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Global Translational Medicine Thromboembolism risk in non-small-cell lung cancer

3 times in cancer patients . In particular, pneumonectomy 2. Materials and methods
[6]
has been associated with a higher risk of VTE than
lobectomy for stage I and II lung cancer . 2.1. Study population
[7]
In comparison to other tumor types, lung cancer has This retrospective observational study was designed to
been associated with a moderate risk of VTE, particularly investigate the relationship between EGFR and ALK gene
mutations and the occurrence of VTE in patients with lung
during the 1 year following cancer diagnosis. The adenocarcinoma (LA). The study included patients older than
st
prevalence of VTE in lung cancer patients has been 18 years who had received a histologically confirmed diagnosis
reported to range between 7% and 15% . Factors such of either locally advanced or advanced-stage adenocarcinoma
[3]
as longer life expectancy, advanced age at the time and followed in our center between January 2014 and
of cancer diagnosis, and utilization of thrombogenic
anti-cancer agents have increased the incidence of VTE in December 2019. Tumor tissue DNA analysis for gene
mutations was conducted at the time of study entry.
cancer patients . Although patients diagnosed with lung
[4]
cancer are also predisposed to arterial thromboembolism The following inclusion criteria were defined as follows:
(ATE), the effect of lung cancer on ATE development is less (i) Patients with a confirmed pathological diagnosis of
pronounced than its effect on VTE development . adenocarcinoma, (ii) patients who underwent mutation
[8]
analysis, and (iii) patients with available data regarding
Research has indicated that certain laboratory occurrences of VTE. Exclusions encompassed patients
parameters can predict an elevated risk of cancer- with ROS1 gene mutations, patients with a confirmed
related thrombosis. However, the identification of a pathological diagnosis of small-cell lung cancer, patients
standardized biomarker specific to lung cancer is still who had undergone surgical intervention, patients receiving
underway. Therefore, there is a growing need to uncover anticoagulant therapy, patients with a diagnosis of chronic
biomarkers that can effectively identify individuals at risk embolism, and patients in the early stages of the disease.
for developing thromboembolism and determine suitable
candidates for thromboprophylaxis. The patients were divided into two groups: those with
gene mutations (mutation [+]) and those without mutation
Lately, significant advancements have been introduced (mutation [-]). The mutation (+) group comprised patients
in the treatment approaches for advanced non-small-cell with EGFR and ALK gene mutations. This study sought to
lung carcinoma (NSCLC). Guidelines now recommend the analyze the incidence of VTE within these groups, discern
thorough investigation of targetable driver gene mutations factors affecting the occurrence of VTE, and compare the
in all patients with advanced NSCLC . At present, lung OS between the mutation (+) and mutation (-) groups.
[9]
cancer patients are categorized based on tumor histological
characteristics and the presence of epidermal growth 2.2. Data collection
factor receptor (EGFR) mutations or anaplastic lymphoma The demographic and clinical data of the patients (age, gender,
kinase (EML4-ALK) translocations such as echinoderm tumor histopathology, clinical stage, number of metastases, and
microtubule-associated protein 4 . the administration of active cancer therapy within the 4 weeks
[9]
Studies have indicated a lack of association between leading up to the diagnosis of VTE), laboratory parameters at
increased risk of VTE and EGFR mutations in patients with the time of VTE onset, and the presence of documented VTE
NSCLC [10,11] . Interestingly, Zer et al. demonstrated that the were recorded. Clinical staging was determined in accordance
th
[17]
incidence of VTE was 3 – 5 times greater in cohorts with with TNM classification (8 edition) .
anaplastic lymphoma kinase (ALK) gene mutations than in
the previously reported NSCLC population . Dou et al.’s 2.3. Laboratory methods
[12]
study, further, corroborated these findings, establishing All tumor molecular tests were conducted by a pathologist
a correlation between the increased VTE risk in NSCLC at regional laboratories.
patients and the presence of ALK gene mutation . Given Tumor biopsy specimens were processed as formalin-
[13]
the heightened VTE risk in cancer patients, the new fixed and paraffin-embedded samples for histological
thromboprophylactic agents have garnered increasing examination and mutation analysis. EGRF mutation
importance [14-16] . analysis (covering exons 18, 19, 20, and 21) was performed
Our study aimed to elucidate the difference in VTE using real-time PCR. ALK rearrangement and ROS1
occurrence between lung cancer patients with EGFR rearrangement were investigated using the FISH method,
mutations, those with ALK mutations, and patients without utilizing the BX51 Olympus fluorescence microscope. For
these mutations. In addition, we evaluated the effect of ALK and ROS1 results to be considered positive, a minimum
VTE on overall survival (OS) within this patient cohort. of 50 scoreable tumor cells in 4 – 5 μm thick tissue sections

Volume 2 Issue 3 (2023) 2 https://doi.org/10.36922/gtm.1027