Thromboprophylaxis in Lung Cancer Patients with Intermediate Tinzaparin Dose: the Icalt Study

Introduction: Lung cancer (LC) is implicated in multiple pathways increasing thrombogenicity. Factors contributing to thrombotic burden are related to cancer, patient, treatment & biomarkers. LC patients have 22x higher risk of venous thromboembolism. Cancer Associated Thrombosis (CAT) can delay cancer treatment and results in increased mortality, morbidity, and burden on healthcare resources. Thromboprophylaxis during active LC treatment with adequate anti-coagulation might improve outcome. Methods: iCaLT is single centre prospective observational study to asses benefits & harms of thromboprophylaxis with tinzaparin 0.5 ml, 10.000 Anti-Xa IU, OD, used in current clinical practice. Enrolled ambulatory patients signed informed consent. Anti-Xa levels was tested. Results: Preliminary results of 60 patients, 34 ongoing: 80% males. Histology: Adenocarcinoma 52%, Small Cell 20%, Squamous 20%, and others. Thrombosis risk factors are depicted in figure, 82% of patients accumulated ≥3 risk factors. One patient experienced thrombotic event (efficacy 98.3%), 4 minor bleeding events (haemoptysis) recorded (6.7%). Anti-Xa levels were low in patients with bleeding compared to others (0.13±0.1 vs. 0.45±0.18, p=0.0103). Conclusions: CAT prophylaxis with tinzaparin intermediate dose in active LC patients is effective and safe as low anti-Xa suggest that haemoptysis could be attributed to disease. Further research is needed.