{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:59:34Z","timestamp":1793192374584,"version":"4.5.0"},"reference-count":50,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T00:00:00Z","timestamp":1754092800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Previous studies have reported inconsistent findings regarding the associationbetween <jats:italic>ALK<\/jats:italic> and <jats:italic>ROS1<\/jats:italic> rearrangements in lung cancer and thromboembolic risk. This retrospective study aimed to investigate this association in advanced lung adenocarcinoma patients with <jats:italic>ALK<\/jats:italic>, <jats:italic>ROS1<\/jats:italic>, <jats:italic>RET<\/jats:italic> rearrangements, and <jats:italic>EGFR<\/jats:italic> mutations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We retrospectively collected information on patients with advanced lung adenocarcinoma in the First Affiliated Hospital of Zhejiang University School of Medicine from January 2013 to March 2021. All patients with confirmed <jats:italic>ALK<\/jats:italic>, <jats:italic>ROS1<\/jats:italic>, or <jats:italic>RET<\/jats:italic> rearrangements, as well as a comparison cohort of those with <jats:italic>EGFR<\/jats:italic> mutation, were included. Clinical characteristics were analyzed, and the association between driver genes and TE risks was analyzed using competing risk and logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 546 patients were included in the study. Among them, those with <jats:italic>ROS1<\/jats:italic> rearrangements exhibited the highest cumulative incidence of thromboembolic events (TEs), reaching 17.5%\u2009\u00b1\u20090.2% during the peri\u2010diagnostic period (within 6\u2009months following diagnosis). Regardless of the entire follow\u2010up or the peri\u2010diagnostic period, <jats:italic>ROS1<\/jats:italic> rearrangements were significantly associated with an increased risk of TEs. Multivariate analysis revealed <jats:italic>ROS1<\/jats:italic> rearrangements, the number of comorbidities, the size of mediastinal lymph nodes, and elevated C\u2010reactive protein (CRP) levels as TE risk factors during the peri\u2010diagnostic period. Throughout the follow\u2010up period, <jats:italic>ROS1<\/jats:italic> rearrangements and hypertension were independent TE risk factors. In addition, the development of TE significantly affected the overall survival of patients with <jats:italic>EGFR<\/jats:italic> mutations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>ROS1<\/jats:italic> rearrangements were significantly associated with an increased risk of TE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.70141","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T10:53:42Z","timestamp":1754132022000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Association Between Thromboembolic Events and <scp><i>ALK<\/i><\/scp>, <scp><i>ROS1<\/i><\/scp>, <scp><i>RET<\/i><\/scp> Rearrangements or <scp><i>EGFR<\/i><\/scp> Mutations in Patients With Advanced Lung Adenocarcinoma: A Retrospective Cohort 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