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Topics:
Thoracic Malignancies • Medical Oncology • Internal Medicine • Hematology • Hemostasis/Thrombosis
How do you counsel patients on the risk of thromboembolic complications with use of immunotherapy in NSCLC?
Given recent data in Blood (Moik et al, 2021), and the potentially overlapping risks with other clinical factors associated with NSCLC.
Will you alter your treatment approach for PD-L1+ NSCLC patients with history of VTE?
Answer from: Medical Oncologist at Academic Institution
Patients with metastatic lung cancer are at increased risk of thromboembolic events with an estimated frequency of 13.9% (Connolly et al., PMID 23026639). Preclinical data show that PD-1/PD-1 pathway blockade may lead to increased levels of pro-inflammatory cytokines and T cell driven progression an...
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Answer from: Medical Oncologist at Academic Institution
I personally have not seen a major increase in incidence of thromboembolic events on CPIs. Patients with metastatic NSCLC run a 20% to 25% risk of clotting. It is hard to separate inherent risk from “added” risk. Other immune-mediated adverse events are far more concerning.
Answer from: Medical Oncologist at Community Practice
I have not previously considered this to be an IO-related toxicity. More to learn on this as we see more data.