4.6 Review

Thrombotic Complications Associated with Immune Checkpoint Inhibitors

期刊

CANCERS
卷 13, 期 18, 页码 -

出版社

MDPI
DOI: 10.3390/cancers13184606

关键词

venous thromboembolism; arterial thrombosis; cancer-associated thrombosis; immune checkpoint inhibitors; anticoagulation

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资金

  1. Sondra and Stephen Hardis Chair in Oncology Research
  2. National Heart, Lung and Blood Institute (Consortium Linking Oncology with Thrombosis) [CLOT-U01HL143402]
  3. Tier 1 Research Chair from the University of Ottawa in Cancer and Thrombosis

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Cancer patients often develop blood clots, with immune checkpoint inhibitors increasing the risk. Studies have shown a connection between immune checkpoint inhibitors and venous and arterial thrombosis, with further investigation needed on risk factors and optimal prevention and treatment strategies.
Simple Summary Patients with cancer commonly develop blood clots, which can cause issues including hospitalizations and complications and can affect cancer treatments. Cancer therapies can be one of the reasons for blood clots. A type of cancer therapy called immune checkpoint inhibitors has been used more and more often in recent years for different types of cancer. Recent reports revealed an increasing concern of blood clots related to immune checkpoint inhibitors. In this review, we will summarize data from the available studies and discuss the rates, risk factors, prevention, and treatment strategies for blood clots related to immune checkpoint inhibitors. Thromboembolism is a common complication in patients with cancer and is associated with significant morbidity and mortality. Anticancer treatment is a known risk factor of cancer-associated thrombosis. Immune checkpoint inhibitors have become a mainstay of treatment in various cancers. Both venous and arterial thrombosis have been increasingly reported as adverse events associated with immune checkpoint inhibitors in recent studies, with a cumulative incidence of venous thrombosis to be 5-8% at 6 months and over 10% at 12 months. Additionally, rates of approximately 1-5% for arterial thrombosis were reported at 12 months. Data also showed an association of thromboembolism with adverse survival. Many pertinent clinical questions in this population deserve further investigation, including the risks of thrombosis associated with immune checkpoint inhibitors as compared to those with traditional systemic therapy, associated risk factors, and the optimal prevention and treatment strategies. In this review, we synthesize data from available literature, provide relevant information for clinicians and potential future directions for research.

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