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

119 Scopus citations

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

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Risk of venous thromboembolism in patients with cancer treated with cisplatin: A systematic review and meta-analysis'. Together they form a unique fingerprint.

  • Cite this

    Seng, S., Liu, Z., Chiu, S. K., Proverbs-Singh, T., Sonpavde, G., Choueiri, T. K., Tsao, C. K., Yu, M., Hahn, N. M., Oh, W. K., & Galsky, M. D. (2012). Risk of venous thromboembolism in patients with cancer treated with cisplatin: A systematic review and meta-analysis. Journal of Clinical Oncology, 30(35), 4416-4426. https://doi.org/10.1200/JCO.2012.42.4358