Brief report: High incidence of peridiagnosis thromboembolic events in patients with BRAF-mutant lung cancer

INTRODUCTION

We aimed to determine if advanced BRAF-mutant NSCLC has a higher thromboembolic events (TEE) rate than the expected.

METHODS

Between 2008 and 2021, 182 patients with BRAF-mutant advanced NSCLC (BRAF V600E, n = 70; BRAF non-V600E, n = 112) were retrospectively identified from 18 centers in Spain. Patients received chemotherapy (n = 147), immunotherapy (n = 69), targeted therapy (n = 42), and immunotherapy + chemotherapy (n = 26).

RESULTS

Incidence rate of TEE was 26.4 % (95%CI: 19.9 %-32.9 %). A total of 72 TEE were documented among 48 patients, as 18 patients (37.5 %) developed more than one event. Median time to TEE onset was 2 months, 69 % of TEE occurred in the peridiagnostic period (+/- 90 days from cancer diagnosis), and in 16 pts. (33 %) TEE was the form of lung cancer presentation. Although most TEE were only venous (82 %; PE, n = 33; DVT, n = 16), arterial events were reported in 31 % and occurred earlier, or TEE presented in atypical locations (13.9 %). TEE were related to high hospitalization rate (59 %), recurrence (23 %), and mortality (10.4 %) despite appropriate anticoagulant/antiaggregant treatment. Median OS in patients without-TEE was 19.4 months (95%CI: 4.6-34.1), and significantly shorter in patients with arterial-TEE vs venous-TEE vs both of them: 9.9 months (95%CI: 0-23.5) vs 41.7 months (95%CI: 11.3-72.2 m) vs 2.7 months (95%CI: 2.1-3.3), p = 0.001. Neither clinical or molecular features (BRAF V600E/non-V600E), nor cancer treatment was associated to TEE occurrence. Khorana score underperformed to predict thrombosis at cancer diagnosis, as only 19.2 % of patients were classified as high-risk.

CONCLUSIONS

Thrombotic events represent a new clinical feature of BRAF-mutant lung cancer. Patients with almost a 30 % incidence of TEE should be offered systematic anticoagulation.

[Change in prevalence of physical and sports activities in a cohort of students]

BACKGROUND

Sedentary lifestyle is one of the worldwide problems of Public Health. Given that, physical activity has both direct and indirect effects on the mortality and morbidity on non-communicable chronic diseases. The aim was to determine the change in prevalence of sedentary lifestyle in a cohort of students.

METHODS

The Universidad Nacional Autónoma de México makes an Automated Medical Examination to students. In this evaluation, the sport, physical activity and other risk factors were analyzed in students admitted in 2010 to the Faculty of Medicine that were previously analyzed in 2007.

RESULTS

A total of 593 students were studied. The mean age was 15.1 ± 1.4 years. The prevalence of physical inactivity increased from 38.3 to 39.9 %. When stratified by gender, women were more sedentary (p < 0.05). Sports activities decreased significantly in frequency and time. In the sedentary population, the prevalence of overweight increased in men and the obesity in women. Smoking increased 4.9 % and alcohol consumption in 36.7 % in both sexes.

CONCLUSIONS

The prevalence of physical inactivity was higher compared to other countries. Smoking and alcohol consumption increased so it is necessary to follow up and implement programs of health promotion.