Evidence map›Paper›PMID 30412630›Full record

Trial reportPloS one2018

Coagulation biomarkers and prediction of venous thromboembolism and survival in small cell lung cancer: A sub-study of RASTEN - A randomized trial with low molecular weight heparin.

E Gezelius, A Flou Kristensen, P O Bendahl, Y Hisada, S Risom Kristensen, L Ek, B Bergman, M Wallberg, U Falkmer, N Mackman and 2 more

Open access · goldAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
5.8field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 1 synthesis or guideline pooled it, 52 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
  8. Article
  9. Mechanisms of cancer-associated thrombosis.Research and practice in thrombosis and haemostasis · 2023
    Article
  10. Review
  11. Article
  12. Cancer-associated venous thromboembolism.Nature reviews. Disease primers · 2022
    Review
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Article
  19. [Tissue factors and venous thromboembolism in cancer patients].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2020
    Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 3 countries.

E GezeliusDepartment of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden.
A Flou KristensenDepartment of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.
P O BendahlDepartment of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden.
Y HisadaDepartment of Medicine, Division of Hematology and Oncology, Thrombosis and Hemostasis Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, United Sttaes of America.ORCID 0000-0001-9157-0524
S Risom KristensenDepartment of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.
L EkDepartment of Respiratory Medicine, Lund University Hospital, Lund, Sweden.
B BergmanDepartment of Lung Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
M WallbergDepartment of Respiratory Medicine, Lund University Hospital, Lund, Sweden.
U FalkmerDepartment of Clinical Medicine, Aalborg University, Aalborg, Denmark.ORCID 0000-0002-9245-7678
N MackmanDepartment of Medicine, Division of Hematology and Oncology, Thrombosis and Hemostasis Program, University of North Carolina at Chapel Hill, Chapel Hill, NC, United Sttaes of America.
S PedersenDepartment of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark.ORCID 0000-0001-6636-0293
M BeltingDepartment of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden.ORCID 0000-0003-1585-5434
Lund University · SEAalborg University Hospital · DKUniversity of North Carolina at Chapel Hill · USSahlgrenska University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Coagulation activation and venous thromboembolism (VTE) are hallmarks of cancer; however, there is an unmet need of improved biomarkers for individualized anticoagulant treatment. The present sub-study of the RASTEN trial was designed to explore the role of coagulation biomarkers in predicting VTE risk and outcome in a homogenous cancer patient population. RASTEN is a multicenter, randomized phase-3 trial investigating the survival effect of low molecular weight heparin enoxaparin when added to standard treatment in newly diagnosed small cell lung cancer (SCLC) patients. Plasma collected at baseline, during treatment, and at follow-up was used in this ad hoc sub-study (N = 242). Systemic coagulation was assessed using four assays reflecting various facets of the coagulation system: Total tissue factor (TF); extracellular vesicle associated TF (EV-TF); procoagulant phospholipids (PPL); and thrombin generation (TG). We found small variations of biomarker levels between baseline, during treatment and at follow-up, and appeared independent on low molecular weight heparin treatment. Overall, none of the measured biomarkers at any time-point did significantly associate with VTE incidence, although increased total TF at baseline showed significant association in control patients not receiving low molecular weight heparin (P = 0.03). Increased TG-Peak was significantly associated with decreased overall survival (OS; P = 0.03), especially in patients with extensive disease. Low baseline EV-TF predicted a worse survival in the low molecular weight heparin as compared with the control group (HR 1.42; 95% CI 1.04-1.95; P = 0.03; P for interaction = 0.12). We conclude that the value of the analyzed coagulation biomarkers for the prediction of VTE risk was very limited in SCLC patients. The associations between TG-Peak and EV-TF with patient survival and response to low molecular weight heparin therapy, respectively, warrant further studies on the role of coagulation activation in SCLC aggressiveness.

Indexed as

Lung NeoplasmsSmall Cell Lung CarcinomaVenous ThromboembolismAgedBiomarkers, TumorDisease-Free SurvivalExtracellular VesiclesFemaleHeparin, Low-Molecular-WeightHumansIncidenceMaleMiddle AgedPhospholipidsSurvival RateThromboplastinBiomarkers, TumorHeparin, Low-Molecular-WeightPhospholipidsThromboplastin

Identifiers

PMID30412630
PMCPMC6226210
OpenAlexW2900261005

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.