Early VTE linked with worse survival in pancreatic ductal adenocarcinoma
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Frequent and early onset of venous thromboembolism are associated with decreased progression-free survival and overall survival among patients diagnosed with pancreatic ductal adenocarcinoma, according to study results.
Dominique Farge, MD, of McGill University, and colleagues wrote that the risk for venous thromboembolism (VTE) is higher in pancreatic ductal adenocarcinoma (PDAC) than any other cancer, with rates as high as 51% in some cohorts.
“However, no study has yet prospectively assessed the relative importance of patients and tumor characteristics, cancer treatments, and the biological markers on the risk of VTE in PDAC,” they wrote. “Whether the onset of VTE is associated with decreased survival in PDAC patients remains unknown, with only few retrospective studies and conflicting results.”
Farge and colleagues collected data from 731 patients enrolled in the Base Clinico-Biologique de l’Adénocarcinome Pancréatique [BACAP] study who had a new diagnosis of PDAC between 2014 and 2018. The primary endpoint of the study was onset of VTE. They also assessed progression-free survival and overall survival.
During follow-up (median 19.3 months), 152 patients developed VTE (20.79%). The median time from diagnosis to VTE onset was 4.49 months.
Investigators determined the cumulative incidence values of VTE were 8.07% at 3 months (95% CI, 6.31–10.29) and 19.21% at 12 months (95% CI, 16.27–22.62). In their analysis, they found that primary tumor location (isthmus vs. head HR = 2.06; 95% CI, 1.09–3.91) and stage (locally advanced vs. resectable. HR = 1.66; 95% CI, 1.1–2.51; metastatic vs. resectable or borderline, HR = 2.5; 95% CI, 1.57–2.6) were independent risk factors for onset of VTE.
Farge and colleagues also found that patients who developed VTE had shorter times of progression-free survival (HR = 1.74; 95% CI, 1.19–2.54) and overall survival (HR = 2.02; 95% CI, 1.57–2.6).
“The median duration between PDAC diagnosis and onset of VTE was 4.49 months, supporting that the VTE risk is higher during the first month after diagnosis,” they wrote. “Selection of patients at high risk for development of VTE and who may benefit from thromboprophylaxis is of importance and adequate risk assessment models are needed to guide clinical decision.” – by Alex Young
Disclosure: The authors report no relevant financial disclosures.
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