentioning

confidence: 99%

Platelet-T cell aggregates in lung cancer patients: Implications for thrombosis

et al. 2020

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Platelet-leukocyte aggregates (PLAs) are associated with increased thrombosis risk. The influence of PLA formation is especially important for cancer patients, since thrombosis accounts for approximately 10% of cancer-associated deaths. Our objective was to characterize and quantify PLAs in whole blood samples from lung cancer patients compared to healthy volunteers with the intent to analyze PLA formation in the context of lung cancer-associated thrombosis. Consenting lung cancer patients (57) and healthy volunteers (56) were enrolled at the Dana Cancer Center at the University of Toledo Health Science Campus. Peripheral blood samples were analyzed by flow cytometry. Patient medical history was reviewed through electronic medical records. Most importantly, we found lung cancer patients to have higher percentages of platelet-T cell aggregates (PTCAs) than healthy volunteers among both CD4+ T lymphocyte and CD8+ T lymphocyte populations. Our findings demonstrate that characterization of PTCAs may have clinical utility in differentiating lung cancer patients from healthy volunteers and stratifying lung cancer patients by history of thrombosis.

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“…The ECOG status is closely related to the treatment and survival of patients ( Scotté et al, 2019 ). Poor ECOG status is associated with an increased risk of VTE, which has been previously confirmed in patients receiving chemotherapy ( Ferroni et al, 2015 ).…”

Section: Risk Factors For Tementioning

confidence: 99%

Risk Factors, Incidence, and Prognosis of Thromboembolism in Cancer Patients Treated With Immune Checkpoint Inhibitors

et al. 2021

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In recent years, immune checkpoint inhibitors (ICIs) have become the standard treatment option for tumors. With the widespread application of ICIs, immune-related adverse events (irAEs) have gradually attracted the attention of researchers. Owing to the characteristics of ICIs, irAEs can affect each organ of the human body. Thromboembolism is uncommon in cancer patients receiving ICIs, but it may affect their survival. Most thromboembolic events do not cause serious effects after early prediction and treatment, but life-threatening toxic reactions are also observed. This condition should not be ignored because of vague and atypical symptoms, which make early diagnosis more challenging. This article focuses on the high-risk factors, underlying mechanisms, incidence, and prognosis of thromboembolism in patients using ICIs and briefly describes the intervention and treatment measures. This information would allow patients to effectively manage the side effects of thromboembolism during Immune checkpoint inhibitors treatment, ensuring the efficacy of ICIs and reducing mortality.

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Treatment and Prevention of Cancer-Associated Thrombosis in Frail Patients: Tailored Management

Cited by 18 publications

References 75 publications

Long-Term Treatment of Cancer-Associated Thrombosis (CAT) Beyond 6 Months in the Medical Practice: USCAT, a 432-Patient Retrospective Non-Interventional Study

Long-Term Treatment of Cancer-Associated Thrombosis (CAT) Beyond 6 Months in the Medical Practice: USCAT, a 432-Patient Retrospective Non-Interventional Study

Platelet-T cell aggregates in lung cancer patients: Implications for thrombosis

Risk Factors, Incidence, and Prognosis of Thromboembolism in Cancer Patients Treated With Immune Checkpoint Inhibitors

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