Predictors for the Development of Thromboembolic Events in Cancer Patients Treated with Bevacizumab, Ramucirumab, and Aflibercept: A Single-Institution Retrospective Analysis.

IF 2.5 3区医学 Q3 ONCOLOGY

Oncology Pub Date : 2024-01-01 Epub Date: 2024-01-10 DOI:10.1159/000536187

Yuko Kanbayashi, Takeshi Ishikawa, Eigo Otsuji, Koichi Takayama

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引用次数: 0

Abstract

Introduction: The risk of thromboembolic events developing limits the dose of antiangiogenic agents, thereby reducing their efficacy. This retrospective study therefore sought to identify predictors for the development of antiangiogenic agent-induced thromboembolic events and to elucidate whether differences in the likelihood of thromboembolic events exist between different antiangiogenic agents or cancer types, to guide future strategies for optimizing safety, efficacy, and quality of life in patients receiving chemotherapy.

Methods: This study retrospectively investigated 468 cancer patients who received chemotherapy with bevacizumab, ramucirumab, or aflibercept at our outpatient chemotherapy center between December 2016 and April 2022. Variables related to the development of thromboembolic events were extracted from the medical records, and multivariate logistic regression analysis was performed to identify predictors for the development of thromboembolic events. The Wilcoxon/Kruskal-Wallis test was used to detect significant differences between groups.

Results: Significant factors included serum albumin level (odds ratio [OR] = 0.363, 95% confidence interval [CI] = 0.193-0.685; p = 0.0017) and diabetes mellitus (OR = 5.356, 95% CI = 1.711-16.769; p = 0.0039). Renin-angiotensin system inhibitors (OR = 0.307) had low OR, although it was not significant. No difference in the development of thromboembolic events was evident between cancer types (p = 0.0781), but differences were identified between the three antiangiogenic agents (p = 0.0132). Ramucirumab was associated with a lower likelihood of thromboembolic events.

Conclusion: Serum albumin level and diabetes mellitus were identified as significant predictors for the development of antiangiogenic agent-induced thromboembolic events. In addition, the likelihood of thromboembolic events did not differ between cancer types but differed between antiangiogenic agents.

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接受贝伐珠单抗、ramucirumab 和 aflibercept 治疗的癌症患者发生血栓栓塞事件的预测因素：一项单一机构回顾性分析。

导言：血栓栓塞事件发生的风险限制了抗血管生成药物的剂量，从而降低了其疗效。因此，本回顾性研究试图找出抗血管生成药物诱发血栓栓塞事件的预测因素，并阐明不同抗血管生成药物或癌症类型之间发生血栓栓塞事件的可能性是否存在差异，从而指导未来优化化疗患者安全性、疗效和生活质量的策略。方法本研究回顾性调查了 2016 年 12 月至 2022 年 4 月期间在本院门诊化疗中心接受贝伐珠单抗、ramucirumab 或 aflibercept 化疗的 468 例癌症患者。我们从病历中提取了与血栓栓塞事件发生相关的变量，并进行了多变量逻辑回归分析，以确定血栓栓塞事件发生的预测因素。采用 Wilcoxon/Kruskal-Wallis 检验来检测组间的显著差异。结果重要因素包括血清白蛋白水平（比值比 [OR] = 0.363，95% 置信区间 [CI] = 0.193-0.685；P = 0.0017）和糖尿病（OR = 5.356，95%CI = 1.711-16.769；P = 0.0039）。RAS抑制剂（OR = 0.307）的OR值较低，但并不显著。不同癌症类型的血栓栓塞事件发生率无明显差异（P = 0.0781），但三种抗血管生成药物之间存在差异（P = 0.0132）。拉穆单抗发生血栓栓塞事件的可能性较低。结论血清白蛋白水平和糖尿病是抗血管生成药物诱发血栓栓塞事件的重要预测因素。此外，不同癌症类型发生血栓栓塞事件的可能性并无差别，但不同抗血管生成药物发生血栓栓塞事件的可能性有所不同。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.