Plasma tissue factor activity in lung cancer patients predicts venous thromboembolism and poor overall survival

Helene Doubre; Isabelle Monnet; Reza Azarian; Philippe Girard; Guy Meyer; Julie Trichereau; Philippe Devillier; Patrick Van Dreden; Louis-Jean Couderc; Christos Chouaid; Marc Vasse

doi:10.1016/j.rpth.2024.102359

Plasma tissue factor activity in lung cancer patients predicts venous thromboembolism and poor overall survival

Res Pract Thromb Haemost. 2024 Mar 1;8(2):102359. doi: 10.1016/j.rpth.2024.102359. eCollection 2024 Feb.

Authors

Affiliations

¹ Service de Pneumologie, Hôpital Foch, Suresnes, France.
² Service de Pneumologie, Centre Hospitalier Intercommunal, Creteil, France.
³ Service de Pneumologie, Centre Hospitalier Versailles, Le Chesnay, France.
⁴ Département de pneumologie, Institut du Thorax Curie-Montsouris, Institut Mutualiste Montsouris, Paris, France.
⁵ Service de Pneumologie, Assistance Publique-Hôpitaux de Paris, Paris, France.
⁶ Direction Recherche Clinique et Innovation, Hôpital Foch, Suresnes, France.
⁷ VIM Suresnes, UMR 0892, Pôle des Maladies Respiratoires, Hopital Foch, Université Paris Saclay, Suresnes, France.
⁸ Clinical Research Department, Diagnostica Stago, Gennevilliers, France.
⁹ Biology Department, Hôpital Foch, Suresnes, France.
¹⁰ UMRS-1176, Le Kremlin-Bicêtre, France.

Abstract

Background: Biomarkers to identify lung cancer (LC) patients with high risk of venous thromboembolism (VTE) are needed.

Objectives: To evaluate the usefulness of plasma tissue factor activity (TFA) and D-dimer levels for the prediction of VTE and overall survival in patients with LC.

Methods: In a prospective multicenter observational cohort of consecutive LC patients, TFA and D-dimer levels were measured at diagnosis before any cancer treatment (V1) and between 8 and 12 weeks after diagnosis (V2).

Results: Among 302 patients, 38 (12.6%) experienced VTE within the first year after diagnosis. V1-TFA and V1-D-dimer levels were significantly (P = .02) higher in patients who presented VTE within 3 months than in patients without VTE: V1-TFA was 2.02 (25th-75th percentiles, 0.20-4.01) vs 0.49 (0.20-3.09) ng/mL and V1-D-dimer was 1.42 (0.64-4.40) vs 0.69 (0.39-1.53) μg/mL, respectively. Cutoffs of 1.92 ng/mL for TFA and 1.26 μg/mL for D-dimer could discriminate both groups of patients. In multivariate analysis, V1-TFA > 1.92 ng/mL was the only significant predictor of VTE risk at 1 year (hazard ratio, 2.10; 95% CI, 1.06-4.16; P = .03). V2-TFA, quantified in 251 patients, decreased significantly compared with V1-TFA (0.20 vs 0.56 ng/mL, P < .05), but a V2-TFA level > 0.77 ng/mL could predict VTE in the following 3 months. Median overall survival was worse for patients with V1-TFA > 1.92 ng/mL (14.6 vs 23.8 months) and V1-D-dimer > 1.26 μg/mL (13.8 vs 24 months, P < .001).

Conclusion: High plasma TFA levels are associated with the occurrence of VTE within the next 3 months after each visit (V1 or V2) and poor survival.

Keywords: D-dimer; lung neoplasms; survival; thromboplastin; venous thromboembolism.