Khorana Risk Score not predictive of VTE in lung cancer
A high Khorana Risk Score did not predict venous thromboembolism among patients with lung cancer, according to study results.
Based on their findings, researchers recommend improved stratification methods to prevent VTE in this patient population.
“Assessment of VTE risk is currently recommended before initiation of chemotherapy. To date, the best validated cancer-associated thrombosis prediction score is the Khorana Risk Score,” Aaron Mansfield, MD, of the division of medical oncology at Mayo Clinic in Rochester, Minnesota, and colleagues wrote. “If the Khorana Risk Score does not perform well among patients with one of the most common types of cancer, this group of patients will need a cancer-specific evaluation of VTE predictors.”
Mansfield and colleagues used a lung cancer database to examine the association between Khorana score and VTE incidence among 719 patients (median age, 68 years; 52% men) treated at Mayo Clinic in Rochester between January 1998 and December 2011.
Eighty-seven percent had non–small cell lung cancer, and 40.5% had metastatic disease.
OS prediction served as a secondary outcome.
Median follow-up was 15.2 months.
More than three-quarters (78.8%; n = 568 patients) died.
VTE occurred in 83 patients (11.5%). Four patients with VTE did not have a determined Khorana score.
The researchers found no association between a high Khorana score and risk for VTE (cumulative incidence: 12.4%; 95% CI, 6.4-20.5) compared with an intermediate score (cumulative incidence: 12.1%; 95% CI, 9.5-15). Eighty-five percent of VTEs occurred in patients with an intermediate score.
Although a high score did not predict VTE, it was independently associated with all-cause mortality (HR = 1.7; 95% CI, 1.4-2.2).
“Our findings stress the need for cancer-specific risk assessment for VTE prediction,” the researchers wrote. – by Andy Polhamus
Disclosure: Mansfield reports honoraria from Celgene and Genentech. The other researchers report no relevant financial disclosures.