Evaluating the effect of immune checkpoint inhibitors on venous thromboembolism in non-small cell lung cancer patients

ABSTRACT

Objective

Currently, immune checkpoint inhibitors (ICIs) therapy is one of the main methods of treatment in non-small cell lung cancer (NSCLC). This study aimed to explore the risk factors of VTE and evaluate the effect of ICIs on VTE in patients with NSCLC.

Research design and methods

We retrospectively studied patients with NSCLC who were divided into VTE group and without VTE (Non-VTE) group. We identified the risk factors of VTE in NSCLC patients and evaluated the effect of ICIs on VTE in NSCLC patients.

Results

We found that clinical stage III-IV (P = 0.015) and Khorana score (KS) ≥ 2 (P = 0.047) were independent risk factors for the occurrence of VTE in NSCLC, and treatment with ICIs reduced the risk of VTE occurrence (P = 0.028). There were no differences of survival rates in the 12-month (P = 0.449), 24-month (P = 0.412), or 36-month (P = 0.315) between the VTE and non-VTE groups. History of anti-angiogenic therapy (P = 0.033) and chronic obstructive pulmonary disease (COPD) (P = 0.046) were independent risk factors for VTE in NSCLC patients who were treated with ICIs.

Conclusion

This study suggests that we should strengthen anticoagulant therapy when using ICIs for NSCLC patients with a history of anti-angiogenic therapy and COPD.

KEYWORDS:

• Non-small cell lung cancer
• venous thromboembolism
• immune checkpoint inhibitor
• risk factors
• overall survival

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

P Wang, X He, S Wei designed the study, supervised all work, and helped write the manuscript. N Geng performed the researched the data. W Qin, B Li and S Song researched the data and/or helped design experiments. All authors contributed to the article and approved the submitted version.

Acknowledgments

We thank all the patients involved in the study for their participation. We thank the doctors and nurses from the department of the Fourth Hospital of Hebei Medical University for assistance with follow-up.

Additional information

Funding

This work was supported by Hebei provincial health technology project [20210471], and prevention and treatment of geriatric diseases by Hebei provincial department of finance [20200316].