Τίτλος:
The impact of thromboprophylaxis on the survival of patients with advanced pancreatic cancer. The pancreatic cancer and tinzaparin (pact) study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Pancreatic cancer (PaC) induces a prothrombotic and hypercoagulable state. The aim of this study was to investigate the effect of tinzaparin in combination with chemotherapy. The PaCT (pancreatic cancer and tinzaparin) study was a retrospective observational study that collected data regarding progression free survival (PFS) in advanced or metastatic PaC patients who received throm-boprophylaxis with tinzaparin during chemotherapy with nab-paclitaxel (N) and gemcitabine (G). The primary end point was to compare, from already published data, the PFS of patients receiving thromboprophylaxis with tinzaparin with the PFS of patients receiving chemotherapy with N–G but no thromboprophylaxis. Secondary end points were efficacy and safety of anticoagulation. In total, 110 PaC patients, 93% with advanced or metastatic disease, treated with N–G and tinzaparin (10,291 ± 1176 Anti-Xa IU, OD, median duration 8.7, IQR: 5.6–11.9 months) were enrolled. Of these, 52% were males and; the median age was 68 (40–86 years). The tumor was located to in the pancreatic head at in 45% of the patients. The median PFS was 7.9 months (IQR: 5.0–11.8 months). Out of 14 sim-ilar studies (involving 2994 patients) identified via systematic search, it was determined that the weighted PFS of patients receiving N–G but no anticoagulation was 5.6 months. Therefore, patients receiving tinzaparin had 39.54% higher PFS than patients without thromboprophylaxis (p < 0.05). During the follow-up period of 18.3 ± 11.7 months, three (2.7%) thrombotic events were recorded while two clinically relevant non-major bleeding events occurred (1.9%). In conclusion, PFS in advanced PaC patients undergoing chemotherapy is positively impacted by anticoagulation. Throm-boprophylaxis with tinzaparin in treatment dose is efficient and safe. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Συγγραφείς:
Karamouzis, M.V.
Athanasiadis, I.
Samelis, G.
Vallilas, C.
Bokas, A.
Nikolaidi, A.
Dimitriadou, A.
Sarantis, P.
Pistamaltzian, N.
Schizas, D.
Papalampros, A.
Felekouras, E.
Dimitroulis, D.
Antoniou, E.
Sotiropoulos, G.
Papakotoulas, P.
Περιοδικό:
Blood cancer journal
Λέξεις-κλειδιά:
gemcitabine; paclitaxel; tinzaparin, adult; advanced cancer; age; aged; anticoagulant therapy; Article; bleeding; cancer chemotherapy; cancer prognosis; cancer survival; cohort analysis; drug efficacy; drug safety; epistaxis; female; gender; human; major clinical study; male; metastasis; multicenter study; observational study; pancreas cancer; progression free survival; retrospective study; thrombosis prevention; treatment duration; tumor localization
DOI:
10.3390/cancers13122884
