Abstract Number: VPB0946
Meeting: ISTH 2022 Congress
Theme: Venous Thromboembolism » Cancer Associated Thrombosis
Background: Pancreatic adenocarcinoma (PaC) carries the highest risk of Venus ThromboEmbolism (VTE) among all cancers, with VTE rates from 5%–41% in retrospective cohorts and up to 67% in postmortem series. The development of VTE in 1 out of 5 patients with PaC, was often associated with significant decreases in PFS and OS.
Aims: Record the clinical practice regarding thromboprophylaxis in patients with active pancreatic cancer.
Methods: ACT4CAT is prospective observational study conducted by HeSMO, recording the clinical practice of thromboprophylaxis in ambulatory ca patient (pts) with solid tumors. This report focuses on pancreatic cancers. Patients enrolled after signed informed consent.
Results: 170 PaC patients enrolled from 18 oncology departments; 118 completed the study (69.4%). Age was 65.5±10.7 years, BMI 25.2±4.1 gr/m2, males 59.4%. Khorana score 2 had 63.5%, 28.85%:3, 5.3%:4 and 2.4%:5. Locally advanced disease had 9%, while 76.2% metastatic. Neoadjuvant treatment received 2% of patients and 1% adjuvant while 71% & 22% 1st line and 2nd line respectively. 79.1% of patients treated with Highly Thrombogenic Agents (HTAs) including: 34.2% platinum and 75.9% antimetabolites. Detailed high thrombotic risk factors presented in figure. Thromboprophylaxis duration lasted 5.6±3.5 months (min:1, max:24 months). Anticoagulants administered: tinzaparin 95.8%, fondaparinux 1.8%, bemiparin 0.6% and enoxaparin 1.8%. Intermediate dose administered to 78.8% of patients irrelevant of Khorana score, metastasis, or treatment line. Regarding efficacy only 2 pulmonary embolisms reported (1.2%, 95%CI: 0.1-4.2%). One minor bleeding reported (0.6%, 95%CI: 0.0-3.20, all events occurred in patients with metastatic disease.
Conclusion(s): Administration of thromboprophylaxis in patients with pancreatic cancer was safe and effective even at intermediate dose and for long duration. Oncologists seem that consider thromboprophylaxis in patients with pancreatic cancer in daily clinical practice.
Image in results
ACT4CAT, Pancreatic cancer cohort, High Thrombotic Burden is based on 4 factors related to: tumor, treatment, patient, and biomarker groups.
To cite this abstract in AMA style:
Tsoukalas N, Christopoulou A, Timotheadou E, Athanasiadis I, Koumarianou A, Peroukidis S, Samelis G, Psyrri A, Kapodistrias N, Nikolakopoulos A, Andreadis C, Ardavanis A, Samantas E, Papandreou C, Mavroudis D, Bokas A, Barbounis V, Athanasiadis A, Papakotoulas P, Boukovinas I. Clinical Impact of Thromboprophylaxis in Pancreatic Cancer Patients: data from ACT4CAT study [abstract]. https://abstracts.isth.org/abstract/clinical-impact-of-thromboprophylaxis-in-pancreatic-cancer-patients-data-from-act4cat-study/. Accessed September 29, 2023.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/clinical-impact-of-thromboprophylaxis-in-pancreatic-cancer-patients-data-from-act4cat-study/