Profile of metastatic lung cancer patients susceptible to development of thromboembolism during immunotherapy
Profile of metastatic lung cancer patients susceptible to development of thromboembolism during immunotherapy
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DOI：
10.1016/j.ctarc.2022.100547
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发表时间：
2022-01-01
影响因子：
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通讯作者：
Miyazaki, Yasunari
中科院分区：
文献类型：
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作者：
Endo, Satoshi;Honda, Takayuki;Miyazaki, Yasunari
背景：血栓栓塞（TE）是肺癌患者的一种严重并发症；然而，免疫肿瘤 (IO) 药物治疗期间发生 TE 的危险因素尚不清楚。材料和方法：对东京医科齿科大学住院的肺癌患者进行回顾性研究，以阐明 TE 与全身治疗（尤其是 IO）之间的关系。患者被分为IO队列、化疗队列（CT队列）和对照队列（术后未复发的患者）。对与 TE 相关的变量进行了关联研究。结果：共有 592 名患者入组（IO 队列，120 例；CT 队列，294 例；对照队列，178 例）。 IO 队列中的 8 名患者 (6.7%)、CT 队列中的 7 名患者 (2.4%) 和对照组中的 3 名患者 (1.7%) 发生了 TE。最小绝对收缩和选择算子 (LASSO) 回归分析确定 IO、TE 病史、不良体能状态 (PS) 和既往抗凝治疗与 TE 相关。随后的多变量逻辑回归分析确定了 TE 病史（比值比 (OR)，6.03；95% 置信区间 (CI)，2.09-17.40；P = 0.01）和不良 PS（OR，3.84；95% CI，1.34-11.00；P < 0.001）是发生 TE 的潜在危险因素。具有这两种特征的 IO 队列患者中 TE 的发生率显着高于对照组（OR，52.82；95% CI，6.72-506.37；P < 0.001）。结论：有 TE 病史且 PS 较差的肺癌患者在 IO 治疗期间发生 TE 的风险增加。微观摘要：肺癌患者在免疫治疗期间易发生血栓栓塞 (TE) 的情况尚不清楚，尽管 TE 与较差的预后相关。在这里，与 TE 相关变量的关联研究表明，有 TE 病史且体力状态不佳的患者在免疫治疗期间发生 TE 的风险较高。
Background: Thromboembolism (TE) is a serious complication in lung cancer patients; however, risk factors for developing TE during treatment with immuno-oncology (IO) drugs are unclear. Materials and methods: A retrospective study of lung cancer patients hospitalized in Tokyo Medical and Dental University was performed to clarify the association between TE and systemic therapy, especially IOs. Patients were divided into an IO cohort, a chemotherapy cohort (CT cohort), and a control cohort (patients without recurrence after surgery). Association studies of variables relevant to TE were performed. Results: A total of 592 patients were enrolled (IO cohort, 120; CT cohort, 294; control cohort, 178). Eight patients (6.7%) in the IO cohort, seven (2.4%) in the CT cohort, and three (1.7%) in the control cohort developed TE. Least Absolute Shrinkage and Selection Operator (LASSO) regression analysis identified IO, a history of TE, poor performance status (PS), and prior anticoagulation therapy as being associated with TE. Subsequent multivariate logistic regression analysis identified a history of TE (odds ratio (OR), 6.03; 95% confidence interval (CI), 2.09-17.40; P = 0.01) and poor PS (OR, 3.84; 95% CI, 1.34-11.00; P < 0.001) as potential risk factors for developing TE. The incidence of TE in the IO cohort patients with both of these characteristics was significantly higher (OR, 52.82; 95% CI, 6.72-506.37; P < 0.001) than that in the control cohort. Conclusion: Lung cancer patients with a history of TE and poor PS are at increased risk of TE during treatment with IOs. Micro abstract: The profiles of lung cancer patients susceptible to development of thromboembolism (TE) during immunotherapy are unclear, even though TE is associated with a worse prognosis. Here, association studies of variables relevant to TE revealed that patients with a history of TE and poor performance status are at higher risk of developing TE during immunotherapy.