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Soo Park, MD
Soo Park, MD
Posted: Tuesday, February 11, 2025
New work published in the European Journal of Cancer offers support for the potential of concomitant antithrombotic therapies to enhance the effectiveness of immune checkpoint inhibition in advanced melanoma. Christoffer Gebhardt, MBChB, MD, of the University Medical Center Hamburg-Eppendorf, Germany, and colleagues pointed out that although previous preclinical studies had indicated benefit, the data from earlier clinical work had been inconsistent. The researchers advocate strongly for further studies to confirm the benefits of adding anticoagulation or platelet inhibition to immune checkpoint inhibition in this patient population.
The study included 2,419 patients with nonresectable disease who were part of ADOReg, the German prospective multicenter skin cancer registry. The team found that largely, compared with those who received no antithrombotic medication at any point during immune checkpoint inhibition, patients who did receive such drugs had a significant benefit in terms of both progression-free and overall survival.
Of 2,419 individuals, 2,097 received no antithrombotic agents. A total of 137 patients received platelet aggregation inhibition (either acetylsalicylic acid or clopidogrel), and 185 of them received anticoagulation agents (either direct oral anticoagulation, phenprocoumon, or heparin).
The progression-free survival was significantly improved in patients who received acetylsalicylic acid (15.1 months vs 6.4 months; P = .0047) and in those who received any anticoagulation agent (15.1 months vs 6.4 months; P = .01). After the investigators adjusted for common risk factors in multivariate analysis, patients who received direct oral anticoagulation (P = .0170) or phenprocoumon (P = .0301) had an overall survival benefit. Dr. Gebhardt and co-investigators noted the seven patients who were treated with clopidogrel seemed to show worse rates of progression-free and overall survival, but the cohort was clearly too small for reliable analysis.
Disclosure: For full disclosures of the study authors, visit ejcancer.com.
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