213P Incidence of venous thromboembolic events in lung cancer patients receiving immunotherapy: A single-institution experience

Abstract

Background: Lung cancer and lung cancer therapies such as chemotherapy and antiangiogenic agents have been associated with an increased incidence of venous thromboembolic events (VTE). However, the incidence of VTE in lung cancer patients on immunotherapy has not been well characterized. The aim of this study was to assess the incidence of VTE in lung cancer patients receiving immunotherapy and ascertain its prognostic utility. Methods: We conducted a single-institution retrospective study, including all lung cancer patients treated with anti-Programmed cell Death 1 (PD-1), anti-Programmed cell Death Ligand-1 (PD-L1), a combination of anti-PD-1/anti-PD-L1 and anti-CTLA4 or a combination including any of these drugs with chemotherapy, antiangiogenic agents or both between June 2013 and April 2019 at La Paz University Hospital, Madrid (Spain). Results: We selected 110 patients. The majority (n = 79, 71.8%) were males with a median age of 66 years (range 43–86 years). Most patients (m = 106, 96.4%) had stage IV at the beginning of immunotherapy treatment. 9 of 110 patients (8.2%) were under use of blood thinners. Pembrolizumab monotherapy was the agent most commonly used (n = 59, 53.6%) and nivolumab plus ipilimumab was the most common multidrug regimen (n = 7, 6.4%). VTE occurred in 10 of 110 patients (9.1%). Female sex was independently associated with an increased risk of VTE (OR 6.11 [95%CI: 1.31–28.40], p = 0.02). 7 of 10 VTE (70%) were symptomatic. Progressive disease to immunotherapy (HR 17.06 [95%CI: 6.03–48.26], p = 0.00) was independently associated with shorter OS. VTE occurrence was not independently associated with shorter OS (HR 1.43 [95%CI: 0.45–4.49], p = 0.53). Conclusions: In our cohort, the incidence of VTE in lung cancer patients receiving immunotherapy was low. Female sex was a risk factor for thrombosis. VTE occurrence did not correlate with the prognosis. Further and prospective studies are needed to derive definitive conclusions. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.