Abstract Number: OC 16.4
Meeting: ISTH 2022 Congress
Background: Non-Small Cell Lung Cancer (NSCLC) is the most common lung cancer subtype. Cancer is known to increase the risk of VTE; majority of which are diagnosed in ambulatory settings. Several RAMs were developed to predict the occurrence of VTE in patients undergoing anti-cancer therapy. Khorana RAM uses five clinical and laboratory variables to classify patients into 3 levels; low (0), intermediate (1-2), and high ( ≥3). COMPASS-CAT RAM, however, uses criteria that include the use of hormonal therapy or anthracyclines, time since diagnosis, central venous catheter (CVC), disease stage, cardiovascular risk factors, recent hospitalization for acute illness, past history of VTE, and platelet count ≥ 350×109/L, and classify patients into Low/Intermediate ( 0-6) and high risk ( ≥7) levels.
Aims: We aim to study the predictors of VTE among NSCLC patients treated with chemotherapy and immunotherapy, and compare those two RAMs in predicting VTE.
Methods: Patients with confirmed diagnoses of NSCLC were retrospectively reviewed. Risk of VTE was assessed using both Khorana and COMPASS-CAT RAMs.
Results: Between 2014 and 2020, a total of 508 patients (mean age ± SD, 58.4 ± 12.2 years) were enrolled. Most (n=357) patients had adenocarcinoma, and 333 patients had metastatic disease (M1). VTE was confirmed in 76 (15.0%) patients; 51.3% were DVT while 34.2% were PE. Rates were higher among patients with M1-disease, and those with adenocarcinoma, table.
We applied the Khorana RAM on all enrolled patients; VTE rates were 21.2%, 14.1%, and 13.9% among the high, intermediate, and low-risk, respectively. Nevertheless, by the COMPASS-CAT RAM 37.4% were classified as high risk; 27.4% had VTE compared to 7.5% of Low/Intermediate risk patients, p < 0.001, table.
Conclusion(s): Patients with NSCLC are at high risk for VTE, especially those with adenocarcinoma or metastatic disease. Compared to Khorana RAM, COMPASS-CAT RAM was better in identifying more high-risk patients with higher VTE rate.
To cite this abstract in AMA style:Abdel-Razeq H, Sharaf B, AlMasri R, Bater R, Abualsha'r M, Salama O, Tamimi F, Ashouri K, Abu Laban D, Salameh T, Al zughul R, Alhalaseh Y. COMPASS versus Khorana Risk Assessment Model for Predicting Venous Thromboembolic Events in Patients with Non-Small Cell Lung Cancer on Active Treatment with Chemotherapy and Immunotherapy. [abstract]. https://abstracts.isth.org/abstract/compass-versus-khorana-risk-assessment-model-for-predicting-venous-thromboembolic-events-in-patients-with-non-small-cell-lung-cancer-on-active-treatment-with-chemotherapy-and-immunotherapy/. Accessed October 1, 2023.
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