Patients with lung carcinoma are at a higher risk for thromboembolism. This serious condition includes both arterial and venous embolism. Understanding the association between immune checkpoint inhibitors and these events becomes increasingly important as these drugs become a standard lung cancer treatment. The results of a recent retrospective study, published in Frontiers in Pharmacology Researchers examined the clinical and incidence risk factors of thromboembolism among lung cancer patients who received ICIs.
Thromboembolism in cancer is a serious problem, as it increases mortality and morbidity. It also raises healthcare costs. Previous research indicates that systemic cancer treatments can increase VTE risks, but the impact of ICIs on ATE has not been fully explored. This study aimed bridge this knowledge gap by analyzing a cohort lung cancer patients undergoing ICI treatments.
Understanding Thromboembolism In Lung Cancer Patient On ICIs
This study was conducted by Chongqing University Cancer Hospital and involved a retrospective review of 504 patients with lung cancer who had received ICIs from January 2019 to December 2022. Researchers concentrated on a critical window of risk, which is defined as the four-week period following the final ICI treatment and the first ICI.
The study’s key findings include:
- After an average follow-up time of 27.2 months, the incidence of thromboembolism was 20.6% in 504 out of 104 patients receiving immunotherapy.
- Ninety-four percent of those suffering from thromboembolism developed VTE. Three nineteen percent experienced ATE. Five eight per cent had both.
- At 3 months the cumulative incidence of all thromboembolic incidents was 10,1%, and at 24 months it rose to 20,6%.
- The cumulative incidence of VTE was 9,1% after 3 months, and 18,7% after 24 months.
- ATEs showed a cumulative frequency of 1,0% in 3 months’ time and 2,0% within 12 months.
This data suggests that a high incidence of VTE is present in the patient population who receives ICIs.
Identified Risk Factors for Thromboembolism
The researchers conducted multivariate analyses to determine independent variables that are associated with increased thromboembolism risk.
- A Charlson Comorbidity Index (ACCI), age-adjusted, greater than 8
- Presence of central venous (CVC).
- D-dimer levels exceeding 0.5 mg/L.
- Brain metastases present at the beginning of treatment.
These factors can help clinicians identify patients with lung cancer who take ICIs at a high risk for developing thromboembolic disorders.
The Clinical Implications of Patient Care
This study suggests that immuno checkpoint inhibitors may be associated with a significant incidence of thromboembolism, especially VTE but also ATE, in patients who have lung cancer. Identification of risk factors can help clinicians assess patient risks more accurately.
These insights, according to researchers at the University of California San Diego, highlight the need for targeted thromboprophylaxis in high-risk patient populations. These proactive measures could reduce the incidence of thromboembolic complications and improve overall outcomes in lung cancer patients receiving immunotherapy. These guidelines could be refined with further research including large prospective studies.
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