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Multidisciplinary Respiratory Medicine
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Open Access 01-12-2017 | Original research article

Mutational status predicts the risk of thromboembolic events in lung adenocarcinoma

Authors: Elsa Davidsson, Nicola Murgia, Cristian Ortiz-Villalón, Emil Wiklundh, Magnus Sköld, Karl Gustav Kölbeck, Giovanni Ferrara

Published in: Multidisciplinary Respiratory Medicine | Issue 1/2017

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Abstract

Background

Precision medicine promises to improve prognosis of patients affected by untreatable diseases. Patients with lung cancer (especially lung adenocarcinoma) bear an increased risk of VTE. Mutations in the EGFR and rearrangement in the ALK genes identify specific subgroups of patients. Aim of this study was to investigate the role of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutational status on the risk of venous thromboembolism (VTE) in lung adenocarcinoma.

Methods

A retrospective longitudinal design was used. Patients with lung adenocarcinoma diagnosed and undergoing a mutational analysis at the Karolinska University Hospital, Stockholm, Sweden between January 2009 and September 2015 were divided in three subgroups based on their mutational status (EGFR-, ALK-mutated, unexposed group). Event-free time for VTE was assessed using Cox regression analysis based on mutation status and treatment received.

Results

Three hundred-ten patients were included. A VTE occurred in 70 (22.6%) patients. Mutation of EGFR was associated with a decreased risk of VTE (HR 0.46, 95% CI 0.23–0.94). Treatment with tyrosine kinase inhibitors (TKI) reduced the risk of VTE compared to other treatment strategies not including TKI (HR 0.42, 95% CI 0.29–0.79).

Conclusions

Our study suggests that patients with lung adenocarcinoma bearing a EGFR-mutation have a decreased risk of VTE compared with patients with other forms of lung adenocarcinoma. Targeted therapy with TKI alone or in combination with other treatments seems to reduce the risk of VTE compared to other treatments not including TKI.
Literature
1.
Mirnezami R, Nicholson J, Darzi A. Preparing for precision medicine. N Engl J Med. 2012;366:489–91.CrossRefPubMed
2.
Jameson JL, Longo DL. Precision medicine — personalized, problematic, and promising. N Engl J Med. 2015;372:2229–34.CrossRefPubMed
3.
4.
5.
6.
Travis WD, Brambilla E, Riely GJ. New pathologic classification of lung cancer: relevance for clinical practice and clinical trials. J Clin Oncol. 2013;31:992–1001.CrossRefPubMed
7.
Sonobe M, Manabe T, Wada H, Tanaka F. Mutations in the epidermal growth factor receptor gene are linked to smoking-independent, lung adenocarcinoma. Br J Cancer. 2005;93:355–63.CrossRefPubMedPubMedCentral
8.
Kang HJ, Lim HJ, Park JS, Cho YJ, Yoon HI, Chung JH, et al. Comparison of clinical characteristics between patients with ALK-positive and EGFR-positive lung adenocarcinoma. Respir Med. 2014;108(2):388–94.CrossRefPubMed
9.
Kwak EL, Bang YJ, Camidge DR, Shaw AT, Solomon B, Maki RG, et al. Anaplastic lymphoma kinase inhibition in Non–small-cell lung cancer. N Engl J Med. 2010;363:1693–703.CrossRefPubMedPubMedCentral
10.
Masters GA, Temin S, Azzoli CG, Giaccone G, Baker Jr S, Brahmer JR, et al. Systemic therapy for stage IV Non-small-cell lung cancer: american society of clinical oncology clinical practice guideline update. J Clin Oncol. 2015;33:3488–515.CrossRefPubMedPubMedCentral
11.
12.
13.
14.
Rosell R, Karachaliou N. Lung cancer in 2014: Optimizing lung cancer treatment approaches. Nat Rev Clin Oncol. 2015;12:75–6.CrossRefPubMed
15.
Ikushima S, Ono R, Fukuda K, Sakayori M, Awano N, Kondo K. Trousseau’s syndrome: cancer-associated thrombosis. Jpn J Clin Oncol. 2016;55:2049-53.
16.
Farge D, Debourdeau P, Beckers M, Baglin C, Bauersachs RM, Brenner B, et al. International clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer. J Thromb Haemost. 2013;11:56–70.CrossRefPubMed
17.
Chew HK, Davies AM, Wun T, Harvey D, Zhou H, White RH. The incidence of venous thromboembolism among patients with primary lung cancer. J Thromb Haemost. 2008;6:601–8.CrossRefPubMed
18.
Alexander M, Kirsa S, Wolfe R, MacManus M, Ball D, Solomon B, et al. Thromboembolism in lung cancer - an area of urgent unmet need. Lung Cancer. 2014;84:275–80.CrossRefPubMed
19.
Zhang Y, Yang Y, Chen W, Guo L, Liang L, Zhai Z, et al, China Venous Thromboembolism (VTE) Study Group. Prevalence and associations of VTE in patients with newly diagnosed lung cancer. Chest. 2014;146:650–8.PubMed
20.
Young J, Badgery-Parker T, Dobbins T, Jorgensen M, Gibbs P, Faragher I, et al. Comparison of ECOG/WHO performance status and ASA score as a measure of functional status. J Pain Symptom Manage. 2015;49:258–64.CrossRefPubMed
21.
Yu JL, May L, Lhotak V, Shahrzad S, Shirasawa S, Weitz JI, Coomber BL, Mackman N, Rak JW, et al. Oncogenic events regulate tissue factor expression in colorectal cancer cells: implications for tumor progression and angiogenesis. Blood. 2005;105:1734–41.
22.
Lee YG, Kim I, Lee E, Bang SM, Kang CH, Kim YT, et al. Risk factors and prognostic impact of venous thromboembolism in Asian patients with non-small cell lung cancer. Thromb Haemost. 2014;111:1112–20.
23.
Yang Y, Zhou Z, Niu XM, Li ZM, Chen ZW, Jian H, et al. Clinical analysis of postoperative venous thromboembolism risk factors in lung cancer patients. J Surg Oncol. 2012;106:736–41.CrossRefPubMed
24.
Corrales-Rodriguez L, Blais N. Lung cancer associated venous thromboembolic disease: a comprehensive review. Lung cancer (Amsterdam, Netherlands). 2012;75:1–8.CrossRef
25.
Lee YG, Lee E, Kim I, Lee KW, Kim TM, Lee SH, et al. Cisplatin-based chemotherapy is a strong risk factor for thromboembolic events in small-cell lung cancer. Cancer Res Treat. 2015;47(4):670–5.CrossRefPubMedPubMedCentral
26.
Korpanty GJ, Graham DM, Vincent MD, Leighl NB. Biomarkers that currently affect clinical practice in lung cancer: EGFR, ALK, MET, ROS-1, and KRAS. Front Oncol. 2014;4:204.CrossRefPubMedPubMedCentral
27.
Lin J, Wakefield TW, Henke PK. Risk factors associated with venous thromboembolic events in patients with malignancy. Blood Coagul Fibrinolysis. 2006;17:265–70.CrossRefPubMed
28.
Agnelli G, Verso M, Mandala M, Gallus S, Cimminiello C, Apolone G, et al. A prospective study on survival in cancer patients with and without venous thromboembolism. Intern Emerg Med. 2014;9:559–67.PubMed
29.
Wang Z, Yan HH, Yang JJ, Wang BC, Chen HJ, Zhou Q, et al. Venous thromboembolism risk factors in Chinese non-small cell lung cancer patients. Support Care Cancer. 2015;23:635–41.CrossRefPubMed
Metadata
Title
Mutational status predicts the risk of thromboembolic events in lung adenocarcinoma
Authors
Elsa Davidsson
Nicola Murgia
Cristian Ortiz-Villalón
Emil Wiklundh
Magnus Sköld
Karl Gustav Kölbeck
Giovanni Ferrara
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Multidisciplinary Respiratory Medicine / Issue 1/2017
Electronic ISSN: 2049-6958
DOI
https://doi.org/10.1186/s40248-017-0097-0

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