Hypercoagulable state (thrombophilia)

Carboplatin & Paclitaxel (CP)

CP: Carboplatin & Paclitaxel

Regimen

Study	Dates of enrollment	Evidence	Comparator	Comparative Efficacy
Forde et al. 2022 (CheckMate 816)	2017-2019	Phase 3 (C)	1a. CP & Nivolumab 1b. CVb & Nivolumab 1c. DC & Nivolumab	Inferior EFS

Note: there were additional comparator options depending on histology; see the respective histology-specific pages for more details. This study was conducted in the United States. The reason for the study was that an unanswered question at the time was whether adding an immune checkpoint inhibitor would improve outcomes.

Biomarker eligibility criteria

• CheckMate 816: No sensitizing EGFR or ALK mutations

Chemotherapy

• Carboplatin (Paraplatin) AUC 5 or 6 IV once on day 1
• Paclitaxel (Taxol) 175 or 200 mg/m² IV once on day 1

21-day cycle for 3 cycles

Subsequent treatment

• Complete resection

References

1. CheckMate 816: Forde PM, Spicer J, Lu S, Provencio M, Mitsudomi T, Awad MM, Felip E, Broderick SR, Brahmer JR, Swanson SJ, Kerr K, Wang C, Ciuleanu TE, Saylors GB, Tanaka F, Ito H, Chen KN, Liberman M, Vokes EE, Taube JM, Dorange C, Cai J, Fiore J, Jarkowski A, Balli D, Sausen M, Pandya D, Calvet CY, Girard N; CheckMate 816 Investigators. Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer. N Engl J Med. 2022 May 26;386(21):1973-1985. Epub 2022 Apr 11. link to original article contains dosing details in manuscript PubMed NCT02998528

Start of hidden/commented information for virtual editor End of hidden/commented information for virtual editor

Start of comment inserted by visual editor(edited again by visual editor)

(edited again by visual editor end)End of comment inserted by visual editor
Use of this site is subject to you reading and agreeing with the terms set forth in the disclaimer. If this is your first time visiting, we suggest you read the tutorial.

Inherited thrombophilias

• Prothrombin gene mutation (G20210A)
• Factor V Leiden mutation
• Antithrombin III deficiency
• Protein C deficiency
• Protein S deficiency
• Dysfibrinogenemia

Controversial:

• Plasminogen deficiency
• Factor XII deficiency

Acquired thrombophilias and clotting risk factors

• Surgery, foreign bodies such as venous catheters, smoking, obesity, elevated factor VIII, advanced age, male sex, trauma, sedentary state, immobilization, malignancy, myeloproliferative disorders-- polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF), pregnancy, medications--e.g. Bevacizumab (Avastin), Lenalidomide (Revlimid), Thalidomide (Thalomid), Tamoxifen (Nolvadex), oral contraceptive use, heparin--in the case of heparin-induced thrombocytopenia/thrombosis (HIT), congestive heart failure, anatomic/low cardiovascular flow states--e.g. inferior vena cava (IVC) abnormalities, chronic inflammation, inflammatory bowel disease, nephrotic syndrome, paroxysmal noctural hemoglobinuria (PNH)
• Prior venous thromboembolism (VTE)
• Antiphospholipid antibody syndrome (APS)
  • Lupus anticoagulant: dilute Russell viper venom time (dRVVT), dilute activated partial thromboplastin time (dAPTT), Staclot LA (hexagonal phase phospholipids), Kaolin clotting time (KCT)
  • Anticardiolipin (aCL) antibody IgG, IgM, IgA
  • Beta 2 glycoprotein 1 (B2GP1) IgG, IgM, IgA
  • Sapporo criteria for APS