Predicting VTE in Cancer Patients: Candidate Biomarkers and Risk Assessment Models
Abstract
:1. Introduction
2. VTE Biomarkers
2.1. D-Dimer
2.2. Soluble P-Selectin
2.3. Microparticles
2.4. Inflammatory Markers
2.5. Routine Laboratory Parameters
2.5.1. Hematological Parameters
2.5.2. Biochemical Parameters
3. Current Models for VTE Risk Prediction in Ambulatory Cancer Patients
4. Artificial Intelligence for Cancer-Associated Thrombosis Risk Assessment
5. Conclusions and Future Perspectives
Funding
Conflicts of Interest
References
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RAM | Score Items | n. of Patients | Type of VTE | c-Statistic | HR | Reference |
---|---|---|---|---|---|---|
Khorana score (KS) | Site of cancer, platelet count, leukocyte count, hemoglobin level or use of red cell growth factors, BMI ≥35 | Derivation cohort, n = 2701 | Symptomatic | 0.7 for both cohorts | NA | [22] |
Validation cohort, n = 365 | ||||||
Vienna CATS score | Adds soluble P-selectin and D-dimer to KS | n = 819 | Symptomatic | NA | 1.9 per 1 point increase | [25] |
PROTECHT score | Adds cisplatin/carboplatin-based chemotherapy or gemcitabine to KS | Placebo arm, n = 381 | Unclear | NA | NA | [27] |
Nadroparin arm, n = 769 | ||||||
ONKOTEV score | Khorana score >2, personal history of VTE, metastatic disease, vascular/lymphatic macroscopic compression | n = 843 | Symptomatic/incidental | 0.719 at 3 months 0.754 at 6 months | Score = 1: 3.29 Score = 2: 6.54 Score > 2: 13.74 | [166] |
COMPASS-CAT score | Anthracycline or anti-hormonal therapy, time since cancer diagnosis, central venous catheter, stage of cancer, presence of cardiovascular risk factors, recent hospitalization for acute medical illness, personal history of VTE and platelet count. | n = 1023 | Symptomatic | 0.850 | NA | [165] |
Tic-ONCO score | Adds genetic risk score to KS | n = 391 | Symptomatic | 0.73 | +LR = 1.69 | [167] |
CATS nomogram | Site of cancer and D-dimer | CATS cohort, n = 1423 | Symptomatic/incidental | 0.66 in CATS | NA | [168] |
MICA cohort, n = 832 | 0.68 in MICA |
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Riondino, S.; Ferroni, P.; Zanzotto, F.M.; Roselli, M.; Guadagni, F. Predicting VTE in Cancer Patients: Candidate Biomarkers and Risk Assessment Models. Cancers 2019, 11, 95. https://doi.org/10.3390/cancers11010095
Riondino S, Ferroni P, Zanzotto FM, Roselli M, Guadagni F. Predicting VTE in Cancer Patients: Candidate Biomarkers and Risk Assessment Models. Cancers. 2019; 11(1):95. https://doi.org/10.3390/cancers11010095
Chicago/Turabian StyleRiondino, Silvia, Patrizia Ferroni, Fabio Massimo Zanzotto, Mario Roselli, and Fiorella Guadagni. 2019. "Predicting VTE in Cancer Patients: Candidate Biomarkers and Risk Assessment Models" Cancers 11, no. 1: 95. https://doi.org/10.3390/cancers11010095