A snapshot of cancer-associated thromboembolic disease in 2018-2019: First data from the TESEO prospective registry
Por:
Carmona-Bayonas, A, Gomez, D, de Castro, E, Segura, P, Langa, J, Jimenez-Fonseca, P, Canovas, M, Moran, L, Escobar, I, Blanco, A, Perez, I, de Prado, P, Balanya, R, Verduguez, T, Rodriguez-Lescure, A and Munoz, A
Publicada:
1 ago 2020
Categoría:
Internal medicine
Resumen:
Background: The ever-growing complexity of cancer-associated thrombosis (CAT), with new antineoplastic drugs and anticoagulants, distinctive characteristics, and decisions with low levels of evidence, justifies this registry.
Method: TESEO is a prospective registry promoted by the Spanish Society of Medical Oncology to which 34 centers contribute cases. It seeks to provide an epidemiological description of CAT in Spain.
Results: Participants (N=939) with CAT diagnosed between July 2018 and December 2019 were recruited. Most subjects had advanced colon (21.4%), non-small cell lung (19.2%), and breast (11.1%) cancers, treated with dual-agent chemotherapy (28.4%), monochemotherapy (14.4%), or immune checkpoint inhibitors (3.6%). Half (51%) were unsuspected events, albeit only 57.1% were truly asymptomatic. Pulmonary embolism (PE) was recorded in 571 (58.3%); in 120/571 (21.0%), there was a concurrent deep venous thromboembolism (VTE). Most initially received low molecular weight heparin (89.7%). Suspected and unsuspected VTE had an OS rate of 9.9 (95% CI, 7.3-non-computable) and 14.4 months (95% CI, 12.6-non-computable) (p=0.00038). Six-month survival was 80.9%, 55.9%, and 55.5% for unsuspected PE, unsuspected PE admitted for another reason, and suspected PE, respectively (p<0.0001). The 12-month cumulative incidence of venous rethrombosis was 7.1% (95% CI, 4.7-10.2) in stage IV vs 3.0% (95% CI, 0.9-7.1) in stages I-III. The 12-month cumulative incidence of major/clinically relevant bleeding was 9.6% (95% CI, 6.1-14.0) in the presence of risk factors.
Conclusion: CAT continues to be a relevant problem in the era of immunotherapy and targeted therapies. The initial TESEO data highlight the evolution of CAT, with new agents and thrombotic risk factors.
Filiaciones:
Carmona-Bayonas, A:
Univ Murcia, Hosp Univ Morales Meseguer, Hematol & Med Oncol Dept, IMIB, Murcia, Spain
Gomez, D:
Univ Basque Country, Hosp Univ Cent Asturias, ISPA, Dept Med Oncol, Oviedo, Spain
de Castro, E:
Hosp Univ Marques de Valdecilla, IDIVAL, Dept Med Oncol, Santander, Spain
Segura, P:
Hosp Univ Clin San Carlos, Dept Med Oncol, Madrid, Spain
Langa, J:
Hosp Clin Univ Valencia, Dept Med Oncol, Valencia, Spain
Jimenez-Fonseca, P:
Hosp Univ Cent Asturias, Dept Med Oncol, ISPA, Oviedo, Spain
Canovas, M:
Univ Murcia, Hosp Univ Morales Meseguer, Hematol & Med Oncol Dept, IMIB, Murcia, Spain
Moran, L:
Hosp Univ Gregorio Maranon, Dept Med Oncol, Calle Dr Esquerdo 46, Madrid 28007, Spain
Escobar, I:
Hosp Gen Univ Ciudad Real, Dept Med Oncol, Ciudad Real, Spain
Blanco, A:
Hosp Univ Fdn Jimenez Diaz, Dept Med Oncol, Madrid, Spain
Perez, I:
Complejo Hosp Univ Vigo, Dept Med Oncol, Vigo, Spain
de Prado, P:
Hosp Basurto, Dept Med Oncol, Bilbao, Spain
Balanya, R:
Inst Catala Oncol, Hosp Univ Dr Josep Trueta, Dept Med Oncol, Girona, Spain
Univ Girona, Fac Med, Dept Ciencies Med, Girona, Spain
:
Hosp Gen Univ Elche, Dept Med Oncol, Elche, Spain
:
Hosp Gen Univ Elche, Dept Med Oncol, Elche, Spain
Munoz, A:
Hosp Univ Gregorio Maranon, Dept Med Oncol, Calle Dr Esquerdo 46, Madrid 28007, Spain
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