Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysis

Abstract Anticoagulants were suggested to influence cancer survival by possible immunomodulatory effect. However, it remained unclear if concomitant use of anticoagulants and various types of them could influence the efficacy of immune checkpoint inhibitors (ICIs) in cancer patients. Accordingly, th...

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Main Authors: Jin Xiong, Hongmei Jian, Zhenzhou Yang, Lei Xia
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-16236-6
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author Jin Xiong
Hongmei Jian
Zhenzhou Yang
Lei Xia
author_facet Jin Xiong
Hongmei Jian
Zhenzhou Yang
Lei Xia
author_sort Jin Xiong
collection DOAJ
description Abstract Anticoagulants were suggested to influence cancer survival by possible immunomodulatory effect. However, it remained unclear if concomitant use of anticoagulants and various types of them could influence the efficacy of immune checkpoint inhibitors (ICIs) in cancer patients. Accordingly, the meta-analysis was performed to systematically evaluate the effect of concomitant anticoagulants in cancer patients receiving ICIs. Relevant studies were obtained by literature search in PubMed, Embase, and Web of Science databases. A conservative random-effect model was used to combine the results. A total of 2686 patients were enrolled, including all the patients analyzed for overall survival (OS) and 2457 patients for progression-free survival (PFS). The publication types of these 5 studies were retrospective studies. We found that concomitant use of anticoagulants significantly impaired the PFS (hazard ratio (HR): 1.29, 95% confidence interval (CI): 1.10–1.51, p = 0.002) and OS (HR:1.26, 95% CI:1.07–1.47, p = 0.004) of cancer patients receiving ICIs. Subgroup analyses showed that there was worse OS in heparin product subgroup (HR, 2.90; 95%CI: 1.71–4.92, p < 0.001). Our findings suggested that concomitant use of anticoagulants seemed to significantly impair the survival of cancer patients treated with ICIs.
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spelling doaj-art-d9664dc656c447c79bda0f1ab9e406722025-08-24T11:23:55ZengNature PortfolioScientific Reports2045-23222025-08-011511910.1038/s41598-025-16236-6Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysisJin Xiong0Hongmei Jian1Zhenzhou Yang2Lei Xia3Department of Cancer Center, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Cancer Center, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Cancer Center, The Second Affiliated Hospital of Chongqing Medical UniversityDepartment of Cancer Center, The Second Affiliated Hospital of Chongqing Medical UniversityAbstract Anticoagulants were suggested to influence cancer survival by possible immunomodulatory effect. However, it remained unclear if concomitant use of anticoagulants and various types of them could influence the efficacy of immune checkpoint inhibitors (ICIs) in cancer patients. Accordingly, the meta-analysis was performed to systematically evaluate the effect of concomitant anticoagulants in cancer patients receiving ICIs. Relevant studies were obtained by literature search in PubMed, Embase, and Web of Science databases. A conservative random-effect model was used to combine the results. A total of 2686 patients were enrolled, including all the patients analyzed for overall survival (OS) and 2457 patients for progression-free survival (PFS). The publication types of these 5 studies were retrospective studies. We found that concomitant use of anticoagulants significantly impaired the PFS (hazard ratio (HR): 1.29, 95% confidence interval (CI): 1.10–1.51, p = 0.002) and OS (HR:1.26, 95% CI:1.07–1.47, p = 0.004) of cancer patients receiving ICIs. Subgroup analyses showed that there was worse OS in heparin product subgroup (HR, 2.90; 95%CI: 1.71–4.92, p < 0.001). Our findings suggested that concomitant use of anticoagulants seemed to significantly impair the survival of cancer patients treated with ICIs.https://doi.org/10.1038/s41598-025-16236-6AnticoagulantsImmune checkpoint inhibitorsHeparinFactor xaMeta-analysis
spellingShingle Jin Xiong
Hongmei Jian
Zhenzhou Yang
Lei Xia
Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysis
Scientific Reports
Anticoagulants
Immune checkpoint inhibitors
Heparin
Factor xa
Meta-analysis
title Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysis
title_full Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysis
title_fullStr Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysis
title_full_unstemmed Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysis
title_short Concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors: a meta-analysis
title_sort concomitant anticoagulants and the survival of cancer patients treated with immune checkpoint inhibitors a meta analysis
topic Anticoagulants
Immune checkpoint inhibitors
Heparin
Factor xa
Meta-analysis
url https://doi.org/10.1038/s41598-025-16236-6
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AT zhenzhouyang concomitantanticoagulantsandthesurvivalofcancerpatientstreatedwithimmunecheckpointinhibitorsametaanalysis
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