The Conundrum of Cancer-Associated Thrombosis: Lesson Learned from Two Intriguing Cases and Literature Review

Author:

Laurino Simona1ORCID,Russi Sabino1ORCID,Omer Ludmila Carmen2ORCID,D’Angelo Alberto3ORCID,Bozza Giovanni4,Gallucci Giuseppina5,Falco Geppino6ORCID,Roviello Giandomenico7ORCID,Bochicchio Anna Maria8

Affiliation:

1. Laboratory of Preclinical and Translational Research, IRCCS CROB Centro di Riferimento Oncologico della Basilicata, 85028 Rionero in Vulture, Italy

2. Trial Office, IRCCS CROB Centro di Riferimento Oncologico della Basilicata, 85028 Rionero in Vulture, Italy

3. Department of Oncology, Royal United Hospital, Bath BA1 3NG, UK

4. Medical Oncology Unit, IRCCS CROB Centro di Riferimento Oncologico della Basilicata, 85028 Rionero in Vulture, Italy

5. Cardiology Unit, IRCCS CROB Centro di Riferimento Oncologico della Basilicata, 85028 Rionero in Vulture, Italy

6. Department of Biology, Università degli Studi di Napoli Federico II, 80138 Naples, Italy

7. Clinical Oncologic Unit, Careggi Hospital, University of Florence, 50121 Florence, Italy

8. Multispecialty Tumor Board, IRCCS CROB Centro di Riferimento Oncologico della Basilicata, 85028 Rionero in Vulture, Italy

Abstract

The correlation between cancer and venous thromboembolism (VTE) is solid, whereas the knowledge about cancer-related arterial thromboembolism (ATE) still needs a deeper investigation to clarify its pathogenesis. We describe two cases that represent useful hints for a comprehensive review of the thrombotic issue. A 75-year-old man with advanced rectal cancer treated with fluoropyrimidines suffered two catheter-related VTE events managed according to current guidelines. There was no indication for “extended” anticoagulant therapy for him, but during antithrombotic wash-out and fluoropyrimidines plus panitumumab regimen, he suffered a massive right coronary artery (RCA) thrombosis. Another patient with no cardiovascular (CV) risk factors and affected by advanced bladder cancer was treated with a platinum-containing regimen and suffered an acute inferior myocardial infarction 2 days after chemotherapy administration. He was successfully treated with primary Percutaneous Transluminal Coronary Angioplasty of RCA, discontinuing platinum-based therapy. Our observations raise the issue of cancer-associated thrombosis (CAT) complexity and the potential correlation between arterial and venous thrombotic events. Moreover, physicians should be aware of the thrombotic risk associated with anticancer therapies, suggesting that an appropriate prophylaxis should be considered.

Funder

Ministero della Salute

Publisher

MDPI AG

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