Venous thromboembolism risk in cancer patients receiving first‐line immune checkpoint inhibitor versus chemotherapy

Li, Ang; May, Sarah; La, Jennifer; Martens, Kylee L; Amos, Christopher I.; Flowers, Christopher R.; Nhan, V.; Brophy, Mary; Chitalia, Vipul C.; Ravid, Katya; Gaziano, J. Michael; Fillmore, Nathanael

doi:10.1002/ajh.26954

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…35 Further, in a recent health care database analysis including 1,823 patients with advanced cancers, a similarly high risk of VTE was observed with ICI therapy compared with patients treated with chemotherapy (6-month cumulative risk: 8.5 vs. 8.4%), with no significant differences in propensity score weighted analysis (weighted hazard ratio: 1.06; 95% CI: 0.88–1.26). 36…”

Section: Immune Checkpoint Inhibitorsmentioning

confidence: 99%

Update on Thrombosis Risk in Patients with Cancer: Focus on Novel Anticancer Immunotherapies

Moik,

Riedl,

Englisch

et al. 2024

Hamostaseologie

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Thromboembolic complications, including venous thromboembolism (VTE) and arterial thromboembolism (ATE), increase mortality and morbidity, and delay treatment in patients with cancer. Therefore, an increased understanding of underlying risk profiles, the identification of risk factors and predictive biomarkers, and ultimately the development of specific cardiovascular prevention strategies in patients with cancer is needed. Medical anticancer therapies have undergone a remarkable development in recent years with the advent of targeted and immunotherapeutic treatment options, including immune checkpoint inhibitors (ICI), chimeric antigen receptor (CAR) T-cell therapies and bispecific T-cell engagers (BiTEs). These developments have important implications for the accompanied risk of thromboembolic events in patients with cancer. First, the increased use of these highly effective therapies renders a growing proportion of patients with cancer at risk of thromboembolic events for a prolonged risk period due to an increase in patient survival despite advanced cancer stages. Second, potential direct cardiovascular toxicity and prothrombotic effect of novel anticancer immunotherapies are a matter of ongoing debate, with emerging reports suggesting a relevant risk of VTE and ATE associated with ICI, and relevant dysregulations of hemostasis in the frequently observed cytokine-release syndrome associated with BiTEs and CAR T-cell therapy. The aim of the present narrative review is to summarize the implications of the emerging use of anticancer immunotherapy for thromboembolic events in patients with cancer, and to provide an overview of available data on the rates and risk factors for VTE and ATE associated with ICI, CAR T-cell therapy, and BiTEs.

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Section: Immune Checkpoint Inhibitorsmentioning

confidence: 99%

Update on Thrombosis Risk in Patients with Cancer: Focus on Novel Anticancer Immunotherapies

Moik,

Riedl,

Englisch

et al. 2024

Hamostaseologie

View full text Add to dashboard Cite

show abstract

Development and validation of a nomogram model for predicting venous thromboembolism risk in lung cancer patients treated with immune checkpoint inhibitors: A cohort study in China

Liang,

Hu,

et al. 2024

Cancer Medicine

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ObjectiveVenous thromboembolism (VTE) poses a significant threat to lung cancer patients, particularly those receiving treatment with immune checkpoint inhibitors (ICIs). We aimed to develop and validate a nomogram model for predicting the occurrence of VTE in lung cancer patients undergoing ICI therapy.MethodsThe data for this retrospective cohort study was collected from cancer patients admitted to Chongqing University Cancer Hospital for ICI treatment between 2019 and 2022. The research data is divided into training and validation sets using a 7:3 ratio. Univariate and multivariate analyses were employed to identify risk factors for VTE. Based on these analyses, along with clinical expertise, a nomogram model was crafted. The model's predictive accuracy was assessed through receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis, clinical impact curve, and other relevant metrics.ResultsThe initial univariate analysis pinpointed 13 potential risk factors for VTE. The subsequent stepwise multivariate regression analysis identified age, Karnofsky performance status, chemotherapy, targeted, platelet count, lactate dehydrogenase, monoamine oxidase, D‐dimer, fibrinogen, and white blood cell count as significant predictors of VTE. These 10 variables were the foundation for a predictive model, illustrated by a clear and intuitive nomogram. The model's discriminative ability was demonstrated by the ROC curve, which showed an area under the curve of 0.815 (95% CI 0.772–0.858) for the training set, and 0.753 (95% CI 0.672–0.835) for the validation set. The model's accuracy was further supported by Brier scores of 0.068 and 0.080 for the training and validation sets, respectively, indicating a strong correlation with actual outcomes.ConclusionWe have successfully established and validated a nomogram model for predicting VTE risk in lung cancer patients treated with ICIs.

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Cardiotoxicity of Anticancer Drugs: Molecular Mechanisms, Clinical Management and Innovative Treatment

Gao,

Xu,

Zang

et al. 2024

DDDT

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With the continuous refinement of therapeutic measures, the survival rate of tumor patients has been improving year by year, while cardiovascular complications related to cancer therapy have become increasingly prominent. Exploring the mechanism and prevention strategy of cancer therapy-related cardiovascular toxicity (CTR-CVT) remains one of the research hotspots in the field of Cardio-Oncology in recent years. Cardiotoxicity of anticancer drugs involves heart failure, myocarditis, hypertension, arrhythmias and vascular toxicity, mechanistically related to vascular endothelial dysfunction, ferroptosis, mitochondrial dysfunction and oxidative stress. To address the cardiotoxicity induced by different anticancer drugs, various therapeutic measures have been put in place, such as reducing the accumulation of anticancer drugs, shifting to drugs with less cardiotoxicity, using cardioprotective drugs, and early detection. Due to the very limited treatments available to ameliorate anticancer drugs-induced cardiotoxicity, a few innovations are being shifted from animal studies to human studies. Examples include mitochondrial transplantation. Mitochondrial transplantation has been proven to be effective in in vivo and in vitro experiments. Several recent studies have demonstrated that intercellular mitochondrial transfer can ameliorate doxorubicin(DOX)-induced cardiotoxicity, laying the foundation for innovative therapies in anticancer drugs-induced cardiotoxicity. In this review, we will discuss the current status of anticancer drugs-induced cardiotoxicity in terms of the pathogenesis and treatment, with a focus on mitochondrial transplantation, and we hope that this review will bring some inspiration to you.

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Venous thromboembolism risk in cancer patients receiving first‐line immune checkpoint inhibitor versus chemotherapy

Cited by 4 publications

References 31 publications

Update on Thrombosis Risk in Patients with Cancer: Focus on Novel Anticancer Immunotherapies

Update on Thrombosis Risk in Patients with Cancer: Focus on Novel Anticancer Immunotherapies

Development and validation of a nomogram model for predicting venous thromboembolism risk in lung cancer patients treated with immune checkpoint inhibitors: A cohort study in China

Cardiotoxicity of Anticancer Drugs: Molecular Mechanisms, Clinical Management and Innovative Treatment

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