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Incidence of venous thromboembolism in patients with colorectal cancer according to oncogenic status

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Abstract

Background

There are conflicting data regarding the role of KRAS mutation on the risk of venous thromboembolism (VTE) in colorectal cancer (CRC) patients. Moreover, the role of other biomarkers such as NRAS or BRAF has not been studied.

Purpose

To analyze the incidence of VTE in a cohort of patients with CRC based on KRAS, NRAS, and BRAF status.

Methods

We performed a retrospective review of patients with unresectable locally advanced and metastatic CRC (mCRC) and known KRAS/NRAS/BRAF status, attended in the Medical Oncology Department of the Hospital General Universitario Gregorio Marañón (Madrid, Spain). The primary outcome was VTE defined as any venous thromboembolic event that occurred either 6 months before or at any time after the diagnosis of CRC. The biomarker status (KRAS, NRAS, and BRAF) and other predictors of thrombosis were collected.

Results

One hundred and ninety-four patients were identified and included in the analysis. Forty-one patients (21.1%) experienced VTE. The incidence was 19.1% in RAS-mutated patients, 28.6% in BRAF-mutated patients and 21% in triple wild-type patients (p = NS). In multivariate analysis, ECOG ≥ 2 was the only independent predictor of VTE (OR 8.73; CI 95% 1.32–57.82; p = 0.025).

Conclusions

In our study, biomarkers have not been associated with an increased risk of VTE in CRC patients. A high incidence of VTE in BRAF-mutated patients has been observed and should be explored in further studies.

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Funding

This study had no funding.

Author information

Author notes

  1. L. O. Morán and P. G. Alfonso contributed equally to this work.

Authors and Affiliations

  1. Medical Oncology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Universidad Complutense, Madrid, España

    L. Ortega Morán, P. García Alfonso, I. Aguilar Caballero, B. Morón García, V. Tirado Anula, M. de Toro Carmena, J. Soto Alsar, N. Gutiérrez Alonso, M. Bringas Beranek, M. Martín Jiménez & A. J. Muñoz Martín

  2. Cancer and Thrombosis Section, Spanish Society of Medical Oncology (SEOM), Madrid, Spain

    L. Ortega Morán & A. J. Muñoz Martín

Authors
  1. L. Ortega Morán
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  2. P. García Alfonso
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  3. I. Aguilar Caballero
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  4. B. Morón García
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  6. M. de Toro Carmena
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  7. J. Soto Alsar
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  8. N. Gutiérrez Alonso
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  9. M. Bringas Beranek
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  10. M. Martín Jiménez
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  11. A. J. Muñoz Martín
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Corresponding author

Correspondence to A. J. Muñoz Martín.

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Conflict of interest

Laura Ortega Morán received speakers’ honoraria or honoraria for participation in Advisory Boards from Amgen and Sanofi; travel, accommodations and expenses from Amgen, Leo Pharma, Roche and Sanofi. Pilar García Alfonso received speakers’ honoraria or honoraria for participation in Advisory Boards from Roche, Amgen, Merck, Sanofi and Servier; travel, accommodations and expenses from Roche and Merck. Iker Aguilar Caballero received speakers’ honoraria from Kyowa Kirin; travel, accommodations and expenses from Astra-Zeneca, Roche, and Sanofi. Blanca Morón García received support for travel, accommodations, and expenses from MSD. Victoria Tirado Anula received support for travel, accommodations, and expenses from MSD. María de Toro Carmena received support for travel, accommodations, and expenses from Leo Pharma and MSD. Javier Soto Alsar has an immediate family member employed by Pfizer and Sanofi; travel, accommodations, and expenses from Angelini, MSD, Rovi, Sanofi, and Vifor Pharma. Marianela Bringas Beranek received support for travel, accommodations, and expenses from MSD, Rovi, Sanofi, and Vifor Pharma. Natalia Gutiérrez Alonso received support for travel, accommodations, and expenses from Angelini, MSD, Rovi, and Sanofi. Miguel Martín received speakers’ honoraria or honoraria for participation in Advisory Boards from Roche, Novartis, Pfizer, Lilly, Astra-Zeneca, Taiho Pharmaceutical, and PharmaMar; research funding from Novartis and Roche. Andrés J. Muñoz Martín received speakers’ honoraria or honoraria for participation in Advisory Boards from Astra-Zeneca, Bayer Halozyme, Celgene, Daiichi Sankyo Roche, Leo Pharma, Pfizer, Sanofi, Servier, Amgen, Lilly, and Rovi; research funding from Celgene, Leo Pharma, and Sanofi; patents: risk assessment model in venous thromboembolism in cancer patients; travel, accodomodations, and expenses from Amgen, Celgene, Merck Serono, Roche, and Sanofi.

Ethical approval

The study was approved by the Ethics Committee of Hospital General Universitario Gregorio Marañón, Madrid, Spain. The study has been approved by the appropriate institutional and/or national research ethics committee and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Ortega Morán, L., García Alfonso, P., Aguilar Caballero, I. et al. Incidence of venous thromboembolism in patients with colorectal cancer according to oncogenic status. Clin Transl Oncol 22, 2026–2031 (2020). https://doi.org/10.1007/s12094-020-02339-1

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  • DOI: https://doi.org/10.1007/s12094-020-02339-1

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