ArticleJournal of thrombosis and haemostasis : JTH2026
Bleeding in patients with lung adenocarcinoma receiving concurrent administration of anticoagulation and vascular endothelial growth factor or epidermal growth factor receptor inhibitors.
Article in Journal of thrombosis and haemostasis : JTH, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundVascular endothelial growth factor (VEGF) inhibitors and epidermal growth factor receptor (EGFR) inhibitors are used to treat various cancers, including lung adenocarcinoma, but their associated bleeding risks when combined with anticoagulation therapy are largely unknown.
objectivesWe sought to determine whether coadministration of VEGF inhibitors or EGFR inhibitors with anticoagulation therapy in patients with lung adenocarcinoma is associated with higher clinically relevant bleeding risks than in patients receiving anticoagulation therapy with systemic therapy alone. PATIENTS/
methodsWe conducted a single-center retrospective cohort study of patients treated for lung adenocarcinoma with therapeutic anticoagulation and concurrent systemic cancer therapy alone, VEGF inhibitors ± systemic therapy, or EGFR inhibitors ± systemic therapy. The index was the first day of concomitant anticoagulation and cancer treatment. Patients were followed for 12 months, and major bleeding and clinically relevant nonmajor bleeding (CRNMB) outcomes were collected using an internally validated natural language processing tool.
resultsA total of 464 patients were included, comprising 156 (34%) systemic therapy alone, 208 (45%) EGFR inhibitors, and 100 (22%) VEGF inhibitors. The 12-month cumulative incidence of major bleeding was statistically similar in the 3 cohorts: VEGF inhibitor (10%; 95% CI, 3.4%-22%), EGFR inhibitor (11%; 95% CI, 6.5%-17%), and systemic therapy cohort (9.3%; 95% CI, 4.1%-17%). We observed statistically similar risks of CRNMB with VEGF inhibitors (hazard ratio, 1.51; 95% CI, 0.71-3.20) and EGFR inhibitors (hazard ratio, 1.35; 95% CI, 0.65-2.80) versus systemic therapy alone. Epistaxis was the most common site, accounting for 25% of clinically relevant events.
conclusionsConcomitant administration of VEGF inhibitors and anticoagulation therapy was not associated with statistically significant increased risks of major bleeding or CRNMB.
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