PB0930 - Cancer associated thrombosis on bevacizumab: risk of recurrence and bleeding if bevacizumab is stopped or continued

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

MM

Marie Mayenga, MD

chief resident
Hôpital Foch
Suresnes, Ile-de-France, France
NF

Nicolas Falvo

Oncologist
CHU de Dijon-Bourgogne
Dijon, Bourgogne, France
IM

Isabelle MAHE

MD,PhD
Paris Cité University, APHP, Hôpital Louis Mourier, Colombes, Internal Medicine Department, INSERM UMR_S1140, and F-CRIN InnoVTE, France
Colombes, Ile-de-France, France
AJ

Anne-Sophie JANNOT

Assistant Professor
AP-HP
Paris, Ile-de-France, France
BG

Benoît Gazeau

Hospital Practitioner
APHP
paris, Ile-de-France, France
GM

Guy Meyer

University Professor - Hospital Practitioner
Hôpital Européen Georges Pompidou
Paris, Ile-de-France, France
OS

Olivier Sanchez

MD, PhD
Georges Pompidou European Hospital, Paris, France
Paris, Ile-de-France, France

Presenting Author(s)

BP

Benjamin Planquette

Physician MD
APHP
Paris, Ile-de-France, France

Background: Cancer associated thrombosis (CAT) is a common complication of cancer and its management is complicated by an increased risk of recurrence and bleeding in these patients. Bevacizumab is an effective anti-angiogenic therapy but increases the risk of bleeding and potentially the risk of CAT.

Aims: The objective of this study was to evaluate the efficacy and tolerance of anticoagulant therapy in the treatment of CAT occurring on bevacizumab, according to the continuation or discontinuation of bevacizumab.

Methods: This was a retrospective multicenter study. Patients with anticoagulated deep vein thrombosis or pulmonary embolism occurring on bevacizumab between June 2000 and December 2020 were included. The primary end point combined the occurrence of thromboembolic recurrence and the occurrence of clinically significant major or non-major bleeding during the entire follow-up period. Secondary end points were recurrence of thromboembolic events, occurrence of bleeding, occurrence of major bleeding, and overall survival.

Results: Of the 162 patients included, bevacizumab was stopped in 70 patients (stop group) and continued in 92 patients (continuation group). During follow-up, 30% of patients experienced CAT recurrence or major or non-major bleeding in the stop group and 29% in the continuation group. Analysis of survival to first event showed no significant difference between the two groups (p=0.19). The same result was found in the multivariate analysis and taking into account the time of exposure to bevacizumab. There was no difference between the groups in recurrence, bleeding, major bleeding, or overall survival.

Conclusion(s): This study suggests the efficacy and safety of anticoagulant therapy with bevacizumab. However, a larger non-inferiority study would be needed to confirm this result.