title: PO-53 - Prospective evaluation of risk assessment models and biological markers of hypercoagulability for the identification of high VTE risk patients with lung adenocarcinoma. The ROADMAP study.
abstract: BACKGROUND
  In patients with lung adenocarcinoma (LA), metastasis (MTS), advanced stage and chemotherapy (CTx) are risk factors for thromboembolism (VTE). Routine thromboprophylaxis is not recommended but individualized risk assessment is encouraged.
  
  
  OBJECTIVE
  The selection of the most relevant hypercoagulability biomarkers (HB) for incorporation into the risk assessment models (RAM) for VTE.
  
  
  METHODS
  Patients with documented LA eligible for CTx at distance of at least 3months from surgery or hospitalization were included. They were either CTx naive (NG) or had received CTx (OTG). Control group (CG) consisted of 30 healthy age & sex-matched individuals. We assessed them for thrombin generation (TG), P-Selectin, heparanase (HPA), procoagulant phospholipids (PPL), factor VIIa, D-Dimers (DDi) and Tissue Factor activity (TFa).
  
  
  RESULTS
  Patients showed significantly shortened PPL and higher levels of TFa, DDi and HPA as compared to the CG. FVIIa levels were lower in patients compared to CG. The NG showed significantly shorter lag-time and lower ETP as compared to the OTG. It also showed significantly higher levels of HPA as compared to the OTG.The increase of TG and of HPA, P-Selectin, FVIIa was associated with the stage. Patients with MTS had higher levels of P-Selectin, TFa, DDi, FVIIa, TGT and HPA than those with localized or advanced disease.Patients with VTE had higher baseline levels of DDi, TGT, shorter PPL and lower levels of HPA as compared to those without. Patients who died within 3-months had higher baseline levels of DDi and lower HPA levels as compared to those who were alive.
  
  
  CONCLUSIONS
  Increased PPL, TF pathway up regulation, DDi and HPA increase is a universal phenomenon in LA. CTx has an impact on TGT and HPA levels. Baseline values of TGT, PPL, HPA, DDi were related with mortality and thrombosis. The incorporation of HB in VTE-RAMs might improve their predictive value. This concept is being studied on an ongoing trial.
authors.affiliation: Oncology Unit GPP, 3(rd) Department of Medicine, Athens School of Medicine, Athens, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Boura
authors.affiliation: Faculté de Médecine Pierre et Marie Curie, University Paris VI; Service d'Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique Hôpitaux de Paris; France.
authors.forename: I
authors.initials: I
authors.lastname: Evmorfiadis
authors.affiliation: Faculté de Médecine Pierre et Marie Curie, University Paris VI.
authors.forename: A
authors.initials: A
authors.lastname: Rousseau
authors.affiliation: Oncology Unit GPP, 3(rd) Department of Medicine, Athens School of Medicine, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Charpidou
authors.affiliation: Oncology Unit GPP, 3(rd) Department of Medicine, Athens School of Medicine, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Giozos
authors.affiliation: Research and Development, Diagnostica Stago, Gennevilliers, France.
authors.forename: P
authors.initials: P
authors.lastname: Van Dreden
authors.affiliation: Oncology Unit GPP, 3(rd) Department of Medicine, Athens School of Medicine, Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Syrigos
authors.affiliation: Faculté de Médecine Pierre et Marie Curie, University Paris VI.
authors.forename: A
authors.initials: A
authors.lastname: Larsen
authors.affiliation: Faculté de Médecine Pierre et Marie Curie, University Paris VI; Service d'Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique Hôpitaux de Paris; France.
authors.forename: I
authors.initials: I
authors.lastname: Elalamy
authors.affiliation: Faculté de Médecine Pierre et Marie Curie, University Paris VI; Service d'Hématologie Biologique Hôpital Tenon, Hôpitaux Universitaires Est Parisien, Assistance Publique Hôpitaux de Paris; France.
authors.forename: G T
authors.initials: GT
authors.lastname: Gerotziafas