Abstract
OBJECTIVE: Venous thromboembolism (VTE) is associated with significant morbidity. Although this risk is multifactorial, recent studies suggest immune checkpoint inhibitors (ICIs) may also contribute to increased VTE risk. The aim of this study is to evaluate VTE risk in a cohort of patients with head and neck cancer treated with surgery and ICIs. METHODS: De-identified data from the TriNetX Global Collaborative Network database was used to identify adult surgical patients (≥18 years) using International Classification of Diseases 10(th) Revision and Common Procedural Terminology codes and were further refined by use of nivolumab, pembrolizumab, or cemiplimab within 1-year before or up to 3-months after surgery. Cohorts were propensity score matched, and the primary study outcome was the 3-month composite rate of VTE. RESULTS: After propensity score matching, there were 1,471 patients in each cohort and they were well balanced according to demographics, body mass index, comorbidities, medication use, and radiation history up to 1-year before the index event. The composite rate of VTE in the study population was 3.7% and was higher in patients treated with ICIs (4.6% versus 2.9%; OR, 1.6; 95% CI, 1.1, 2.5). CONCLUSIONS: This study highlights the importance of risk stratification and risk reduction in the setting of increasing ICI use for patients with HNC undergoing surgery.