Early changes of a novel APC-dependent thrombin generation assay during chemotherapy independently predict venous thromboembolism in cancer patients - A pilot study

Patrizia Ferroni, Francesca Martini, Ilaria Portarena, Italia Grenga, Silvia Riondino, Francesca La Farina, Anastasia Laudisi, Fiorella Guadagni, Mario Roselli

Research output: Contribution to journalArticle

Abstract

Purpose Identifying cancer patients who are most at risk for venous thromboembolism (VTE) is essential to improve timely delivery of chemotherapy. Several studies have been performed to identify novel candidate biomarkers, but no agreement has yet been reached. In this light, we sought to analyze whether a dynamic evaluation of early changes of activated protein C (APC) function during chemotherapy could be predictive of a first VTE episode in cancer outpatients, thus improving risk stratification. Methods A retrospective single-center pilot study was conducted to investigate the adequacy of a dynamic evaluation of a novel APC-dependent thrombin generation assay (HemosIL ThromboPath (ThP)) in predicting VTE in 208 ambulatory cancer patients, enrolled on the basis of tight inclusion criteria, prior to start and before the second cycle of a new chemotherapy regimen. Results Retrospective analysis of samples showed the occurrence of an acquired APC resistance during chemotherapy, which was predictive of VTE. Univariate Cox proportional hazards survival analysis showed that early ThP changes predicted VTE (stable vs. decreasing ThP: hazard ratio (HR) 0.21; 95% CI 0.10-0.19; p

Original languageEnglish
Pages (from-to)2713-2720
Number of pages8
JournalSupportive Care in Cancer
Volume20
Issue number11
DOIs
Publication statusPublished - Nov 2012

Keywords

  • Activated proteinC
  • Cancer
  • Chemotherapy
  • Protac-induced coagulation inhibition
  • Thromboprophylaxis
  • Venous thromboembolism

ASJC Scopus subject areas

  • Oncology

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