Risk of venous thromboembolism in patients with cancer treated with cisplatin

A systematic review and meta-analysis

Sonia Seng, Ziyue Liu, Sophia K. Chiu, Tracy Proverbs-Singh, Guru Sonpavde, Toni K. Choueiri, Che Kai Tsao, Menggang Yu, Noah M. Hahn, William K. Oh, Matthew D. Galsky

Research output: Contribution to journalArticle

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Abstract

Purpose: Several reports suggest that cisplatin is associated with an increased risk of thromboembolism. However, because the excess risk of venous thromboembolic events (VTEs) with cisplatin-based chemotherapy has not been well described, we conducted a systemic review and meta-analysis of randomized controlled trials evaluating the incidence and risk of VTEs associated with cisplatin-based chemotherapy. Methods: PubMed was searched for articles published from January 1, 1990, to December 31, 2010. Eligible studies included prospective randomized phase II and III trials evaluating cisplatin-based versus non-cisplatin-based chemotherapy in patients with solid tumors. Data on all-grade VTEs were extracted. Study quality was calculated using Jadad scores. Incidence rates, relative risks (RRs), and 95% CIs were calculated using a random effects model. Results: A total of 8,216 patients with various advanced solid tumors from 38 randomized controlled trials were included. The incidence of VTEs was 1.92% (95% CI, 1.07 to 2.76) in patients treated with cisplatin-based chemotherapy and 0.79% (95% CI, 0.45 to 1.13) in patients treated with non-cisplatin-based regimens. Patients receiving cisplatin-based chemotherapy had a significantly increased risk of VTEs (RR, 1.67; 95% CI, 1.25 to 2.23; P = .01). Exploratory subgroup analysis revealed the highest RR of VTEs in patients receiving a weekly equivalent cisplatin dose > 30 mg/m 2 (2.71; 95% CI, 1.17 to 6.30; P = .02) and in trials reported during 2000 to 2010 (1.72; 95% CI, 1.27 to 2.34; P = .01). Conclusion: Cisplatin is associated with a significant increase in the risk of VTEs in patients with advanced solid tumors when compared with non-cisplatin-based chemotherapy.

Original languageEnglish
Pages (from-to)4416-4426
Number of pages11
JournalJournal of Clinical Oncology
Volume30
Issue number35
DOIs
StatePublished - Dec 10 2012

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Venous Thromboembolism
Cisplatin
Meta-Analysis
Drug Therapy
Neoplasms
Incidence
Randomized Controlled Trials
Thromboembolism
PubMed
Prospective Studies

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Risk of venous thromboembolism in patients with cancer treated with cisplatin : A systematic review and meta-analysis. / Seng, Sonia; Liu, Ziyue; Chiu, Sophia K.; Proverbs-Singh, Tracy; Sonpavde, Guru; Choueiri, Toni K.; Tsao, Che Kai; Yu, Menggang; Hahn, Noah M.; Oh, William K.; Galsky, Matthew D.

In: Journal of Clinical Oncology, Vol. 30, No. 35, 10.12.2012, p. 4416-4426.

Research output: Contribution to journalArticle

Seng, S, Liu, Z, Chiu, SK, Proverbs-Singh, T, Sonpavde, G, Choueiri, TK, Tsao, CK, Yu, M, Hahn, NM, Oh, WK & Galsky, MD 2012, 'Risk of venous thromboembolism in patients with cancer treated with cisplatin: A systematic review and meta-analysis', Journal of Clinical Oncology, vol. 30, no. 35, pp. 4416-4426. https://doi.org/10.1200/JCO.2012.42.4358
Seng, Sonia ; Liu, Ziyue ; Chiu, Sophia K. ; Proverbs-Singh, Tracy ; Sonpavde, Guru ; Choueiri, Toni K. ; Tsao, Che Kai ; Yu, Menggang ; Hahn, Noah M. ; Oh, William K. ; Galsky, Matthew D. / Risk of venous thromboembolism in patients with cancer treated with cisplatin : A systematic review and meta-analysis. In: Journal of Clinical Oncology. 2012 ; Vol. 30, No. 35. pp. 4416-4426.
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abstract = "Purpose: Several reports suggest that cisplatin is associated with an increased risk of thromboembolism. However, because the excess risk of venous thromboembolic events (VTEs) with cisplatin-based chemotherapy has not been well described, we conducted a systemic review and meta-analysis of randomized controlled trials evaluating the incidence and risk of VTEs associated with cisplatin-based chemotherapy. Methods: PubMed was searched for articles published from January 1, 1990, to December 31, 2010. Eligible studies included prospective randomized phase II and III trials evaluating cisplatin-based versus non-cisplatin-based chemotherapy in patients with solid tumors. Data on all-grade VTEs were extracted. Study quality was calculated using Jadad scores. Incidence rates, relative risks (RRs), and 95{\%} CIs were calculated using a random effects model. Results: A total of 8,216 patients with various advanced solid tumors from 38 randomized controlled trials were included. The incidence of VTEs was 1.92{\%} (95{\%} CI, 1.07 to 2.76) in patients treated with cisplatin-based chemotherapy and 0.79{\%} (95{\%} CI, 0.45 to 1.13) in patients treated with non-cisplatin-based regimens. Patients receiving cisplatin-based chemotherapy had a significantly increased risk of VTEs (RR, 1.67; 95{\%} CI, 1.25 to 2.23; P = .01). Exploratory subgroup analysis revealed the highest RR of VTEs in patients receiving a weekly equivalent cisplatin dose > 30 mg/m 2 (2.71; 95{\%} CI, 1.17 to 6.30; P = .02) and in trials reported during 2000 to 2010 (1.72; 95{\%} CI, 1.27 to 2.34; P = .01). Conclusion: Cisplatin is associated with a significant increase in the risk of VTEs in patients with advanced solid tumors when compared with non-cisplatin-based chemotherapy.",
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T1 - Risk of venous thromboembolism in patients with cancer treated with cisplatin

T2 - A systematic review and meta-analysis

AU - Seng, Sonia

AU - Liu, Ziyue

AU - Chiu, Sophia K.

AU - Proverbs-Singh, Tracy

AU - Sonpavde, Guru

AU - Choueiri, Toni K.

AU - Tsao, Che Kai

AU - Yu, Menggang

AU - Hahn, Noah M.

AU - Oh, William K.

AU - Galsky, Matthew D.

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N2 - Purpose: Several reports suggest that cisplatin is associated with an increased risk of thromboembolism. However, because the excess risk of venous thromboembolic events (VTEs) with cisplatin-based chemotherapy has not been well described, we conducted a systemic review and meta-analysis of randomized controlled trials evaluating the incidence and risk of VTEs associated with cisplatin-based chemotherapy. Methods: PubMed was searched for articles published from January 1, 1990, to December 31, 2010. Eligible studies included prospective randomized phase II and III trials evaluating cisplatin-based versus non-cisplatin-based chemotherapy in patients with solid tumors. Data on all-grade VTEs were extracted. Study quality was calculated using Jadad scores. Incidence rates, relative risks (RRs), and 95% CIs were calculated using a random effects model. Results: A total of 8,216 patients with various advanced solid tumors from 38 randomized controlled trials were included. The incidence of VTEs was 1.92% (95% CI, 1.07 to 2.76) in patients treated with cisplatin-based chemotherapy and 0.79% (95% CI, 0.45 to 1.13) in patients treated with non-cisplatin-based regimens. Patients receiving cisplatin-based chemotherapy had a significantly increased risk of VTEs (RR, 1.67; 95% CI, 1.25 to 2.23; P = .01). Exploratory subgroup analysis revealed the highest RR of VTEs in patients receiving a weekly equivalent cisplatin dose > 30 mg/m 2 (2.71; 95% CI, 1.17 to 6.30; P = .02) and in trials reported during 2000 to 2010 (1.72; 95% CI, 1.27 to 2.34; P = .01). Conclusion: Cisplatin is associated with a significant increase in the risk of VTEs in patients with advanced solid tumors when compared with non-cisplatin-based chemotherapy.

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