Immune checkpoint inhibitors and venous thromboembolism in patients with head and neck cancer undergoing surgery.

IF 2.3 4区医学 Q3 IMMUNOLOGY

Immunotherapy Pub Date : 2025-07-22 DOI:10.1080/1750743X.2025.2536460

Kiranya E Arnold, Febronia M Mansour, Komal Akhtar

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引用次数: 0

Abstract

Objective: Venous thromboembolism (VTE) is associated with significant morbidity. Although this risk is multifactorial, recent studies suggest immune checkpoint inhibitors (ICIs) may also contribute to increased VTE risk. The aim of this study is to evaluate VTE risk in a cohort of patients with head and neck cancer treated with surgery and ICIs.

Methods: De-identified data from the TriNetX Global Collaborative Network database was used to identify adult surgical patients (≥18 years) using International Classification of Diseases 10^th Revision and Common Procedural Terminology codes and were further refined by use of nivolumab, pembrolizumab, or cemiplimab within 1-year before or up to 3-months after surgery. Cohorts were propensity score matched, and the primary study outcome was the 3-month composite rate of VTE.

Results: After propensity score matching, there were 1,471 patients in each cohort and they were well balanced according to demographics, body mass index, comorbidities, medication use, and radiation history up to 1-year before the index event. The composite rate of VTE in the study population was 3.7% and was higher in patients treated with ICIs (4.6% versus 2.9%; OR, 1.6; 95% CI, 1.1, 2.5).

Conclusions: This study highlights the importance of risk stratification and risk reduction in the setting of increasing ICI use for patients with HNC undergoing surgery.

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头颈癌手术患者的免疫检查点抑制剂和静脉血栓栓塞。

目的：静脉血栓栓塞（VTE）与显著的发病率相关。尽管这种风险是多因素的，但最近的研究表明，免疫检查点抑制剂（ICIs）也可能导致静脉血栓栓塞风险增加。本研究的目的是评估一组接受手术和体外循环治疗的头颈癌患者的静脉血栓栓塞风险。方法：使用TriNetX全球协作网络数据库中的去识别数据，使用国际疾病分类第10版和通用程序术语代码识别成人手术患者（≥18岁），并在手术前1年或术后3个月内通过使用纳武单抗、派姆单抗或塞米单抗进一步细化。队列倾向评分匹配，主要研究结果为3个月静脉血栓栓塞综合发生率。结果：倾向评分匹配后，每个队列中有1471名患者，根据人口统计学、体重指数、合并症、药物使用和指数事件前1年的放射史，他们得到了很好的平衡。研究人群中静脉血栓栓塞（VTE）的综合发生率为3.7%，在接受静脉血栓栓塞治疗的患者中更高(4.6% vs 2.9%；或者,1.6;95% ci, 1.1, 2.5)。结论：本研究强调了在接受手术的HNC患者增加ICI使用的情况下进行风险分层和降低风险的重要性。

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

Immunotherapy 医学-免疫学

CiteScore

5.00

自引率

3.60%

发文量

113

审稿时长

6-12 weeks

期刊介绍： Many aspects of the immune system and mechanisms of immunomodulatory therapies remain to be elucidated in order to exploit fully the emerging opportunities. Those involved in the research and clinical applications of immunotherapy are challenged by the huge and intricate volumes of knowledge arising from this fast-evolving field. The journal Immunotherapy offers the scientific community an interdisciplinary forum, providing them with information on the most recent advances of various aspects of immunotherapies, in a concise format to aid navigation of this complex field. Immunotherapy delivers essential information in concise, at-a-glance article formats. Key advances in the field are reported and analyzed by international experts, providing an authoritative but accessible forum for this vitally important area of research. Unsolicited article proposals are welcomed and authors are required to comply fully with the journal''s Disclosure & Conflict of Interest Policy as well as major publishing guidelines, including ICMJE and GPP3.