Junmin Song, Ahmed Ashraf Morgan, Ana Maria Diaz Abram, Daniel Hong, Gagi Kim, Wing Fai Li, Jaeun Ahn, Yu Chang, Kuan-Yu Chi, Cho-Han Chiang
{"title":"接受免疫检查点抑制剂治疗的肺癌患者的 Khorana 风险评分：一项真实世界研究。","authors":"Junmin Song, Ahmed Ashraf Morgan, Ana Maria Diaz Abram, Daniel Hong, Gagi Kim, Wing Fai Li, Jaeun Ahn, Yu Chang, Kuan-Yu Chi, Cho-Han Chiang","doi":"10.1007/s11239-025-03086-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lung cancer patients are at increased risk of venous thromboembolism (VTE) and arterial thrombosis, particularly when treated with immune checkpoint inhibitors (ICIs). The Khorana Risk Score (KRS), an effective tool for predicting VTE risk in chemotherapy recipients, needs further validation in lung cancer patients treated with ICIs.</p><p><strong>Methods: </strong>We utilized a global database and conducted a retrospective cohort study. Lung cancer patients receiving ICIs were classified into intermediate (KRS 1-2) and high-risk (KRS ≥ 3) groups. The primary outcome was VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE); secondary outcomes included arterial thrombosis and all-cause mortality. Risk comparisons were performed using Cox proportional hazards analysis.</p><p><strong>Results: </strong>Among 5,378 patients, those with a high KRS had a greater risk of VTE (HR: 1.38, 95% CI: 1.15-1.65), including DVT (HR: 1.43, 95% CI: 1.12-1.82) and PE (HR: 1.32, 95% CI: 1.05-1.67). High KRS was also associated with increased arterial thrombosis (HR: 1.60, 95% CI: 1.29-1.96), ischemic stroke (HR: 1.73, 95% CI: 1.32-2.25), and elevated mortality (HR: 1.66, 95% CI: 1.48-1.87).</p><p><strong>Conclusion: </strong>A high KRS (≥ 3) is associated with a higher risk of thrombotic events and mortality in lung cancer patients treated with ICIs. These findings suggest that KRS may aid risk stratification in this population, warranting further prospective research.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"497-502"},"PeriodicalIF":2.2000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Khorana risk score in lung cancer patients treated with immune checkpoint inhibitors: a real-world study.\",\"authors\":\"Junmin Song, Ahmed Ashraf Morgan, Ana Maria Diaz Abram, Daniel Hong, Gagi Kim, Wing Fai Li, Jaeun Ahn, Yu Chang, Kuan-Yu Chi, Cho-Han Chiang\",\"doi\":\"10.1007/s11239-025-03086-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lung cancer patients are at increased risk of venous thromboembolism (VTE) and arterial thrombosis, particularly when treated with immune checkpoint inhibitors (ICIs). The Khorana Risk Score (KRS), an effective tool for predicting VTE risk in chemotherapy recipients, needs further validation in lung cancer patients treated with ICIs.</p><p><strong>Methods: </strong>We utilized a global database and conducted a retrospective cohort study. Lung cancer patients receiving ICIs were classified into intermediate (KRS 1-2) and high-risk (KRS ≥ 3) groups. The primary outcome was VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE); secondary outcomes included arterial thrombosis and all-cause mortality. Risk comparisons were performed using Cox proportional hazards analysis.</p><p><strong>Results: </strong>Among 5,378 patients, those with a high KRS had a greater risk of VTE (HR: 1.38, 95% CI: 1.15-1.65), including DVT (HR: 1.43, 95% CI: 1.12-1.82) and PE (HR: 1.32, 95% CI: 1.05-1.67). High KRS was also associated with increased arterial thrombosis (HR: 1.60, 95% CI: 1.29-1.96), ischemic stroke (HR: 1.73, 95% CI: 1.32-2.25), and elevated mortality (HR: 1.66, 95% CI: 1.48-1.87).</p><p><strong>Conclusion: </strong>A high KRS (≥ 3) is associated with a higher risk of thrombotic events and mortality in lung cancer patients treated with ICIs. 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Khorana risk score in lung cancer patients treated with immune checkpoint inhibitors: a real-world study.
Background: Lung cancer patients are at increased risk of venous thromboembolism (VTE) and arterial thrombosis, particularly when treated with immune checkpoint inhibitors (ICIs). The Khorana Risk Score (KRS), an effective tool for predicting VTE risk in chemotherapy recipients, needs further validation in lung cancer patients treated with ICIs.
Methods: We utilized a global database and conducted a retrospective cohort study. Lung cancer patients receiving ICIs were classified into intermediate (KRS 1-2) and high-risk (KRS ≥ 3) groups. The primary outcome was VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE); secondary outcomes included arterial thrombosis and all-cause mortality. Risk comparisons were performed using Cox proportional hazards analysis.
Results: Among 5,378 patients, those with a high KRS had a greater risk of VTE (HR: 1.38, 95% CI: 1.15-1.65), including DVT (HR: 1.43, 95% CI: 1.12-1.82) and PE (HR: 1.32, 95% CI: 1.05-1.67). High KRS was also associated with increased arterial thrombosis (HR: 1.60, 95% CI: 1.29-1.96), ischemic stroke (HR: 1.73, 95% CI: 1.32-2.25), and elevated mortality (HR: 1.66, 95% CI: 1.48-1.87).
Conclusion: A high KRS (≥ 3) is associated with a higher risk of thrombotic events and mortality in lung cancer patients treated with ICIs. These findings suggest that KRS may aid risk stratification in this population, warranting further prospective research.
期刊介绍：
The Journal of Thrombosis and Thrombolysis is a long-awaited resource for contemporary cardiologists, hematologists, vascular medicine specialists and clinician-scientists actively involved in treatment decisions and clinical investigation of thrombotic disorders involving the cardiovascular and cerebrovascular systems. The principal focus of the Journal centers on the pathobiology of thrombosis and vascular disorders and the use of anticoagulants, platelet antagonists, cell-based therapies and interventions in scientific investigation, clinical-translational research and patient care.
The Journal will publish original work which emphasizes the interface between fundamental scientific principles and clinical investigation, stimulating an interdisciplinary and scholarly dialogue in thrombosis and vascular science. Published works will also define platforms for translational research, drug development, clinical trials and patient-directed applications. The Journal of Thrombosis and Thrombolysis'' integrated format will expand the reader''s knowledge base and provide important insights for both the investigation and direct clinical application of the most rapidly growing fields in medicine-thrombosis and vascular science.
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