Contemporary Oncology
eISSN: 1897-4309
ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
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4/2025
vol. 29
 
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abstract:
Original paper

Cancer-associated thromboses in non-small cell lung cancer patients with epidermal growth factor receptor mutation

Yosuke Maezawa
1
,
Manato Taguchi
2, 3
,
Takeshi Kawakami
2, 3
,
Toshihide Inui
3, 4
,
Takeshi Numata
5
,
Toshihiro Shiozawa
3
,
Kunihiko Miyazaki
6
,
Ryota Nakamura
5
,
Takeo Endo
5
,
Tohru Sakamoto
4
,
Hiroaki Satoh
1
,
Nobuyuki Hizawa
3

  1. Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Japan
  2. Division of Respiratory Medicine, Kobari General Hospital, Noda, Japan
  3. Division of Respiratory Medicine, Faculty of Medicine, University of Tsukuba,Tsukuba, Japan
  4. Division of Respiratory Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan
  5. Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan
  6. Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
Contemp Oncol (Pozn) 2025; 29 (4): 347–353
DOI: https://doi.org/10.5114/wo.2025.155693
Online publish date: 2025/10/30
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Introduction
The purposes of this study were to clarify whether non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) gene mutation have a higher incidence of cancer-associated venous and arterial thrombosis/thromboses (CATs) than EGFR-negative patients, and whether patients who develop CATs have a significantly poorer survival.

Material and methods
The relationship between EGFR mutation and the development of CATs was evaluated retrospectively in 1,891 patients with NSCLC, including 381 who were EGFR-positive. Propensity matching and logistic regression analysis were performed.

Results
Among 1,891 patients with NSCLC, 37 patients (2.0%) developed CATs. After propensity matching, the incidence of CATs was 3.9% in EGFR-positive patients and 0.9% in EGFR-negative patients (p = 0.011). Therefore, the risk of developing CATs was higher in EGFR-positive than EGFR-negative patients. In EGFR-positive patients, the most common time to develop CATs was at the time of lung cancer diagnosis, but there were some patients who developed CATs during second-line treatment or later when EGFR-tyrosine kinase inhibitors were no longer effective. In advanced EGFR-positive patients, there was no significant difference in overall survival depending on the presence or absence of CATs, but the development of CATs impaired the long survival expected in EGFR-positive patients.

Conclusions
EGFR-positive patients are currently treated with tyrosine kinase inhibitors and are expected to have a certain long-term prognosis. However, there is concern that overall survival might be shortened if CATs develop. Therefore, the possibility of developing CATs in EGFR-positive NSCLC patients must be addressed.

keywords:

cancer-associated ischemic stroke, non-small cell lung cancer, epidermal growth factor receptor, tyrosine kinase inhibitor, propensity matching
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