EMERGING data highlights a critical complication for patients with metastatic lung cancer undergoing treatment with immune checkpoint inhibitors (ICIs), including PD-1 and PD-L1 blockers. A new study of over 10,000 patients has uncovered a heightened risk of thromboembolic events (TEE) like deep vein thrombosis (DVT), pulmonary embolism (PE), and myocardial infarction (MI) among those treated with ICIs.
Researchers analyzed data from the TriNetX Research Network, focusing on adult patients with metastatic lung cancer diagnosed between 2014 and 2023. They compared patients treated with PD-1 inhibitors (cemiplimab, nivolumab, pembrolizumab) or PD-L1 inhibitors (atezolizumab, durvalumab) to those who did not receive these therapies. The results showed that DVT occurred in 20% of ICI recipients versus 13.1% of non-recipients, and PE incidence was increased (17.7% vs. 10.8%).
Propensity score-matching showed a persistent increase in risk for PE (17% vs. 14.6%, p=0.033). PD-1 inhibitors posed an elevated risk for PE, with a 20.3% incidence compared to 14.3% for PD-L1 inhibitors (p=0.018). While the risks for MI and cerebrovascular accidents (CVA) were not statistically significant after matching, clinicians should remain vigilant for these complications.
Clinical Takeaway: Patients with metastatic lung cancer treated with ICIs face a higher risk of venous thromboembolism. Monitoring for signs of thrombosis to mitigate adverse outcomes is recommended.
Reference: Fowler C et al. Thromboembolic risk among immune checkpoint inhibitor recipients with metastatic lung cancer. Chest. 2024;166(4): A4269-A4270.
Anaya Malik | AMJ
