Risk Assessment Models for Venous Thromboembolism in Cancer Patients Show Limited Discriminatory Performance

Strategic Insights -

Cancer patients undergoing contemporary systemic anticancer therapies are at high risk of developing venous thromboembolism (VTE), a potentially life-threatening condition. To identify patients with high VTE risk who may benefit from primary thromboprophylaxis, several risk assessment models (RAMs) have been developed. However, the performance of these RAMs has not been well established in contemporary cohorts of cancer patients receiving modern systemic therapies. A recent study published in Blood Advances aimed to evaluate the performance of six externally validated RAMs in a prospective observational cohort study of 806 patients with cancer initiating contemporary systemic anticancer therapies.

Key Takeaways:

  • The study found that the CAT Score had the best discriminatory performance among the evaluated scores, with a c-statistic of 0.65 (95% CI, 0.62-0.67).
  • The COMPASS-CAT score showed the lowest area under the curve value (c-statistic: 0.50, 95% CI, 0.47-0.53).
  • The study included 806 patients (49.5% female) with a median age of 61 years (interquartile range, 53-69).
  • The most common cancer types were lung (21.8%), breast (10.8%), and pancreatic (10.3%).
  • During an observation period of 6 months, 91 patients experienced a VTE (cumulative incidence, 11.2%; 95% confidence interval, 9.0-13.3).
  • The study concluded that the RAMs showed poor to modest discriminatory performance in the contemporary cohort of patients with cancer.

Statistics:

  • 806 patients were included in the study (49.5% female, median age 61 years, interquartile range 53-69).
  • 91 patients experienced a VTE during the 6-month observation period (cumulative incidence, 11.2%; 95% CI, 9.0-13.3).
  • The CAT Score had a c-statistic of 0.65 (95% CI, 0.62-0.67).
  • The COMPASS-CAT score had the lowest area under the curve value (c-statistic: 0.50, 95% CI, 0.47-0.53).
  • The study included patients with lung, breast, and pancreatic cancer (21.8%, 10.8%, and 10.3%, respectively).

Sources:

  • Blood Advances, "Validation of risk assessment models for venous thromboembolism in patients with cancer receiving systemic therapies," 2025, 9(13):3340-3349.
  • NewsRx, "New Venous Thromboembolism Study Findings Have Been Reported by Researchers at Medical University of Vienna (Validation of risk assessment models for venous thromboembolism in patients with cancer receiving systemic therapies)," Hematology Week, July 14, 2025, p 3109.