conference abstract
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Background: Cancer associated thrombosis (CAT) frequently causes morbidity and mortality. Clinical scores like the Khorana Risk Score (KRS) are used to intercept patients eligible for anticoagulant prophylaxis; new biomarkers could help make them more specific for lung cancer. Extracellular vesicle-associated tissue factor (EV-TF) is involved in CAT and cancer progression but few data about its role in lung cancer are available. Aims: To explore the role of EV-TF as a predictor of CAT and clinical outcomes (disease progression, death) in lung cancer patients. Patients and methods: In this observational, prospective study, we enrolled outpatients at first lung cancer diagnosis attending the Respiratory Unit in Pisa, Italy. Clinical data, relevant events and EV-TF levels in peripheral blood samples were collected at baseline and during follow-up. Results: 77 patients were enrolled between April 2023 and December 2024. During the observation period, 9 thrombotic events (11%) and 17 deaths (22%) occurred. Patients with metastatic disease at onset showed higher baseline levels of EV-TF than stage I-III patients. EV-TF levels were not significantly different between patients who developed any thrombotic event and those who did not (p = 0.417), but they were significantly higher if considering only the group of patients without metastases (p = 0.029). Adding EV-TF values to KRS, we achieved greater accuracy in predicting thrombotic risk (p = 0.012). Conclusions: Higher EV-TF values correlate with greater cancer extension. EV-TF values may improve CAT risk prediction in lung cancer. More data are needed to confirm these findings.