Thromboembolic events in lung cancer patients treated with platinum-based chemotherapy

Introduction: Risk of venous thromboembolism (VTE) in lung cancer patients substantially increases with the addition of chemotherapy. Platinum-based regimens claim to be associated with a very high VTE rate. Objectives: Determine the prevalence and characteristics of VTE in adult patients receiving platinum-based chemotherapy and analyze the importance of the patients’ tumor and treatment characteristics in predicting the occurrence of VTE. Patients and Methods: Patients who had received platinum based chemotherapy for lung cancer between January 2016 and December 2018 were retrospectively identified. Patients were followed for development of VTE throughout the entire duration of therapy and one month thereafter. Results: Eighteen patients (88.8% males, median age: 62 years) treated with platinum-based regimens (49 cisplatin, 31 carboplatin) were included. VTE were reported in 15 patients (18.8%). Thrombosis included deep vein thrombosis (DVT) in 8 (10%), pulmonary embolism (PE) in 6 (7,5%) and DVT with PE in 1 (1,25%). Most patients (70%) had stage IV cancer and only 5% had stage I or II. In the multivariate analysis, the occurrence of TVE were not associated statistically with advanced-stage disease, gender, age, and different risk scores. Carboplatin-Etoposide was associated with a higher risk of VTE (p=0.049) in univariate analysis. In multivariate analysis, Carboplatin-Etoposide (p=0,045) and carboplatin-Navelbine (p=0.048) increased the risk of VTE. Conclusion: A high incidence of VTE in patients receiving platinum based chemotherapy was demonstrated in this study. Prospective studies are crucial to highlight the necessity of thromboprophylaxis in patients receiving platinum based chemotherapy.