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细胞周期蛋白依赖性激酶抑制剂治疗的乳腺癌患者的血栓形成:生存影响及预测因素——西班牙医学肿瘤学会(SEOM)癌症与血栓形成小组的一项研究

Thrombosis in breast cancer patients on cyclin-dependent kinase inhibitors: Survival impact and predictive factors - A study by the cancer and thrombosis group of the spanish society of medical oncology (SEOM).

作者信息

Sánchez Cánovas Manuel, López Robles Javier, Adoamnei Evdochia, Cacho Lavin Diego, Diaz Pedroche Carmen, Coma Salvans Eva, Quintanar Verduguez Teresa, García Verdejo Francisco José, Cejuela Solís Mónica, García Adrián Silvia, Obispo Portero Berta, Garrido Fernández Alberto, Salvador Coloma Carmen, Martínez Del Prado María Purificación, Mendiola Jaime, Muñoz Martín Andres J

机构信息

Medical Oncology Department, Morales Meseguer University Hospital, Murcia, Spain.

Medical Oncology Department, Morales Meseguer University Hospital, Murcia, Spain.

出版信息

Eur J Intern Med. 2024 Dec;130:98-105. doi: 10.1016/j.ejim.2024.08.005. Epub 2024 Aug 21.

Abstract

Thrombosis may be included in the profile of side effects associated with CDK4/6 inhibitors. Its significance might be greater than reported in randomized clinical trials. To investigate this, a retrospective, multicenter study was conducted. The primary objective was to calculate the incidence of thrombosis associated with CDK4/6 inhibitors. Secondary objectives included examining the impact of thrombosis on survival and identifying predictor variables for the development of venous thromboembolism (VTE) or arterial thrombosis (AT). A total of 986 patients were recruited. The incidence of VTE/AT associated with CDK4/6 inhibitor treatment during the follow-up period was 5.48 %. Survival analysis did not indicate that the development of VTE/AT during CDK4/6 inhibitor treatment significantly impacted patient survival (p = 0.133). In our analysis, two variables were found to be statistically significant (p < 0.05) as predictors of VTE/AT in breast cancer patients receiving CDK4/6 inhibitor therapy. These variables were the presence of central nervous system (CNS) metastasis with an odds ratio (OR) of 3.68 (95 % CI 1.18 - 11.49) and the use of abemaciclib with an OR of 2.3 (95 % CI 1.16 - 4.57).

摘要

血栓形成可能包含在与CDK4/6抑制剂相关的副作用范围内。其重要性可能比随机临床试验中报告的更大。为了对此进行研究,开展了一项回顾性多中心研究。主要目的是计算与CDK4/6抑制剂相关的血栓形成发生率。次要目的包括检查血栓形成对生存的影响以及确定静脉血栓栓塞(VTE)或动脉血栓形成(AT)发生的预测变量。共招募了986名患者。随访期间与CDK4/6抑制剂治疗相关的VTE/AT发生率为5.48%。生存分析未表明CDK4/6抑制剂治疗期间VTE/AT的发生对患者生存有显著影响(p = 0.133)。在我们的分析中,发现两个变量作为接受CDK4/6抑制剂治疗的乳腺癌患者VTE/AT的预测因子具有统计学意义(p < 0.05)。这些变量是存在中枢神经系统(CNS)转移,比值比(OR)为3.68(95%CI 1.18 - 11.49),以及使用阿贝西利,OR为2.3(95%CI 1.16 - 4.57)。

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