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Exploratory retrospective study of risk factors for thromboembolism treated with multi-kinase inhibitor pazopanib or lenvatinib

Authors:

Kenta Nio,

Department of Medical Oncology, Sasebo Kyosai Hospital, Nagasaki; Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, JP
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MD, PhD

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Kenji Tsuchihashi,

Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, JP
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MD, PhD

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Keisuke Taguchi,

Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, JP
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MD

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Tomoyasu Yoshihiro,

Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD

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Kyoko Yamaguchi,

Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Mamoru Ito,

Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, JP
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MD, PhD

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Shohei Moriyama,

Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, JP
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MD

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Mitsuhiro Fukata,

Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, JP
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MD, PhD

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Toshifumi Fujiwara,

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Nokitaka Setsu,

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Makoto Endo,

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Yoshihiro Matsumoto,

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Yasuharu Nakashima,

Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Takahiro Wakasaki,

Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Ryuji Yasumatsu,

Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Hiroshi Ariyama,

Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Hitoshi Kusaba,

Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, JP
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MD, PhD

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Junji Kishimoto,

Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, JP
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MA

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Koichi Akashi,

Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Eishi Baba

Department of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP
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MD, PhD

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Abstract

Tyrosine kinase inhibitors (TKI) work against various types of cancer by inhibiting angiogenic signaling. Little is understood about the incidence, characteristics, and risk factors associated with thromboembolism induced by TKI in routine clinical practice. We retrospectively analyzed data derived from 29 patients with thyroid cancer or soft tissue sarcoma (STS) treated with lenvatinib (n=10) and pazopanib (n=19). Eight (arterial n=4; venous n=4) thromboembolic events developed in 6 (20%) patients. Thromboembolisms occurred during a mean of 149 (range, 42–847) days from starting TKI. The primary disease progressed in all patients with thromboembolism. The overall survival durations of patientswith and without improved thromboembolism were 572 [95% confidence interval (CI), 225– 918] and 176 (95% CI, 84–394) days, respectively, which did not significantly differ (P=0.33). Patients with and without improved thromboembolism survived after onset for 122 (95% CI, 71–173) versus 27 (95%CI, 21–42) days (P=0.049), which significantly differed. Univariate analysis and variate selection for multivariate analysis selected a history of thromboembolism as the most powerful risk factor for new thromboembolism. In summary, the frequency of thromboembolism in clinical practice was higher than that in previous clinical trials. Furthermore, a history of thromboembolism was a risk factor for the development of new thromboembolism in patients treated with TKI. Thromboembolism developed particularly as the primary disease progressed. Our findings require validation in a large-scale study.

How to Cite: Nio K, Tsuchihashi K, Taguchi K, Yoshihiro T, Yamaguchi K, Ito M, et al.. Exploratory retrospective study of risk factors for thromboembolism treated with multi-kinase inhibitor pazopanib or lenvatinib. International Journal of Surgery: Oncology. 2020;5(4):e89. DOI: http://doi.org/10.1097/IJ9.0000000000000089
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Published on 26 Jun 2020.
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