A large single-center study has found an association between immune checkpoint inhibitor use and an increased incidence of venous thromboembolism in people with cancer.

An analysis of the CCC19 registry has demonstrated a significant link between receipt of anticancer therapies within 3 months of a COVID-19 diagnosis and an elevated risk for venous thromboembolism

And he calls for more implementation science “to translate the findings of RCTs [randomized clinical trials] to the clinic so that stellar efforts such as those by the investigators of TARGET-TP truly lead to a reduction in the public health burden of [venous thromboembolism] in people with cancer.”

medwireNews : ESMO has issued a Clinical Practice Guideline for the prevention and treatment of venous thromboembolism (VTE) in people with cancer.

They explain that abemaciclib already has a black-box warning for increased venous thromboembolism (VTE) risk on its FDA label as a result of clinical trial data, but thrombosis rates in real-world populations are unclear.

Additional CVAEs were over-reported with VEGFR-TKIs treatment, including aortic dissection [n = 61 (0.1%), ROR = 3.50 (2.71–4.51)], pericardial diseases [n = 173 (0.3%), ROR = 1.98 (1.70–2.30)], cardiomyopathy [n = 61 (0.1%), ROR = 1.89 (1.47–2.43)], heart failure [n = 868 (1.7%), ROR = 1.35 (1.26–1.44)], and venous thromboembolism [n = 604 (1.2%), ROR = 1.33 (1.23–1.45), all IC025 > 0].

Certain AEs of interest – namely venous thromboembolism, interstitial lung disease, and febrile neutropenia – were observed more frequently in the abemaciclib than control arm, but “overall the incidence of these events was low,” he pointed out.

The direct oral anticoagulant apixaban is noninferior to subcutaneous dalteparin for the treatment of cancer-related venous thromboembolism, without an associated increase in the risk for major bleeding, suggest phase 3 trial results.

Patients were also significantly more likely to die if they had severe neutropenia (odds ratio [OR]=16.4), a previous episode of venous thromboembolic disease (VTED; OR=4.8), and pulmonary tumor involvement (OR=4.3).

Updated clinical practice guidance on the prophylaxis and treatment of venous thromboembolism in patients with cancer is now available from ASCO.

The results of the randomized CASSINI and AVERT trials support the prophylactic use of the direct oral anticoagulants rivaroxaban and apixaban in cancer patients undergoing chemotherapy who are at risk for venous thromboembolism events.

They found that the risk for venous thromboembolism (VTE) was significantly elevated among survivors of 90% of the cancer types they studied, with hazard ratios (HRs) ranging from 1.72 for prostate cancer to 9.72 for pancreatic cancer.

The oral factor Xa inhibitor edoxaban is as good as subcutaneous dalteparin for the prevention of recurrent venous thromboembolism or major bleeding in patients with cancer, show results of the Hokusai VTE cancer trial.

Nonetheless, Matthews et al say that these findings highlight “the need for clinical vigilance and possible preventive measures when prescribing endocrine therapies to women at risk of venous thromboembolism.”

Overt CVD was detected in 4.5% of CVSS participants and most commonly presented as venous thromboembolism (VTE; 2.0%) and congestive heart failure (CHF; 1.2%).

The full prescribing information also includes a Boxed Warning for the increased risk of tumor progression or recurrence in patients with breast, non-small-cell lung, head and neck, or cervical cancer, and lymphoid tumors, as well as death, stroke, myocardial infarction, venous thromboembolism, tumor progression or recurrence, and other serious events.