Meta-analysis of randomized controlled trials on primary ambulatory thromboprophylaxis in patients with nonpancreatic gastrointestinal cancers receiving chemotherapy

Thura Win Htut; Kyaw Zin Thein; Donald Paul Quick; Thein Hlaing Oo

doi:10.1080/08998280.2021.1973340

Meta-analysis of randomized controlled trials on primary ambulatory thromboprophylaxis in patients with nonpancreatic gastrointestinal cancers receiving chemotherapy

Proc (Bayl Univ Med Cent). 2021 Sep 16;35(1):51-55. doi: 10.1080/08998280.2021.1973340. eCollection 2022.

Authors

Thura Win Htut¹, Kyaw Zin Thein^{2

3}, Donald Paul Quick^{4

5}, Thein Hlaing Oo⁶

Affiliations

¹ Department of Hematology, Aberdeen Royal Infirmary, Aberdeen, UK.
² Department of Investigational Cancer Therapeutics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
³ Division of Hematology and Medical Oncology, Oregon Health and Science University/Knight Cancer Institute, Portland, Oregon.
⁴ Joe Arrington Cancer Research and Treatment Center, Lubbock, Texas.
⁵ Texas Tech University Health Sciences Center, Lubbock, Texas.
⁶ Section of Benign Hematology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.

Abstract

Primary ambulatory thromboprophylaxis (PATP) in patients with solid malignancies is not routinely indicated. We performed a meta-analysis of randomized controlled trials (RCTs) to determine the benefit and risk of PATP in patients with nonpancreatic gastrointestinal cancers receiving chemotherapy. RCTs with venous thromboembolism (VTE) reduction as primary or secondary endpoints were included. A total of 1932 patients from subgroups of 3 RCTs were eligible. The VTE incidence was 1.26% and 2.55% in PATP and control arms, respectively (risk ratio 0.49; confidence interval 0.25 to 0.96; P = 0.04), with a number needed to treat of 78 to prevent one VTE event. In gastric and gastroesophageal junction cancer patients, the VTE incidence was 1.37% and 3.40% in PATP and control arms, respectively (risk ratio 0.40; confidence interval 0.13 to 1.24; P = 0.11). PATP should not be recommended in patients with nonpancreatic gastrointestinal cancers on chemotherapy.

Keywords: Ambulatory thromboprophylaxis; colorectal cancer; gastric cancer; gastroesophageal junctional cancer; meta-analysis; venous thromboembolism.