Director, Division of Hematology McGill University Health Center Montreal, Quebec, Canada
Background: Cancer-associated thrombosis (CAT) is estimated to comprise 20-30% of venous thromboembolisms (VTEs). Randomized control trials have expanded available treatment options, which now not only include low-molecular weight heparins (LMWHs) but also direct oral anticoagulants (DOACs). However, the rate of recurrence or treatment failure ranges from 4-16% and remains a clinical challenge due to the lack of data between risk factors and their impact on clinical decisions.
Aims: The aim of this study is to determine the risk factors predisposing certain anticoagulation modalities to fail in CAT.
Methods: This is a retrospective chart review that will include all adult patients during a period of 7.5 years with an active cancer diagnosis and a new thromboembolic event at the McGill University Health Centre (MUHC). Chart review will allow for analysis of multiple data points to evaluate risk factors that may be patient-related (age, gender), cancer-related (subtype, stage), and thrombosis-related (unusual vs usual site), and laboratory markers. Each treatment modality will be evaluated with these variables to assess if any risk factors arise using a univariate analysis and Cox proportional hazards model.
Results: Of 53245 cancer patients treated at the MUHC over 7.5 years, we aim to uncover a certain percentage of CAT patients. Treatment failure or VTE recurrence prevalence will be discussed, as well as the main significant patient-related, cancer-related, or thrombosis-related risk factors identified, and then determine if risk factors are more significant within specific treatment modalities.
Conclusion(s): We hypothesize that determining such risk factors will allow for better patient risk stratification and therapeutic choices for this challenging population.