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Cisplatin-based chemotherapy resulted in high-rate of thromboembolic events
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51st ASH Annual Meeting
Patients assigned to cisplatin-based chemotherapy for any of a variety of cancers are at an increased risk for thromboembolic events, according to the results of a large retrospective analysis presented by Russell A. Moore, PharmD, at the 51st ASH Annual Meeting.
“Incidence of thrombosis during or within four weeks of cisplatin treatment was 18.1%,” said Moore, of the Memorial Sloan-Kettering Cancer Center. “However, this may even be an underestimate of the true incidence of thrombosis in this population due to potentially undocumented events and events documented outside of the [MSKCC].”
Previous research has shown that cisplatin can potentiate both venous and arterial thrombotic complications. This study was conducted to determine the overall incidence of thromboembolic events in patients treated with cisplatin-based therapies at Memorial Sloan-Kettering Cancer Center.
The study included 1,093 patients, of whom 932 were included in the analysis. Patients were aged 18 or older and had received first cisplatin dose of their current regimen in 2008 with at least four weeks of follow-up from the last dose. Median age was 60 years.
Researchers defined a thromboembolic event as cisplatin-associated if it occurred between the time of the first dose of the therapy and up to four weeks after the last dose.
Thrombosis occurred in 18.1% of patients. Of these, 51% were deep vein thrombosis and 26% were pulmonary embolisms. Twenty-three patients (2.5%) died.
Thromboembolic events occurred most often in patients with pancreatic, gastroesophageal cancer, bladder cancer and germ cell seminoma. Of 79 patients with pancreatic cancer in the study, about 36% had thromboembolic events. The amount of thrombosis in patients with lung cancer (11.8%) was lower than that expected by the researchers.
In addition, most thromboembolic events occurred in patients with metastatic disease (21.6%) compared to locally advanced disease.
The researchers also found that a majority of patients had thromboembolic events earlier in treatment course. About 85% of patients who had an event had it within first 90 days of the start of cisplatin. No correlation was found between the mean cisplatin dose and thrombosis.
“In Conclusion, DVT prophylaxis is needed for future patients receiving cisplatin-based chemotherapy. However, a prophylactic prospective study is warranted,” Moore said. - by Leah Lawrence
For more information:
- Moore RA. #456. Presented at: 51st ASH Annual Meeting and Exposition; Dec. 5-8, 2009; New Orleans.
