Outpatient management of cancer-associated pulmonary embolism: A post-hoc analysis from the HOME-PE trial
Abstract
Introduction: Cancer-related pulmonary embolism (PE) is associated with poor prognosis. Some decision rules identifying patients eligible for home treatment categorize cancer patients at high risk of complications, precluding home treatment. We sought to assess the effectiveness and the safety of outpatient management of patients with low-risk cancer-associated PE.
Methods:In the HOME-PE trial, hemodynamically stable patients with symptomatic PE were randomized to either triaging with Hestia criteria or sPESI score. We analyzed 3 groups of lowrisk PE patients: 47 with active cancer treated at home (group 1), 691 without active cancer treated at home (group 2), and 33 with active cancer as the only sPESI criterion qualifying them for hospitalization (group 3). The main outcome was the composite of recurrent venous thromboembolism, major bleeding, and all-cause death within 30 days after randomization.
Results: Patients treated at home had composite outcome rates of 4.3% (2/47) for those with cancer vs. 1.0% (7/691) for those without (odds ratio (OR) 4.98, 95%CI 1.15-21.49). Patients with cancer had rates of complications of 4.3% when treated at home vs. 3.0% (1/33) when hospitalized (OR 1.19, 95%CI 0.15-9.47). In multivariable analysis, active cancer was associated with an increased risk of complications for patients treated at home (OR 7.95; 95%CI 1.48-42.82). For patients with active cancer, home treatment was not associated with the primary outcome (OR 1.19, 95%CI 0.15-9.74).
Conclusions: Among patients treated at home, active cancer was a risk factor for complications, but among patients with active cancer, home treatment was not associated with adverse outcomes.
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BibTeX
@article{chaibi2026outpatient,
title = {{Outpatient management of cancer-associated pulmonary embolism: A post-hoc analysis from the HOME-PE trial}},
author = {Sérine Chaibi and Pierre-Marie Roy and Armelle Arnoux Guénégou and Yohann Tran and Olivier Hugli and Andréa Penaloza and Francis Couturaud and Cécile Tromeur and Tali-Anne Szwebel and Gilles Pernod and Antoine Elias and Alexandre Ghuysen and Ygal Benhamou and Nicolas Falvo and Henry Juchet and Mathilde Nijkeuter and Ronne Mairuhu and Laura M Faber and Isabelle Mahé and Karine Montaclair and Benjamin Planquette and David Jimenez and Menno V Huisman and Federikus A Klok and Olivier Sanchez},
journal = {Thrombosis Research},
year = {2026},
month = sep,
doi = {10.1016/j.thromres.2024.01.014},
url = {https://univ-brest.hal.science/hal-05751309v1},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Outpatient management of cancer-associated pulmonary embolism: A post-hoc analysis from the HOME-PE trial
AU - Sérine Chaibi
AU - Pierre-Marie Roy
AU - Armelle Arnoux Guénégou
AU - Yohann Tran
AU - Olivier Hugli
AU - Andréa Penaloza
AU - Francis Couturaud
AU - Cécile Tromeur
AU - Tali-Anne Szwebel
AU - Gilles Pernod
AU - Antoine Elias
AU - Alexandre Ghuysen
AU - Ygal Benhamou
AU - Nicolas Falvo
AU - Henry Juchet
AU - Mathilde Nijkeuter
AU - Ronne Mairuhu
AU - Laura M Faber
AU - Isabelle Mahé
AU - Karine Montaclair
AU - Benjamin Planquette
AU - David Jimenez
AU - Menno V Huisman
AU - Federikus A Klok
AU - Olivier Sanchez
PY - 2026
DA - 2026/09/16
JO - Thrombosis Research
DO - 10.1016/j.thromres.2024.01.014
UR - https://univ-brest.hal.science/hal-05751309v1
AB - Introduction: Cancer-related pulmonary embolism (PE) is associated with poor prognosis. Some decision rules identifying patients eligible for home treatment categorize cancer patients at high risk of complications, precluding home treatment. We sought to assess the effectiveness and the safety of outpatient management of patients with low-risk cancer-associated PE. Methods:In the HOME-PE trial, hemodynamically stable patients with symptomatic PE were randomized to either triaging with Hestia criteria or sPESI score. We analyzed 3 groups of lowrisk PE patients: 47 with active cancer treated at home (group 1), 691 without active cancer treated at home (group 2), and 33 with active cancer as the only sPESI criterion qualifying them for hospitalization (group 3). The main outcome was the composite of recurrent venous thromboembolism, major bleeding, and all-cause death within 30 days after randomization. Results: Patients treated at home had composite outcome rates of 4.3% (2/47) for those with cancer vs. 1.0% (7/691) for those without (odds ratio (OR) 4.98, 95%CI 1.15-21.49). Patients with cancer had rates of complications of 4.3% when treated at home vs. 3.0% (1/33) when hospitalized (OR 1.19, 95%CI 0.15-9.47). In multivariable analysis, active cancer was associated with an increased risk of complications for patients treated at home (OR 7.95; 95%CI 1.48-42.82). For patients with active cancer, home treatment was not associated with the primary outcome (OR 1.19, 95%CI 0.15-9.74). Conclusions: Among patients treated at home, active cancer was a risk factor for complications, but among patients with active cancer, home treatment was not associated with adverse outcomes.
SN - 0049-3848
SN - 1879-2472
ER -