Thrombosis Rates and Genetic Thrombophilia Risk Among Patients With Advanced Germ Cell Tumors Treated With Chemotherapy.

Men with advanced germ cell tumors (GCT) treated with chemotherapy are at high risk of venous thromboembolism (VTE). Predictors of VTE may identify patients who would benefit from prophylactic anticoagulation. Men with advanced GCT (Stage IS, II, III) treated with chemotherapy were identified at 2 centers. High genomic risk was defined from a 5 single nucleotide polymorphism (SNP) germline panel. Logistic regression was used to evaluate the impact of genomic risk on VTE within 6 months of chemotherapy initiation. Orthogonal Projection to Latent Structures Discriminant Analysis (OPLS-DA) was used to build models to predict VTE based on clinical variables and an 86 SNP panel. This 123-patient cohort experienced a VTE rate of 26% with an incidence of high genomic risk of 21%. Men with high genomic risk did not have a significantly higher VTE rate (31%, 8/26) than men with low genomic risk (25%, 24/97), unadjusted OR 1.4 (95% CI 0.5-3.5, P = .54). Incorporation of clinical variables (Khorana score, N3 status and elevated LDH) resulted in adjusted OR 2.1 (95% CI 0.7-6.5, P = .18). A combined model using clinical variables and 86 SNPs performed similarly (AUC 0.77) compared to clinical variables alone (AUC 0.72). A previously established 5-SNP panel was not associated with VTE among patients with GCT receiving chemotherapy. However, multivariable models based on clinical variables alone warrant further validation to inform prophylactic anticoagulation strategies.

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Copyright © 2024. Published by Elsevier Inc.

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Disclosure LCB declares the following relationships: Consulting with Seattle Genetics and Pfizer. MR, MM, NS, JS, WS, RP, BN, TA, CL, WL, NH, AH, MH, and PEC report no conflicts of interest pertaining to this project. JP declares the following relationships: Research funding from Bristol Myer Squibb. EFB declares the following relationships: Stock/ownership with Exelixis, Becton Dickson, Gilead Sciences, Medtronic; Honoraria from Exelixis, Janssen Oncology, Novartis, Pfizer, Merck, Consulting for Johnson & Johnson; Speakers Bureau for AstraZenica and Exelixis, Research funding from Pfizer and Astellas Pharma.