PO105 | IMPACT OF ECOG PERFORMANCE STATUS ON CANCER-ASSOCIATED THROMBOSIS TREATED WITH DOACS: DATA FROM A MULTICENTER COHORT STUDY
Abstract
Background. Data on safety and effectiveness of direct oral anticoagulants (DOACs) in patients with cancer-associated thrombosis (CAT) and impaired functional status is limited. We evaluated the impact of Eastern Cooperative Oncology Group (ECOG) performance status on bleeding and thrombotic events in a real-world cohort. Methods. Patients with CAT on DOACs were prospectively included in cohorts from six Italian centers and stratified by ECOG status (0–1 vs. 2-4). Primary outcomes were major bleeding (MB) and recurrent venous thromboembolism (VTE); secondary outcome was all-cause mortality. Incidence rates were calculated, and predictors of MB and VTE recurrence were assessed using Cox models within each ECOG subgroup. Results. Among 817 patients, 702 had ECOG 0–1 and 115 had ECOG 2-4. Patients with ECOG ≥2 were older, had worse renal function, and more comorbidities (Table 1). MB occurred at 10.3% vs. 2.8% patient-years (HR 2.92, 95% CI 1.43–5.94) and recurrent VTE at 7.2% vs. 3.6% patient-years (HR 2.16, 95% CI 0.96–4.86) in ECOG 2–4 compared with 0–1 patients. In ECOG 0–1, bleeding was mainly related to anticoagulant treatment, whereas in ECOG 2-4 it was predominantly associated with chronic kidney disease. All-cause mortality occurred at 78.4% patient-years in ECOG 2–4 and 10.5% patient-years in ECOG 0–1 (HR 6.28, 95% CI 4.69–8.41). Conclusions. Impaired functional status was associated to higher MB and mortality, while VTE recurrence did not differ across groups. Bleeding mechanisms differed by ECOG status, underscoring the need for individualized anticoagulation. In frail or end-of-life patients, deprescribing and shared decision-making are essential to balance benefit and harm.
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BibTeX
@article{talerico2026po105,
title = {{PO105 | IMPACT OF ECOG PERFORMANCE STATUS ON CANCER-ASSOCIATED THROMBOSIS TREATED WITH DOACS: DATA FROM A MULTICENTER COHORT STUDY}},
author = {Rosa Talerico},
journal = {Bleeding, Thrombosis and Vascular Biology},
year = {2026},
month = oct,
url = {https://www.btvb.org/btvb/article/view/921},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - PO105 | IMPACT OF ECOG PERFORMANCE STATUS ON CANCER-ASSOCIATED THROMBOSIS TREATED WITH DOACS: DATA FROM A MULTICENTER COHORT STUDY
AU - Rosa Talerico
PY - 2026
DA - 2026/10/26
JO - Bleeding, Thrombosis and Vascular Biology
UR - https://www.btvb.org/btvb/article/view/921
AB - Background. Data on safety and effectiveness of direct oral anticoagulants (DOACs) in patients with cancer-associated thrombosis (CAT) and impaired functional status is limited. We evaluated the impact of Eastern Cooperative Oncology Group (ECOG) performance status on bleeding and thrombotic events in a real-world cohort. Methods. Patients with CAT on DOACs were prospectively included in cohorts from six Italian centers and stratified by ECOG status (0–1 vs. 2-4). Primary outcomes were major bleeding (MB) and recurrent venous thromboembolism (VTE); secondary outcome was all-cause mortality. Incidence rates were calculated, and predictors of MB and VTE recurrence were assessed using Cox models within each ECOG subgroup. Results. Among 817 patients, 702 had ECOG 0–1 and 115 had ECOG 2-4. Patients with ECOG ≥2 were older, had worse renal function, and more comorbidities (Table 1). MB occurred at 10.3% vs. 2.8% patient-years (HR 2.92, 95% CI 1.43–5.94) and recurrent VTE at 7.2% vs. 3.6% patient-years (HR 2.16, 95% CI 0.96–4.86) in ECOG 2–4 compared with 0–1 patients. In ECOG 0–1, bleeding was mainly related to anticoagulant treatment, whereas in ECOG 2-4 it was predominantly associated with chronic kidney disease. All-cause mortality occurred at 78.4% patient-years in ECOG 2–4 and 10.5% patient-years in ECOG 0–1 (HR 6.28, 95% CI 4.69–8.41). Conclusions. Impaired functional status was associated to higher MB and mortality, while VTE recurrence did not differ across groups. Bleeding mechanisms differed by ECOG status, underscoring the need for individualized anticoagulation. In frail or end-of-life patients, deprescribing and shared decision-making are essential to balance benefit and harm.
SN - 2785-5309
ER -