PB0956 - Performance of score in cat prediction in the setting of different subtypes of digestive cancer from oncocip database

Monday, June 26, 2023

18:30 – 19:30 ET

Room: Exhibition

Presenting Author(s)

Géraldine Poenou, MD

Dept of Vascular Medicine and Therapeutics, University Hospital of Saint-Etienne, INSERM U-1059, France
Saint-Etienne, Rhone-Alpes, France

Co-Author(s)

TD

Téona Dumitru Dumitru

MD
Therapeutic and Vascular Medicine Department, University Hospital of Saint Etienne, 42270 Saint Etienne, France
Cartagena, Murcia, Spain
EP

Emilie Presles

Msc
Department of Clinical Pharmacology and Clinical Research Unit, University Hospital of Saint-Etienne;
Saint Etienne, Rhone-Alpes, France
vM

valentine Mismetti

Interne
Dept. of Pulmonology and Thoracic Oncology, University Hospital of Saint-Etienne, France
Saint-Etienne, Rhone-Alpes, France
FC

Franck Chauvin

MD,PhD
University Institute for Prevention and Global Health (PRESAGE), Jean Monnet University, Saint-Etienne, France Clinical Investigation Center (CIC), INSERM, Saint-Etienne
Saint Etienne, Rhone-Alpes, France
SL

Silvy Laporte

PharmD, PhD
Department of Clinical Pharmacology and Clinical Research Unit, University Hospital of Saint-Etienne; UMR 1059 DVH-Sainbiose, Jean Monnet University, Saint-Etienne; INSERM F-CRIN INNOVTE Network France
Saint Etienne, Rhone-Alpes, France
Laurent Bertoletti, MD, PhD (he/him/his)

MD, PhD
Service de Médecine Vasculaire et Thérapeutique, Centre Hospitalo-Universitaire de Saint-Etienne ; INSERM CIC 1408 CHU de St-Etienne; INSERM UMR 1059, Université Jean Monnet, Saint-Etienne ; FCRIN INNOVTE, France.
Saint-Etienne, Rhone-Alpes, France

Background: Cancer associated thrombosis (CAT) is a frequent complication in cancer patients. For patients at high risk, thromboprophylaxis is recommended. Several risk assessment models have been developed to propose score to help clinician to identify patient at high risk of CAT. Digestive cancer patients are systematically classified at high risk of CAT in those scores. Consequently, their interest is limited to personalize thromboprophylaxis. Therefore, we hypothesize that the scores could be improved when tailoring scores to specific digestive cancer sites.

Aims: To compare the 3 existing scores (PROTECHT, KHORANA and CONKO) to predict the risk of CAT in 3 digestive cancer sites (pancreatic, gastric and colorectal cancer).

Methods: We used data on digestive cancer from the ONCOCIP Study, a multicentric study of consecutive ambulatory adult patients requiring catheter implantation for chemotherapy. Primary outcome was symptomatic proximal pulmonary embolism or non-catheter related proximal deep venous thrombosis validated by a central adjudication committee. Three scores were selected: PROTECHT, KHORANA and CONKO. Cut- off value for high risk patient was fixed at 3 points for all the scores. Scores discriminative power was assessed by calculating area under the ROC curve (AUC).

Results: We included 474 colorectal cancer patients with an incidence of 40 CAT (8.7%), 162 pancreatic cancer patients with 24 CAT (15.2%), and 103 gastric cancer patients with 19 CAT (18.4%). Among patients with a score classifying into high risk of CAT, the scores performed differently by site. None of the AUCs exceeded 0.6.

Conclusion(s): In our cohort, scores work poorly and differently between the digestive cancer site group and within the same cancer site group. The scores are based on RAMs build on hundreds of patient’s cohorts which not allow the power to obtain a better discrimination. Data-sharing could potentially optimize the construction of site-tailored scores or site-driven improvements for existing scores.