ALK -rearranged non-small cell lung cancer is associated with a high rate of venous thromboembolism

Abstract Micro-abstract We examined the rate of VTE in a cohort of consecutive patients with ALK -rearranged NSCLC in single center and found it is 3-5-fold higher than previously reported in the setting of advanced NSCLC. The results were comparable when we included a validation cohort of consecutive patients in two other centers with an overall rate of 36%. Prospective confirmation is warranted. Background Patients with lung cancer are at increased risk for venous thromboembolism (VTE), particularly those receiving chemotherapy. It is estimated that 8-15% of patients with advanced non-small cell lung cancer (NSCLC) experience a VTE in the course of their disease. The incidence in patients with specific molecular subtypes of NSCLC is unknown. We undertook this review to determine the incidence of VTE in patients with ALK -rearranged NSCLC. Patients/Methods We identified all patients with ALK -rearranged NSCLC, diagnosed and/or treated at the Princess Margaret Cancer Centre (PM CC) in Canada between July 2012 and January 2015. Retrospective data were extracted from electronic medical records. We then included a validation cohort comprising all consecutive patients with ALK -rearranged NSCLC treated in two tertiary centers in Israel. Results Within the PM CC cohort, of 55 patients with ALK -rearranged NSCLC, at a median follow-up of 22 months, 23 (42%) experienced VTE. Patients with VTE were more likely to be Caucasian (p=0.006). The occurrence of VTE was associated with a trend towards worse prognosis (overall survival HR=2.88, p=0.059). Within the validation cohort (N=43), VTE rate was 28% at a median follow-up of 13 months. Combining the cohorts (N=98) the VTE rate was 36%. Patients with VTE were younger (age 52 vs 58, p=0.04) and had a worse ECOG performance status (p=0.04). VTE was associated with shorter OS (HR=5.71, p=0.01). Conclusions We found the rate of VTE in our ALK -rearranged cohort is 3-5-fold higher than previously reported for the general NSCLC population. This warrants confirmation in larger cohorts.