In collaboration with international partners, a study group from the Medical University of Vienna (MedUni Vienna) has developed a new model for predicting cancer-associated venous thrombosis/pulmonary embolism. This model is used to calculate the risk of such a condition, so that appropriate countermeasures can be taken. The study, which has now been published in leading journal "The Lancet Haematology", represents a further step towards personalised medicine (precision medicine).
It is well known that cancer patients have a much higher risk of developing venous thrombosis and pulmonary embolism and that these can be life-threatening complications, particularly if they go undiagnosed. On top of that, the patients' quality of life is adversely affected by the symptoms of thrombosis or pulmonary embolism and cancer treatment is often delayed. In principle, such thromboses can be prevented by anticoagulants but the risk varies greatly between different groups of patients, from 1% to more than 20%.
With this predictive model it is possible to estimate a patient's individual risk for the first six months, thereby taking a further step towards personalised medicine. Lead investigator Ingrid Pabinger says: "This model enables us to specifically identify high-risk patients, to inform them of the risk and probably protect them with anticoagulants in the future. However, this last step still requires study data, which we expect to gather later this year from international studies."
Predictive model is practical and easy to use
The new predictive model is very simple and can be used practically anywhere. It only consists of two factors, namely assignment to a cancer risk group on the basis of the primary tumour and the D-dimer laboratory parameter, which is available in every hospital and in many laboratories. Using these two parameters, it is possible to make an individual prediction for the first six months following a cancer diagnosis. Co-lead investigator Cihan Ay emphasises: "This model is very simple to use: oncologists can either use the nomogram shown in the publication or the electronic, web-based calculation tool that can be accessed via MedUni Vienna under: catscore.meduniwien.ac.at. In just a matter of seconds, this can predict the probability of a patient developing venous thrombosis or pulmonary embolism."
For 15 years now, the working group led by haemostasis and thrombosis experts Ingrid Pabinger and Cihan Ay has been conducting the Vienna Cancer and Thrombosis Study (CATS), which has already provided a lot of information about the causes and risks of venous thromboembolism, which is a common complication of cancer. Recently, the study also received funding as part of a special research programme run by the Austrian Science Fund (InThro – Inflammation and Thrombosis). http://catscore.meduniwien.ac.at/.
Service: Lancet Haematology
A clinical prediction model for cancer-associated venous thromboembolism: a development and validation study in two independent prospective cohorts. Ingrid Pabinger, Nick van Es, Georg Heinze, Florian Posch, Julia Riedl, Eva-Maria Reitter, Marcello Di Nisio, Gabriela Cesarman-Maus, Noémie Kraaijpoel, Christoph Carl Zielinski, Harry Roger Büller, Cihan Ay. Lancet Haematology July;5(7):e289-e298. doi: 10.1016/S2352-3026(18)30063-2