A New Risk Prediction Model for Venous Thromboembolism and Death in Ambulatory Lung Cancer Patients

Patricia Gomez-Rosas; Cinzia Giaccherini; Laura Russo; Cristina Verzeroli; Sara Gamba; Carmen Julia Tartari; Silvia Bolognini; Chiara Ticozzi; Francesca Schieppati; Luca Barcella; Roberta Sarmiento; Giovanna Masci; Carlo Tondini; Fausto Petrelli; Francesco Giuliani; Andrea D'Alessio; Mauro Minelli; Filippo De Braud; Armando Santoro; Roberto Labianca; Giampietro Gasparini; Marina Marchetti; Anna Falanga; HYPERCAN Investigators

doi:10.3390/cancers15184588

A New Risk Prediction Model for Venous Thromboembolism and Death in Ambulatory Lung Cancer Patients

Patricia Gomez-Rosas, Cinzia Giaccherini, Laura Russo, Cristina Verzeroli, Sara Gamba, Carmen Julia Tartari, Silvia Bolognini, Chiara Ticozzi, Francesca Schieppati, Luca Barcella, Roberta Sarmiento, Giovanna Masci, Carlo Tondini, Fausto Petrelli, Francesco Giuliani, Andrea D'Alessio, Mauro Minelli, Filippo De Braud, Armando Santoro, Roberto LabiancaGiampietro Gasparini, Marina Marchetti^*, Anna Falanga, HYPERCAN Investigators

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

(1) Background: Venous thromboembolism (VTE) is a frequent complication in ambulatory lung cancer patients during chemotherapy and is associated with increased mortality. (2) Methods: We analyzed 568 newly diagnosed metastatic lung cancer patients prospectively enrolled in the HYPERCAN study. Blood samples collected before chemotherapy were tested for thrombin generation (TG) and a panel of hemostatic biomarkers. The Khorana risk score (KRS), new-Vienna CATS, PROTECHT, and CONKO risk assessment models (RAMs) were applied. (3) Results: Within 6 months, the cumulative incidences of VTE and mortality were 12% and 29%, respectively. Patients with VTE showed significantly increased levels of D-dimer, FVIII, prothrombin fragment 1 + 2, and TG. D-dimer and ECOG performance status were identified as independent risk factors for VTE and mortality by multivariable analysis and utilized to generate a risk score that provided a cumulative incidence of VTE of 6% vs. 25%, death of 19% vs. 55%, and in the low- vs. high-risk group, respectively (p < 0.001). While all published RAMs significantly stratified patients for risk of death, only the CATS and CONKO were able to stratify patients for VTE. (4) Conclusions: A new prediction model was generated to stratify lung cancer patients for VTE and mortality risk, where other published RAMs failed.

Original language	English
Article number	4588
Number of pages	18
Journal	Cancers
Volume	15
Issue number	18
DOIs	https://doi.org/10.3390/cancers15184588
Publication status	Published - 1 Sept 2023

Keywords

non-small cell lung cancer
venous thromboembolism
hypercoagulability
biomarkers
survival
D-dimer
thrombin generation
risk assessment model
ESSENTIAL THROMBOCYTHEMIA
RECEIVING CHEMOTHERAPY
EVENTS
PROGNOSIS
ASPIRIN
VALIDATION
DIAGNOSIS
STATINS
SCORE

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Gomez-Rosas, P., Giaccherini, C., Russo, L., Verzeroli, C., Gamba, S., Tartari, C. J., Bolognini, S., Ticozzi, C., Schieppati, F., Barcella, L., Sarmiento, R., Masci, G., Tondini, C., Petrelli, F., Giuliani, F., D'Alessio, A., Minelli, M., De Braud, F., Santoro, A., ... HYPERCAN Investigators (2023). A New Risk Prediction Model for Venous Thromboembolism and Death in Ambulatory Lung Cancer Patients. Cancers, 15(18), Article 4588. https://doi.org/10.3390/cancers15184588

@article{9882d487b3334f47a4d9d36727bddc14,

title = "A New Risk Prediction Model for Venous Thromboembolism and Death in Ambulatory Lung Cancer Patients",

abstract = "(1) Background: Venous thromboembolism (VTE) is a frequent complication in ambulatory lung cancer patients during chemotherapy and is associated with increased mortality. (2) Methods: We analyzed 568 newly diagnosed metastatic lung cancer patients prospectively enrolled in the HYPERCAN study. Blood samples collected before chemotherapy were tested for thrombin generation (TG) and a panel of hemostatic biomarkers. The Khorana risk score (KRS), new-Vienna CATS, PROTECHT, and CONKO risk assessment models (RAMs) were applied. (3) Results: Within 6 months, the cumulative incidences of VTE and mortality were 12% and 29%, respectively. Patients with VTE showed significantly increased levels of D-dimer, FVIII, prothrombin fragment 1 + 2, and TG. D-dimer and ECOG performance status were identified as independent risk factors for VTE and mortality by multivariable analysis and utilized to generate a risk score that provided a cumulative incidence of VTE of 6% vs. 25%, death of 19% vs. 55%, and in the low- vs. high-risk group, respectively (p < 0.001). While all published RAMs significantly stratified patients for risk of death, only the CATS and CONKO were able to stratify patients for VTE. (4) Conclusions: A new prediction model was generated to stratify lung cancer patients for VTE and mortality risk, where other published RAMs failed.",

keywords = "non-small cell lung cancer, venous thromboembolism, hypercoagulability, biomarkers, survival, D-dimer, thrombin generation, risk assessment model, ESSENTIAL THROMBOCYTHEMIA, RECEIVING CHEMOTHERAPY, EVENTS, PROGNOSIS, ASPIRIN, VALIDATION, DIAGNOSIS, STATINS, SCORE",

author = "Patricia Gomez-Rosas and Cinzia Giaccherini and Laura Russo and Cristina Verzeroli and Sara Gamba and Tartari, {Carmen Julia} and Silvia Bolognini and Chiara Ticozzi and Francesca Schieppati and Luca Barcella and Roberta Sarmiento and Giovanna Masci and Carlo Tondini and Fausto Petrelli and Francesco Giuliani and Andrea D'Alessio and Mauro Minelli and {De Braud}, Filippo and Armando Santoro and Roberto Labianca and Giampietro Gasparini and Marina Marchetti and Anna Falanga and {HYPERCAN Investigators}",

year = "2023",

month = sep,

day = "1",

doi = "10.3390/cancers15184588",

language = "English",

volume = "15",

journal = "Cancers",

issn = "2072-6694",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "18",

}

Gomez-Rosas, P, Giaccherini, C, Russo, L, Verzeroli, C, Gamba, S, Tartari, CJ, Bolognini, S, Ticozzi, C, Schieppati, F, Barcella, L, Sarmiento, R, Masci, G, Tondini, C, Petrelli, F, Giuliani, F, D'Alessio, A, Minelli, M, De Braud, F, Santoro, A, Labianca, R, Gasparini, G, Marchetti, M, Falanga, A & HYPERCAN Investigators 2023, 'A New Risk Prediction Model for Venous Thromboembolism and Death in Ambulatory Lung Cancer Patients', Cancers, vol. 15, no. 18, 4588. https://doi.org/10.3390/cancers15184588

TY - JOUR

T1 - A New Risk Prediction Model for Venous Thromboembolism and Death in Ambulatory Lung Cancer Patients

AU - Gomez-Rosas, Patricia

AU - Giaccherini, Cinzia

AU - Russo, Laura

AU - Verzeroli, Cristina

AU - Gamba, Sara

AU - Tartari, Carmen Julia

AU - Bolognini, Silvia

AU - Ticozzi, Chiara

AU - Schieppati, Francesca

AU - Barcella, Luca

AU - Sarmiento, Roberta

AU - Masci, Giovanna

AU - Tondini, Carlo

AU - Petrelli, Fausto

AU - Giuliani, Francesco

AU - D'Alessio, Andrea

AU - Minelli, Mauro

AU - De Braud, Filippo

AU - Santoro, Armando

AU - Labianca, Roberto

AU - Gasparini, Giampietro

AU - Marchetti, Marina

AU - Falanga, Anna

AU - HYPERCAN Investigators

PY - 2023/9/1

Y1 - 2023/9/1

N2 - (1) Background: Venous thromboembolism (VTE) is a frequent complication in ambulatory lung cancer patients during chemotherapy and is associated with increased mortality. (2) Methods: We analyzed 568 newly diagnosed metastatic lung cancer patients prospectively enrolled in the HYPERCAN study. Blood samples collected before chemotherapy were tested for thrombin generation (TG) and a panel of hemostatic biomarkers. The Khorana risk score (KRS), new-Vienna CATS, PROTECHT, and CONKO risk assessment models (RAMs) were applied. (3) Results: Within 6 months, the cumulative incidences of VTE and mortality were 12% and 29%, respectively. Patients with VTE showed significantly increased levels of D-dimer, FVIII, prothrombin fragment 1 + 2, and TG. D-dimer and ECOG performance status were identified as independent risk factors for VTE and mortality by multivariable analysis and utilized to generate a risk score that provided a cumulative incidence of VTE of 6% vs. 25%, death of 19% vs. 55%, and in the low- vs. high-risk group, respectively (p < 0.001). While all published RAMs significantly stratified patients for risk of death, only the CATS and CONKO were able to stratify patients for VTE. (4) Conclusions: A new prediction model was generated to stratify lung cancer patients for VTE and mortality risk, where other published RAMs failed.

AB - (1) Background: Venous thromboembolism (VTE) is a frequent complication in ambulatory lung cancer patients during chemotherapy and is associated with increased mortality. (2) Methods: We analyzed 568 newly diagnosed metastatic lung cancer patients prospectively enrolled in the HYPERCAN study. Blood samples collected before chemotherapy were tested for thrombin generation (TG) and a panel of hemostatic biomarkers. The Khorana risk score (KRS), new-Vienna CATS, PROTECHT, and CONKO risk assessment models (RAMs) were applied. (3) Results: Within 6 months, the cumulative incidences of VTE and mortality were 12% and 29%, respectively. Patients with VTE showed significantly increased levels of D-dimer, FVIII, prothrombin fragment 1 + 2, and TG. D-dimer and ECOG performance status were identified as independent risk factors for VTE and mortality by multivariable analysis and utilized to generate a risk score that provided a cumulative incidence of VTE of 6% vs. 25%, death of 19% vs. 55%, and in the low- vs. high-risk group, respectively (p < 0.001). While all published RAMs significantly stratified patients for risk of death, only the CATS and CONKO were able to stratify patients for VTE. (4) Conclusions: A new prediction model was generated to stratify lung cancer patients for VTE and mortality risk, where other published RAMs failed.

KW - non-small cell lung cancer

KW - venous thromboembolism

KW - hypercoagulability

KW - biomarkers

KW - survival

KW - D-dimer

KW - thrombin generation

KW - risk assessment model

KW - ESSENTIAL THROMBOCYTHEMIA

KW - RECEIVING CHEMOTHERAPY

KW - EVENTS

KW - PROGNOSIS

KW - ASPIRIN

KW - VALIDATION

KW - DIAGNOSIS

KW - STATINS

KW - SCORE

U2 - 10.3390/cancers15184588

DO - 10.3390/cancers15184588

M3 - Article

SN - 2072-6694

VL - 15

JO - Cancers

JF - Cancers

IS - 18

M1 - 4588

ER -

A New Risk Prediction Model for Venous Thromboembolism and Death in Ambulatory Lung Cancer Patients

Abstract

Keywords

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