Lung Cancer Related Thrombosis (LCART): Focus on Immune Checkpoint Blockade.

Publication date: Jan 20, 2024

Cancer-associated thrombosis (CAT) is a common complication in lung cancer patients. Lung cancer confers an increased risk of thrombosis compared to other solid malignancies across all stages of the disease. Newer treatment agents, including checkpoint immunotherapy and targeted agents, may further increase the risk of CAT. Different risk-assessment models, such as the Khorana Risk Score, and newer approaches that incorporate genetic risk factors have been used in lung cancer patients to evaluate the risk of thrombosis. The management of CAT is based on the results of large prospective trials, which show similar benefits to low-molecular-weight heparins (LMWHs) and direct oral anticoagulants (DOACs) in ambulatory patients. The anticoagulation agent and duration of therapy should be personalized according to lung cancer stage and histology, the presence of driver mutations and use of antineoplastic therapy, including recent curative lung surgery, chemotherapy or immunotherapy. Treatment options should be evaluated in the context of the COVID-19 pandemic, which has been shown to impact the thrombotic risk in cancer patients. This review focuses on the epidemiology, pathophysiology, risk factors, novel predictive scores and management of CAT in patients with active lung cancer, with a focus on immune checkpoint inhibitors.

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Concepts Keywords
Basel anticoagulation
Cancer cancer-associated thrombosis
Cat immune checkpoint inhibitor
Immunotherapy lung cancer
Predictive venous thromboembolism


Type Source Name
disease MESH Lung Cancer
disease MESH Thrombosis
disease MESH Cancer
disease MESH COVID-19 pandemic
drug DRUGBANK Coenzyme M
disease MESH venous thromboembolism
disease IDO blood
disease MESH hypercoagulability
disease VO population
disease MESH death
disease IDO history
disease VO time
disease MESH lung adenocarcinoma
disease MESH bleeding
disease MESH morbidities
disease MESH anemia
disease MESH obesity
disease MESH COPD
disease MESH hypertension
disease MESH pulmonary tuberculosis
disease MESH Immobilization
disease MESH adenocarcinomas
disease MESH squamous carcinoma
disease IDO host
disease MESH inflammation
disease MESH colitis
disease MESH pneumonitis
drug DRUGBANK Platinum
drug DRUGBANK Cisplatin
drug DRUGBANK Carboplatin
disease MESH thromboembolism
drug DRUGBANK Thrombin
drug DRUGBANK Phosphatidyl serine
disease MESH Pulmonary embolism
disease IDO immune response
disease MESH carcinogenesis
disease IDO process
disease MESH metastasis
disease MESH immunothrombosis
disease IDO cell
drug DRUGBANK Durvalumab
disease VO stomach
disease MESH lymphoma
drug DRUGBANK Rivaroxaban
drug DRUGBANK Apixaban
disease MESH breast cancer
pathway KEGG Breast cancer
disease MESH peripheral artery disease
disease MESH ischemic stroke
disease MESH coronary artery disease
disease MESH hyperlipidemia
drug DRUGBANK Gemcitabine
disease MESH thrombocytopenia
drug DRUGBANK L-Citrulline
disease VO organ
disease MESH hepatic insufficiency
disease MESH brain metastases
disease MESH gastrointestinal disorders
drug DRUGBANK Heparin
disease MESH contraindication
disease VO dose
disease VO Imovax ID
disease MESH hepatitis
disease MESH acute stroke
disease VO effective
disease MESH atrial fibrillation
disease VO Glycoprotein
drug DRUGBANK Filgrastim
drug DRUGBANK Dexamethasone
drug DRUGBANK Prednisolone
drug DRUGBANK Denosumab
drug DRUGBANK Zoledronic acid
drug DRUGBANK Ondansetron
drug DRUGBANK Palonosetron
drug DRUGBANK Metoclopramide
drug DRUGBANK Aprepitant
drug DRUGBANK Fosaprepitant
drug DRUGBANK Oxycodone
drug DRUGBANK Hydromorphone
drug DRUGBANK Morphine
drug DRUGBANK Fentanyl
drug DRUGBANK Acetaminophen
drug DRUGBANK Lorazepam
drug DRUGBANK Clonazepam
drug DRUGBANK Erythropoietin
drug DRUGBANK Darbepoetin alfa
drug DRUGBANK Didanosine
disease MESH drug interaction

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