ALK-Rearranged Non-Small-Cell Lung Cancer Is Associated With a High Rate of Venous Thromboembolism.
BACKGROUND
Patients with lung cancer are at increased risk for venous thromboembolism (VTE), particularly those receiving chemotherapy. It is estimated that 8% to 15% of patients with advanced non-small-cell lung cancer (NSCLC) experience a VTE in the course of their disease. The incidence in patients with specific molecular subtypes of NSCLC is unknown. We undertook this review to determine the incidence of VTE in patients with ALK (anaplastic lymphoma kinase)-rearranged NSCLC.


PATIENTS AND METHODS
We identified all patients with ALK-rearranged NSCLC diagnosed and/or treated at the Princess Margaret Cancer Centre (PM CC) in Canada between July 2012 and January 2015. Retrospective data were extracted from electronic medical records. We then included a validation cohort comprising all consecutive patients with ALK-rearranged NSCLC treated in 2 tertiary centers in Israel.


RESULTS
Within the PM CC cohort, of 55 patients with ALK-rearranged NSCLC, at a median follow-up of 22 months, 23 (42%) experienced VTE. Patients with VTE were more likely to be white (P = .006). The occurrence of VTE was associated with a trend toward worse prognosis (overall survival hazard ratio = 2.88, P = .059). Within the validation cohort (n = 43), the VTE rate was 28% at a median follow-up of 13 months. Combining the cohorts (n = 98), the VTE rate was 36%. Patients with VTE were younger (age 52 vs. 58 years, P = .04) and had a worse Eastern Cooperative Oncology Group performance status (P = .04). VTE was associated with shorter overall survival (hazard ratio = 5.71, P = .01).


CONCLUSION
The rate of VTE in our ALK-rearranged cohort was 3- to 5-fold higher than previously reported for the general NSCLC population. This warrants confirmation in larger cohorts.
['Zer|Alona|A|', 'Moskovitz|Mor|M|', 'Hwang|David M|DM|', 'Hershko-Klement|Anat|A|', 'Fridel|Ludmila|L|', 'Korpanty|Grzegorz J|GJ|', 'Dudnik|Elizabeth|E|', 'Peled|Nir|N|', 'Shochat|Tzippy|T|', 'Leighl|Natasha B|NB|', 'Liu|Geoffrey|G|', 'Feld|Ronald|R|', 'Burkes|Ronald|R|', 'Wollner|Mira|M|', 'Tsao|Ming-Sound|MS|', 'Shepherd|Frances A|FA|']
D000328:Adult D000368:Aged D000077548:Anaplastic Lymphoma Kinase D014408:Biomarkers, Tumor D002170:Canada D002289:Carcinoma, Non-Small-Cell Lung D005260:Female D005500:Follow-Up Studies D015321:Gene Rearrangement D006801:Humans D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D009367:Neoplasm Staging D015995:Prevalence D011379:Prognosis D020794:Receptor Protein-Tyrosine Kinases D012189:Retrospective Studies D015996:Survival Rate D054556:Venous Thromboembolism
Venous thromboembolism NSCLC Anaplastic lymphoma kinase (ALK) Thrombosis