Arterial Thromboembolism in Patients With Advanced Lung Cancer: Secondary Analyses of the Rising‐VTE/NEJ037 Study
ABSTRACT Background Cancer‐associated thromboembolism has been thoroughly investigated in previous studies, and direct oral anticoagulants (DOACs) were established for the treatment and prevention of venous thromboembolism (VTE). However, the risks of cancer‐associated arterial thromboembolism (ATE)...
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Wiley
2025-01-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70568 |
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| author | Naoki Furuya Yukari Tsubata Takamasa Hotta Toshihide Yokoyama Masahiro Yamasaki Nobuhisa Ishikawa Kazunori Fujitaka Tetsuya Kubota Kunihiko Kobayashi Takeshi Isobe |
| author_facet | Naoki Furuya Yukari Tsubata Takamasa Hotta Toshihide Yokoyama Masahiro Yamasaki Nobuhisa Ishikawa Kazunori Fujitaka Tetsuya Kubota Kunihiko Kobayashi Takeshi Isobe |
| author_sort | Naoki Furuya |
| collection | DOAJ |
| description | ABSTRACT Background Cancer‐associated thromboembolism has been thoroughly investigated in previous studies, and direct oral anticoagulants (DOACs) were established for the treatment and prevention of venous thromboembolism (VTE). However, the risks of cancer‐associated arterial thromboembolism (ATE) and the efficacy of DOACs remain unclear. Objectives To evaluate the risk factors and the clinical activity of edoxaban (EDO) for the prevention of ATE in patients with advanced lung cancer. Methods From the prospective Rising‐VTE/NEJ037 study which investigated VTE in newly diagnosed advanced lung cancer, we investigated the incidence rate and the risk factors of ATE as secondary endpoints. Results A total of 1008 patients were screened for VTE at study baseline and were followed up for 2 years. Excluding patients with a contraindication to DOACs, those with VTE were treated with EDO. ATE events were identified in 41 patients (4.1%). The most common location for ATE was cerebral infarction (N = 31, 75.6%), followed by myocardial infarction (N = 4, 9.8%). Multivariate analysis determined the incidence of VTE, D‐dimer, a comorbidity of atrial fibrillation, and four other factors as independent risk factors of ATE. For VTE (+) patients, the incidence rate of ATE was 15.9% for the EDO administration (+) patients, compared with 11.1% for the EDO administration (−) patients (p = 0.626). Conclusions The incidence rate of ATE was 4.1% over 2‐year follow‐up in advanced lung cancer patients. VTE was further identified as an independent risk factor for ATE, while intervention with DOACs was seen as less effective for the prevention of ATE in advanced lung cancer patients with VTE. Trial Registration This trial was registered in the Japan Registry of Clinical Trials (jRCTs061180025) |
| format | Article |
| id | doaj-art-bb21f0a3d8714cc3be7fbca0ab94bb53 |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-bb21f0a3d8714cc3be7fbca0ab94bb532025-01-13T13:22:39ZengWileyCancer Medicine2045-76342025-01-01141n/an/a10.1002/cam4.70568Arterial Thromboembolism in Patients With Advanced Lung Cancer: Secondary Analyses of the Rising‐VTE/NEJ037 StudyNaoki Furuya0Yukari Tsubata1Takamasa Hotta2Toshihide Yokoyama3Masahiro Yamasaki4Nobuhisa Ishikawa5Kazunori Fujitaka6Tetsuya Kubota7Kunihiko Kobayashi8Takeshi Isobe9Division of Respiratory Medicine, Department of Internal Medicine St. Marianna University School of Medicine Kawasaki JapanDivision of Medical Oncology and Respiratory Medicine, Department of Internal Medicine Shimane University Faculty of Medicine Izumo JapanDivision of Medical Oncology and Respiratory Medicine, Department of Internal Medicine Shimane University Faculty of Medicine Izumo JapanDepartment of Respiratory Medicine Kurashiki Central Hospital Kurashiki JapanDepartment of Respiratory Disease Hiroshima Red Cross Hospital and Atomic‐Bomb Survivors Hospital Hiroshima JapanDepartment of Respiratory Medicine Hiroshima Prefectural Hospital Hiroshima JapanDepartment of Respiratory Medicine Hiroshima University Hospital Hiroshima JapanDepartment of Respiratory Medicine and Allergology Kochi University Hospital Kochi JapanDepartment of Respiratory Medicine Saitama Medical University International Medical Center Saitama JapanDivision of Medical Oncology and Respiratory Medicine, Department of Internal Medicine Shimane University Faculty of Medicine Izumo JapanABSTRACT Background Cancer‐associated thromboembolism has been thoroughly investigated in previous studies, and direct oral anticoagulants (DOACs) were established for the treatment and prevention of venous thromboembolism (VTE). However, the risks of cancer‐associated arterial thromboembolism (ATE) and the efficacy of DOACs remain unclear. Objectives To evaluate the risk factors and the clinical activity of edoxaban (EDO) for the prevention of ATE in patients with advanced lung cancer. Methods From the prospective Rising‐VTE/NEJ037 study which investigated VTE in newly diagnosed advanced lung cancer, we investigated the incidence rate and the risk factors of ATE as secondary endpoints. Results A total of 1008 patients were screened for VTE at study baseline and were followed up for 2 years. Excluding patients with a contraindication to DOACs, those with VTE were treated with EDO. ATE events were identified in 41 patients (4.1%). The most common location for ATE was cerebral infarction (N = 31, 75.6%), followed by myocardial infarction (N = 4, 9.8%). Multivariate analysis determined the incidence of VTE, D‐dimer, a comorbidity of atrial fibrillation, and four other factors as independent risk factors of ATE. For VTE (+) patients, the incidence rate of ATE was 15.9% for the EDO administration (+) patients, compared with 11.1% for the EDO administration (−) patients (p = 0.626). Conclusions The incidence rate of ATE was 4.1% over 2‐year follow‐up in advanced lung cancer patients. VTE was further identified as an independent risk factor for ATE, while intervention with DOACs was seen as less effective for the prevention of ATE in advanced lung cancer patients with VTE. Trial Registration This trial was registered in the Japan Registry of Clinical Trials (jRCTs061180025)https://doi.org/10.1002/cam4.70568arterial thromboembolismcancer‐associated thromboembolismdirect oral anticoagulantslung cancerprospective cohort study |
| spellingShingle | Naoki Furuya Yukari Tsubata Takamasa Hotta Toshihide Yokoyama Masahiro Yamasaki Nobuhisa Ishikawa Kazunori Fujitaka Tetsuya Kubota Kunihiko Kobayashi Takeshi Isobe Arterial Thromboembolism in Patients With Advanced Lung Cancer: Secondary Analyses of the Rising‐VTE/NEJ037 Study Cancer Medicine arterial thromboembolism cancer‐associated thromboembolism direct oral anticoagulants lung cancer prospective cohort study |
| title | Arterial Thromboembolism in Patients With Advanced Lung Cancer: Secondary Analyses of the Rising‐VTE/NEJ037 Study |
| title_full | Arterial Thromboembolism in Patients With Advanced Lung Cancer: Secondary Analyses of the Rising‐VTE/NEJ037 Study |
| title_fullStr | Arterial Thromboembolism in Patients With Advanced Lung Cancer: Secondary Analyses of the Rising‐VTE/NEJ037 Study |
| title_full_unstemmed | Arterial Thromboembolism in Patients With Advanced Lung Cancer: Secondary Analyses of the Rising‐VTE/NEJ037 Study |
| title_short | Arterial Thromboembolism in Patients With Advanced Lung Cancer: Secondary Analyses of the Rising‐VTE/NEJ037 Study |
| title_sort | arterial thromboembolism in patients with advanced lung cancer secondary analyses of the rising vte nej037 study |
| topic | arterial thromboembolism cancer‐associated thromboembolism direct oral anticoagulants lung cancer prospective cohort study |
| url | https://doi.org/10.1002/cam4.70568 |
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