1. Do Antiangiogenics Promote Clot Instability? Data from the TESEO Prospective Registry and Caravaggio Clinical Trial.
- Author
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Carmona-Bayonas A, Verso M, Sánchez Cánovas M, Rubio Pérez J, García de Herreros M, Martínez Del Prado P, Fernández Pérez I, Quintanar Verduguez T, Obispo Portero B, Pachón Olmos V, Gómez D, Ortega L, Serrano Moyano M, M Brozos E, Biosca M, Antonio Rebollo M, Teijeira Sanchez L, Hernández Pérez C, David Cumplido Burón J, Martínez Lago N, García Pérez E, Muñoz Langa J, Pérez Segura P, Martínez de Castro E, Jimenez-Fonseca P, Agnelli G, and Muñoz A
- Subjects
- Anticoagulants therapeutic use, Bevacizumab adverse effects, Humans, Registries, Risk Factors, Neoplasms chemically induced, Neoplasms complications, Neoplasms drug therapy, Pulmonary Embolism complications, Thrombosis drug therapy, Venous Thromboembolism complications, Venous Thromboembolism drug therapy, Venous Thromboembolism epidemiology
- Abstract
Background: Venous thromboembolism (VTE) is a common complication in cancer patients. Much of its morbidity stems from the development of fatal pulmonary embolisms (PE). Little is known about the factors involved in clot stability, with angiogenesis possibly being implicated., Methods: The database is from the TESEO prospective registry that recruits cancer patients with VTE from 41 Spanish hospitals. Independent validation was conducted in a cohort from the Caravaggio trial. The objective is to evaluate the association between exposure to antiangiogenic therapies and the PE/VTE proportion in oncological patients., Results: In total, 1,536 subjects were evaluated; 58.4% ( n = 894) had a PE and 7% ( n = 108) received antiangiogenic therapy (bevacizumab in 75%). The PE/VTE proportion among antiangiogenic-treated individuals was 77/108 (71.3%) versus 817/1,428 (57.2%) among those receiving other alternative therapies ( p = 0.004). The effect of the antiangiogenics on the PE/VTE proportion held up across all subgroups except for active smokers or those with chronic obstructive pulmonary disease. Exposure to antiangiogenics was associated with increased PEs, odds ratio (OR) 2.27 (95% CI, 1.42-3.63). In the Caravaggio trial, PE was present in 67% of the individuals treated with antiangiogenics, 50% of those who received chemotherapy without antiangiogenic treatment, and 60% without active therapy ( p = 0.0016)., Conclusion: Antiangiogenics are associated with increased proportion of PE in oncological patients with VTE. If an effect on clot stability is confirmed, the concept of thrombotic risk in cancer patients should be reconsidered in qualitative terms., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
- Published
- 2022
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