Abstract Number: OC 30.3
Meeting: ISTH 2021 Congress
Theme: Venous Thromboembolism » Cancer Associated Thrombosis
Background: Patients with glioblastoma have a high risk of developing venous thromboembolism (VTE). However, the underlying genetic risk factors remain largely unknown.
Aims: To discover whether genetic aberrations in glioblastoma associate with VTE.
Methods: In this retrospective cohort study, all patients diagnosed with glioblastoma between February 2017 and August 2020 in two hospitals (Leiden University Medical Center and Haaglanden Medical Center) were included (n=341). Targeted DNA next-generation sequencing (NGS) of all glioblastomas was performed for diagnostic purposes and included tumor mutational status of the genes ATRX, BRAF, CIC, FUBP1, H3F3A, IDH1, IDH2, PIK3CA, PTEN and TP53 and amplification/gain or deletion of BRAF, CDKN2A, EGFR, NOTCH1 and PTEN. Through extensive chart review, we collected data on VTE events (deep vein thrombosis and/or pulmonary embolism) three months before until two years after glioblastoma diagnosis, which were adjudicated by an independent investigator. Patients with cerebral vein thrombosis (n=3) and low quality NGS data (n=1; minimum reads/samples: <1.5M and/or minimum depth: <100 reads) were excluded. Cox regression analysis and competing risk analysis (CICR) were performed to compare patients that developed VTE with patients that did not.
Results: Of the 337 patients, 215 had died, 26 were diagnosed with VTE and 37 were lost to follow-up. CDKN2A deletion was found to associate most significantly with VTE (HR:2.65, 95%CI:1.18-5.94, p=0.018, see Table 1). Competing risk analysis confirmed this finding, demonstrating a 12-month adjusted cumulative incidence of 12.7% (95%CI:7.5-19.3) compared to 5.2% (95%CI:2.5-9.2) in patients with CDKN2A wild-type (see Figure 1, p=0.013). No significant association was found between any of the investigated genes, including CDKN2A deletion, and death.
| Cum. Incidence VTE (1y after diagnosis) |
|||||||
| Type of variant (Mutation (M), Amplification (A), Deletion (D) | Cohort frequency | HR (95%CI) | p-value Cox | Wild-type | Mutant | p-value CICR |
|
| CDKN2A |
D | 43.3% (142/328) |
2.65 (1.18-5.94) |
0.018 |
5.2% |
12.7% |
0.013 |
| TP53 |
M | 27.8% (93/335) |
0.48 (0.17-1.39) |
0.175 |
9.6% |
4.4% |
0.153 |
| EGFR |
A | 31.1% (102/328) |
1.49 (0.67-3.28) |
0.327 |
7.1% |
11.5% |
0.315 |
| PIK3CA |
M | 3.6% (12/335) |
0.05 (0.00-629.65) |
0.529 |
8.5% |
0.0% |
0.328 |
| PTEN |
M, D | 43.9% (143/326) |
1.24 (0.57-2.67) |
0.585 |
8.1% |
8.7% |
0.656 |
| ATRX |
M | 6.6% (22/335) |
0.59 (0.08-4.36) |
0.605 |
8.5% |
4.5% |
0.518 |
| IDH1 | M | 3.6% (12/335) |
0.91 (0.12-6.69) |
0.922 |
8.2% |
8.3% |
0.991 |
Genetic mutations from targeted DNA NGS data studied for their role in glioblastoma-associated VTE using univariate Cox regression analysis (Cox) and cumulative incidence competing risk analysis (CICR). A cut off frequency of 2.5% was used.
CDKN2A mutational status is associated with venous thromboembolism in glioblastoma using Cumulative Incidence Competing Risk (CICR) analysis.
Conclusions: This study demonstrates that CDKN2A deletion is associated with VTE in glioblastoma patients. Therefore, CDKN2A mutational status may be a promising predictor to identify patients with glioblastoma at high risk of VTE, who may benefit from thromboprophylaxis.
To cite this abstract in AMA style:
Kapteijn MY, Kaptein FH, Stals MA, Klaase EE, van Eijk R, Cannegieter SC, van Duinen SG, Taphoorn MJ, Dirven L, Koekkoek JA, Klok FA, Versteeg HH, Buijs JT. CDKN2A Mutational Status is Associated with Venous Thromboembolism in Patients with Glioblastoma [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/cdkn2a-mutational-status-is-associated-with-venous-thromboembolism-in-patients-with-glioblastoma/. Accessed November 30, 2023.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/cdkn2a-mutational-status-is-associated-with-venous-thromboembolism-in-patients-with-glioblastoma/