Cancer Clinical Trial
Official title:
FIIT Project - Biomarkers of Thrombosis as Predictors of Venous Thromboembolism Risk in Cancer Patients
The main venous thromboembolism (VTE) risk prediction model for ambulatory cancer patients is
Khorana. Cancer thrombosis is associated with elevated thrombin generation. Its
quantification is a promising method for evaluating patient's thrombotic profile.
This study aims to develop a predictive model of VTE risk in ambulatory cancer patients,
combining thrombosis biomarkers (D-dimers and thrombin generation potential) with the Khorana
score.
This is a prospective observational study that includes newly diagnosed cancer patients
proposed for anti-tumor treatment (chemotherapy, immunotherapy or targeted therapies).
Patients with disease progression are allowed if chemotherapy-free for 3 months. A 6-month
mean incidence of VTE 6-10% is expected, requiring a sample size of 600 patients. Blood
sample is collected at inclusion to analyze thrombosis biomarkers and blood count. The
primary endpoint is the occurrence of symptomatic or incidental VTE within 6 months of
inclusion. Models will follow a logistic approach with K-fold cross-validation (k=10). Model
quality will be assessed with Akaike Information Criterion (AIC) and Bayesian Information
Criterion (BIC). Decision for entering predictors in multivariate models will be based on p
<.10 in the univariate analysis.
The main aims will be the following:
- Evaluate the utility of the combination of thrombosis biomarkers (D-dimers and thrombin
generation potential) with the Khorana score in order to stratify VTE risk in ambulatory
cancer patients;
- Determine the potential of this new score in the stratification of cancer patients into
high- and low-risk VTE groups, in order to identify patients who would benefit from
primary thromboprophylaxis;
- Determine the applicability of the thrombin generation test as an independent factor in
the stratification of VTE risk in the cancer population under study;
- Determine the predictive value of D-dimers in the cancer population under study (high
versus low risk discrimination).
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