Lowering the Risk of Venous Thromboembolism With Ovarian Cancer Treatment

Twenty-five percent of patients receiving neoadjuvant chemotherapy treatment for ovarian cancer develop venous thromboembolism (VTE), according to a new study published in the journal Obstetrics & Gynecology.¹

Patients with ovarian cancer have historically been associated with developing VTE, and significant risk factors have included obesity, older age, advanced disease stage, debulking surgery, and use of anticoagulants. Development of this hematological condition can in turn lead to a poor prognosis or a reduced quality of life for the patient. While postoperative efforts have focused on reducing the incidence of thromboembolic events in women with ovarian cancer, the 4-week standard treatment that is currently offered may not be sufficient to reduce the long-term risk.²

With the hypothesis that neoadjuvant chemotherapy increases the incidence of VTE, the authors of the current study conducted a retrospective analysis among 112 patients with ovarian cancer who were being treated with neoadjuvant chemotherapy. Thirteen patients who presented with a symptom of VTE were disregarded prior to analysis. Thirty of the 112 patients at risk (26.8%; 95% CI, 19.3%-35.9%) experienced a venous thromboembolism. Thirteen patients (11.6%; 95% CI, 6.8%-19.1%) experienced this hematological event during the neoadjuvant chemotherapy treatment, 6 (5.4%; 95% CI, 2.4%-11.5%) developed the condition postoperatively, and 11 (9.9%; 95% CI, 5.5%-17%) developed VTE during adjuvant chemotherapy.

Based on these findings, the authors confirm that neoadjuvant chemotherapy positions patients with ovarian cancer at an extremely high risk of developing VTE. Highlighting the importance of prophylactic treatment in preventing the incidence of VTE, they note that prophylaxis could potentially improve survival in this patient population. This is especially important because of the rapidly growing population of patients with ovarian cancer who are administered neoadjuvant chemotherapy in the United States, they write.

References

1. Greco PS, Bazzi AA, McLean K, et al. Incidence and timing of thromboembolic events in patients with ovarian cancer undergoing neoadjuvant chemotherapy [published online May 5, 2017]. Obstet Gynecol. 2017. doi: 10.1097/AOG.0000000000001980.

2. Pant A, Liu D, Schink J, Lurain J. Venous thromboembolism in advanced ovarian cancer patients undergoing frontline adjuvant chemotherapy. Int J Gynecol Cancer. 2014;24(6):997-1002. doi: 10.1097/IGC.0000000000000164.