Gene testing could highlight breast cancer patients at increased risk of venous thromboembolism, new research suggests.
These patients could potentially benefit from thromboprophylaxis, say the researchers, led by Dr Judith Brand at the Karolinska Institutet in Stockholm, Sweden, and colleagues.
They explain that venous thromboembolism can be a serious complication of cancer and cancer treatment. So they looked at the effects of chemotherapy and the patient’s genetics on the risk of this complication.
The team looked at figures on 4,261 women diagnosed with primary invasive breast cancer between 2001 and 2008 in Stockholm, followed for an average of nearly eight years. A total of 276 of these patients experienced venous thromboembolism.
Those given chemotherapy and patients in the highest genetic risk category were both at twice the risk of venous thromboembolism compared with other patients.
The rate over the first year in patients with both risk factors was 10%, versus 1% for those with neither. The influence of genetic risk factors increased with age.
The study was published yesterday (1 November) in Clinical Cancer Research.
Dr Brand and colleagues point out that venous thromboembolism is preventable through thromboprophylaxis with the anticoagulant drug low molecular weight heparin. But this is not normally recommended in patients undergoing chemotherapy due to side effects such as bleeding.
"Our study demonstrates that information on genetic susceptibility can be used to identify patients at high risk of developing venous thromboembolism," Dr Braund said.
"Combined with other clinical risk factors and biomarkers, these findings will guide future studies evaluating routine venous thromboembolism risk assessment in chemotherapy outpatients, and prophylaxis for those at highest risk."
Brand, J. S. et al. Chemotherapy, Genetic Susceptibility, and Risk of Venous Thromboembolism in Breast Cancer Patients. Clinical Cancer Research 1 November 2016 doi: 10.1158/1078-0432.CCR-16-1110
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