Association of ALK rearrangement and risk of venous thromboembolism in patients with non-small cell lung cancer: A prospective cohort study. Issue 186 (February 2020)

• Record Type: Journal Article
• Authors: Dou, Feifei; Zhang, Yuan; Yi, Jiawen; Zhu, Min; Zhang, Shu; Zhang, Di; Zhang, Yuhui
• Is Part Of: Thrombosis research. Issue 186(2020)
• Page Start: 36
• Page End: 41
• Publication Date: 2020-02
• Subjects: ALK anaplastic lymphoma kinase -- ARMS-PCR amplification refractory mutation system polymerase chain reaction -- Cl confidence interval -- DVT deep vein thrombosis -- ECOG eastern cooperative oncology group -- EGFR epidermal growth factor receptor -- FISH fluorescence in situ hybridization -- SHR sub-distribution hazard ratio -- IHC immunohistochemistry -- KRAS kitten rat sarcoma -- NSCLC non-small cell lung cancer -- PE pulmonary embolism -- PS performance status -- TKI tyrosine kinase inhibitor -- TF tissue factor -- VTE venous thromboembolism; Non-small cell lung cancer -- Venous thromboembolism -- Anaplastic lymphoma kinase -- Rearrangement -- Oncogene; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2019.12.009
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Background: Isolated reports are inconsistent regarding the risk of venous thromboembolism (VTE) in patients with anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC). This study examined whether ALK rearrangement could have an influence on VTE in a prospective cohort. Methods: In a cohort of 836 consecutive patients with NSCLC, patients with epidermal growth factor receptor (EGFR) or kitten rat sarcoma (KRAS) mutations were ruled out for VTE interference. Finally, 341 qualified patients were observed. The median follow up period is 7.5 months (3.1–15.4m). ALK rearrangement was detected by fluorescence in situ hybridization at baseline. Results: Overall VTE events occurred in 37 (10.9%) of 341 patients. In multivariable analysis including age, sex, tumor histology, tumor stage, performance status, and ALK status, ALK rearrangement (sub-distribution hazard radio 2.47, 95% confidence interval 1.04–5.90) was associated with the increased risk of VTE. The cumulative incidence of VTE was 26.9% and 9.2% in the patients with and without ALK rearrangement after 6 months. After 1 year the corresponding cumulative incidence was 26.9% and 9.7% respectively (Gray test P = .005). Conclusions: The presence of ALK rearrangement is associated with increased risk of VTE in patients with NSCLC. Highlights: Venous thromboembolism (VTE) is associated with worse prognosis in patients with non-small cell lung cancer (NSCLC). Whether anaplastic lymphoma kinase (ALK) rearrangement affects the risk of thrombosis has been a focus of study. The presence of ALK rearrangement was associated with increased risk of VTE. The analysis of ALK status might be helpful for identifying VTE risk for NSCLC.