Mayenga Marie, Falvo Nicolas, Mahé Isabelle, Jannot Anne-Sophie, Gazeau Benoit, Meyer Guy, Gendron Nicolas, Sanchez Olivier, Djennaoui Sadji, Planquette Benjamin
Department of Pulmonology and Intensive Care, Hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France.
Department of Vascular Pathology, Centre Hospitalier Universitaire Dijon-Bourgogne, 21000 Dijon, France.
Cancers (Basel). 2023 Jul 31;15(15):3893. doi: 10.3390/cancers15153893.
Cancer-associated thrombosis (CAT) is a common complication during cancer, with complex management due to an increased risk of both recurrence and bleeding. Bevacizumab is an effective anti-angiogenic treatment but increases the risk of bleeding and potentially the risk of venous thromboembolism (VTE). The aim of this study was to evaluate the efficacy and safety of anticoagulant therapy in patients with CAT receiving bevacizumab, according to the continuation or discontinuation of bevacizumab. In a retrospective multicenter study, patients receiving anticoagulant for CAT occurring under bevacizumab therapy were included. The primary endpoint combined recurrent VTE and/or major or clinically relevant non-major bleeding. Among the 162 patients included, bevacizumab was discontinued in 70 (43.2%) patients and continued in 92 (56.8%) patients. After a median follow-up of 318 days, 21 (30.0%) patients in the discontinuation group experienced VTE recurrence or major or clinically relevant non-major bleeding, compared to 27 (29.3%) in the continuation group. The analysis of survival following the first event showed no significant difference between the groups in uni- or multivariate analysis ( = 0.19). The primary endpoint was not influenced by the duration of bevacizumab exposure. These results suggest that the efficacy and safety of anticoagulant therapy in patients with CAT receiving bevacizumab is not modified regardless of whether bevacizumab is continued or discontinued.
癌症相关血栓形成（CAT）是癌症期间的常见并发症，由于复发和出血风险增加，其管理较为复杂。贝伐单抗是一种有效的抗血管生成治疗药物，但会增加出血风险以及潜在的静脉血栓栓塞（VTE）风险。本研究的目的是根据贝伐单抗的继续使用或停用情况，评估接受贝伐单抗治疗的CAT患者抗凝治疗的疗效和安全性。在一项回顾性多中心研究中，纳入了在贝伐单抗治疗期间发生CAT并接受抗凝治疗的患者。主要终点为复发性VTE和/或大出血或临床相关非大出血的联合情况。在纳入的162例患者中，70例（43.2%）患者停用了贝伐单抗，92例（56.8%）患者继续使用。中位随访318天后，停用组有21例（30.0%）患者发生VTE复发或大出血或临床相关非大出血，继续使用组为27例（29.3%）。首次事件后的生存分析显示，单因素或多因素分析中两组之间无显著差异（P = 0.19）。主要终点不受贝伐单抗暴露持续时间的影响。这些结果表明，无论贝伐单抗继续使用还是停用，接受贝伐单抗治疗的CAT患者抗凝治疗的疗效和安全性均未改变。
