Venous thromboembolism (VTE) in melanoma patients (pts) on immunotherapy (IO)
Autor: | Joanna Roopkumar, Hong Li, Alok A. Khorana, Tamara A. Sussman, Brian Hobbs, Pauline Funchain |
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Rok vydání: | 2020 |
Předmět: |
Oncology
Cancer Research medicine.medical_specialty business.industry medicine.medical_treatment Incidence (epidemiology) Melanoma Cancer Immunotherapy medicine.disease 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Internal medicine medicine cardiovascular diseases business Venous thromboembolism 030215 immunology |
Zdroj: | Journal of Clinical Oncology. 38:94-94 |
ISSN: | 1527-7755 0732-183X |
Popis: | 94 Background: VTE in cancer significantly contributes to morbidity and a worse overall prognosis. Little is known about the incidence of VTE in melanoma pts receiving IO. This study aims to assess the incidence of VTE in melanoma pts on IO, interrogate potential association with specific therapies, and ascertain its prognostic utility. Methods: We conducted a retrospective cohort study of melanoma pts who received any IO including ipilimumab (ipi), nivolumab (nivo) or pembrolizumab (pembro) from July 2015 to December 2017 at the Cleveland Clinic. VTE including deep venous thrombosis and pulmonary embolism were identified by chart review. VTE-free survival and overall survival (OS) were estimated by Kaplan-Meier and Cox proportional hazard models; association between VTE and IO was examined using the Pearson’s chi-squared test. Results: This cohort comprised 219 pts with median age of 65 years (range 24-92) and 66.7% male. Pembro was most common (36.5%), followed by ipi/nivo (26.9%), ipi (21.9%), and nivo (14.6%). Most had distant metastatic disease (79.9%), and 16.4% had brain metastases. VTE occurred in 14.2% (n = 31) of pts on therapy. Of those with VTE, 12 (38.7%) were receiving ipi/nivo and 19 (61.3%) single agent IO. Median VTE-free time was 4.9 months on ipi/nivo compared to 9.2 months on single agent IO (p = 0.05). The 6-month VTE-free survival was 18.5% for ipi/nivo and 71.8% for single agent IO. Among pts with distant metastatic disease, ipi/nivo was significantly associated with earlier time to VTE when adjusted for age, gender, and presence of brain metastases, (median VTE-free time 4.9 months vs. 9.3; p = 0.024; HR 2.96 [95% CI, 1.15-7.59]). Among pts without brain metastases, VTE was associated with worse OS (median OS 1.3 years vs. NR; p |
Databáze: | OpenAIRE |
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