Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22646
Title: A multicenter study of thromboembolic events among patients diagnosed with ROS1-rearranged non-small cell lung cancer.
Authors: Alexander, Marliese;Pavlakis, Nick;John, Thomas;O'Connell, Rachel;Kao, Steven;Hughes, Brett G M;Lee, Adrian;Hayes, Sarah A;Howell, Viive M;Clarke, Stephen J;Millward, Michael;Burbury, Kate;Solomon, Benjamin;Itchins, Malinda
Affiliation: Department of Pharmacy, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Heidelberg, Victoria, Australia
Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
Department of Medical Oncology, Austin Health, Heidelberg, Victoria, Australia
Department of Haematology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Department of Medical Oncology, The Prince Charles Hospital, Chermside West, Queensland, Australia
School of Medicine, University of Queensland, Brisbane, Queensland, Australia
Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia
Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
Olivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia
Department of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
NHMRC Clinical Trial Centre, University of Sydney, Camperdown, New South Wales, Australia
Bill Walsh Translational Research Laboratory, Kolling Institute Medical Institute of Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia
Northern Cancer Institute, St Leonards, New South Wales, Australia
Department of Medical Oncology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
School of Medicine, University of Western Australia, Perth, Western Australia, Australia
Issue Date: 22-Jan-2020
EDate: 2020-01-22
Citation: Lung cancer (Amsterdam, Netherlands) 2020; 142: 34-40
Abstract: This study aimed to describe the longitudinal thromboembolism (TE) risk relative to the natural history of disease and clinical course of ROS1 rearranged non-small cell lung cancer (NSCLC). Cases of ROS1-rearranged NSCLC from six Australian hospitals were pooled and evaluated for incidence, timing, predictors and outcomes of venous or arterial TE, as well as objective response rate (ORR) to active therapy and overall survival (OS). Of 42 patients recruited, 20 (48%) experienced TE; one (2%) arterial, 13 (31%) a pulmonary emboli (PE), and 12 (29%) a deep vein thrombosis. Among those with TE, six (30%) experienced multiple events, three as concurrent and three as recurrent diagnoses. The cumulative incidence of TE over time, adjusted for death as a competing risk factor, approached 50%. TE occurred prior to, during and post the peri-diagnostic period and occurred irrespective of treatment strategy. A thrombophilia was identified in n = 3/10 (30%) cases screened: in two factor V Leiden and in one anti-thrombin III (ATIII) deficiency. Median OS was 21.3 months in those with TE vs. 28.8 months in those without; hazard ratio 1.16 (95%CI 0.43-3.15). Respective ORR to first-line therapy with TE was 50% vs. 44% without TE in the chemotherapy arm and 67% vs. 50% in the targeted therapy arm. In the rare cancer subtype, ROS1, these real-world data demonstrate sustained TE risk beyond the diagnostic period irrespective of therapeutic strategy. High incidence of PE, concurrent TE, and recurrent TE warrant validation in larger cohorts. Consideration of primary thromboprophylaxis in ROS1 populations is recommended.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22646
DOI: 10.1016/j.lungcan.2020.01.017
PubMed URL: 32087434
Type: Journal Article
Subjects: Non-small cell lung cancer
ROS1
Thromboembolism
venous thromboembolism
Appears in Collections:Journal articles

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