The Impact of Thromboprophylaxis on the Survival of Patients with Advanced Pancreatic Cancer. The Pancreatic Cancer and Tinzaparin (PaCT) Study
| Autor: | P. Papakotoulas, Evangelos Felekouras, Georgios C. Sotiropoulos, Panagiotis Sarantis, Michalis V. Karamouzis, Areti Dimitriadou, Alexandros Papalampros, Alexandros Bokas, Ilias Athanasiadis, Christos Vallilas, Eustathios Antoniou, Adamantia Nikolaidi, Dimitrios Schizas, Georgios Samelis, Dimitrios Dimitroulis, Nikolaos Pistamaltzian |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty medicine.medical_treatment pancreatic cancer Pact chemotherapy Gastroenterology survival Article 03 medical and health sciences 0302 clinical medicine Pancreatic cancer Internal medicine Clinical endpoint Medicine Progression-free survival RC254-282 Chemotherapy tinzaparin business.industry Neoplasms. Tumors. Oncology. Including cancer and carcinogens Retrospective cohort study Tinzaparin medicine.disease Gemcitabine 030104 developmental biology Oncology 030220 oncology & carcinogenesis LMWHs thromboprophylaxis business medicine.drug |
| Zdroj: | Cancers, Vol 13, Iss 2884, p 2884 (2021) Cancers Volume 13 Issue 12 |
| ISSN: | 2072-6694 |
| Popis: | Pancreatic cancer (PaC) induces a prothrombotic and hypercoagulable state. The aim of this study was to investigate the effect of tinzaparin in combination with chemotherapy. The PaCT (pancreatic cancer and tinzaparin) study was a retrospective observational study that collected data regarding progression free survival (PFS) in advanced or metastatic PaC patients who received thromboprophylaxis with tinzaparin during chemotherapy with nab-paclitaxel (N) and gemcitabine (G). The primary end point was to compare, from already published data, the PFS of patients receiving thromboprophylaxis with tinzaparin with the PFS of patients receiving chemotherapy with N–G but no thromboprophylaxis. Secondary end points were efficacy and safety of anticoagulation. In total, 110 PaC patients, 93% with advanced or metastatic disease, treated with N–G and tinzaparin (10,291 ± 1176 Anti-Xa IU, OD, median duration 8.7, IQR: 5.6–11.9 months) were enrolled. Of these, 52% were males and the median age was 68 (40–86 years). The tumor was located to in the pancreatic head at in 45% of the patients. The median PFS was 7.9 months (IQR: 5.0–11.8 months). Out of 14 similar studies (involving 2994 patients) identified via systematic search, it was determined that the weighted PFS of patients receiving N–G but no anticoagulation was 5.6 months. Therefore, patients receiving tinzaparin had 39.54% higher PFS than patients without thromboprophylaxis (p < 0.05). During the follow-up period of 18.3 ± 11.7 months, three (2.7%) thrombotic events were recorded while two clinically relevant non-major bleeding events occurred (1.9%). In conclusion, PFS in advanced PaC patients undergoing chemotherapy is positively impacted by anticoagulation. Thromboprophylaxis with tinzaparin in treatment dose is efficient and safe. |
| Databáze: | OpenAIRE |
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