{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:58:01Z","timestamp":1792508281577,"version":"4.5.0"},"reference-count":18,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Greisch Family Fund for Skin Cancer Research at Dana-Farber Cancer Institute","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2025,3,26]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The relationship between venous thromboembolism (VTE) and immune checkpoint inhibitor therapy (ICI) is unclear. This analysis investigates the incidence of and risk factors for VTE in VTE-naive patients with cancer receiving ICI treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of patients receiving any type or combination of ICI from 2009 to 2022 at Dana-Farber Cancer Institute was conducted to identify VTE occurring after initiation of ICI treatment. Cumulative incidences of VTE were determined using Fine and Gray\u2019s methods. Associations between VTE, ICI regimens, and clinical risk factors were evaluated using propensity-score stratified, multivariable Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 10,638 patients without a prior history of VTE, the 6-month cumulative incidence of VTE was 7.6% (95% CI: 7.1% to 8.1%) and 11.1% (95% CI: 10.5% to 11.8%) at 12\u2009months. Clinical risk factors included: age 15\u201359 (HR 1.27; 95%\u2009CI: 1.12 to 1.43; p=0.002), obesity (HR: 1.41; 95%\u2009CI: 1.16 to 1.71)\n                      <jats:underline>,<\/jats:underline>\n                      and history of anticoagulation prior to ICI start (HR: 1.43; 95%\u2009CI: 1.26 to 1.61). Compared with pembrolizumab, treatment with ipilimumab\/nivolumab increased the risk of VTE (HR: 1.36; 95%\u2009CI: 1.02 to 1.82), while durvalumab conveyed lower risk (HR: 0.52; 95%\u2009CI: 0.31 to 0.87). Treatment with programmed cell death ligand 1 had significantly reduced risk of VTE (HR: 0.79; 95%\u2009CI: 0.63 to 0.99) compared with programmed cell death 1 monotherapy. Dual ICI blockade with cytotoxic T lymphocyte antigen 4\/PD-1 significantly increased the risk of VTE (HR: 1.43; 95%\u2009CI 1.12 to 1.84). Initiation of anticoagulation after starting ICI for indications other than VTE reduced the risk by 40% (HR: 0.60, 95%\u2009CI: 0.48 to 0.73).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ICI treatment appears to be independently associated with a high incidence of VTE in patients with cancer warranting further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jitc-2024-010761","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T02:10:21Z","timestamp":1746670221000},"page":"e010761","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Immune checkpoint inhibitor-associated risk for venous thromboembolism: a comprehensive analysis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3429-4468","authenticated-orcid":false,"given":"Tamara A","family":"Sussman","sequence":"first","affiliation":[{"name":"Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA"},{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Giobbie-Hurder","sequence":"additional","affiliation":[{"name":"Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian D","family":"Dryg","sequence":"additional","affiliation":[{"name":"Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"},{"name":"Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Manos","sequence":"additional","affiliation":[{"name":"Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"},{"name":"Melanoma Disease Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason L","family":"Weirather","sequence":"additional","affiliation":[{"name":"Department of Data Sciences, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"},{"name":"Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole R","family":"LeBoeuf","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Center for Cutaneous Oncology, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F Stephen","family":"Hodi","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean M","family":"Connors","sequence":"additional","affiliation":[{"name":"Division of Hematology, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"2026052723001324000_13.5.e010761.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020007338"},{"key":"2026052723001324000_13.5.e010761.2","doi-asserted-by":"crossref","first-page":"2921","DOI":"10.1111\/jth.15883","article-title":"The Khorana score and venous and arterial thrombosis in patients with cancer treated with immune checkpoint inhibitors: A Danish cohort study","volume":"20","author":"Overvad","year":"2022","journal-title":"J Thromb Haemost"},{"key":"2026052723001324000_13.5.e010761.3","doi-asserted-by":"crossref","DOI":"10.1136\/jitc-2022-006072","article-title":"Venous thromboembolism incidence and risk factors associated with immune checkpoint inhibitors among patients with advanced non-small cell lung cancer","volume":"11","author":"Khorana","year":"2023","journal-title":"J Immunother Cancer"},{"key":"2026052723001324000_13.5.e010761.4","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/ejh.13734","article-title":"Assessing the risk of thromboembolism in cancer patients receiving immunotherapy","volume":"108","author":"Goel","year":"2022","journal-title":"Eur J Haematol"},{"key":"2026052723001324000_13.5.e010761.5","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020007878"},{"key":"2026052723001324000_13.5.e010761.6","first-page":"18","article-title":"OncDRS: An integrative clinical and genomic data platform for enabling translational research and precision medicine","volume":"6","author":"Orechia","year":"2015","journal-title":"Appl Transl Genom"},{"key":"2026052723001324000_13.5.e010761.7","doi-asserted-by":"publisher","DOI":"10.2307\/2670170"},{"key":"2026052723001324000_13.5.e010761.8","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1214\/aos\/1176350951","article-title":"A Class of $K$-Sample Tests for Comparing the Cumulative Incidence of a Competing Risk","volume":"16","author":"Gray","year":"1988","journal-title":"Ann 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Immunotherapy","volume":"2","author":"Roopkumar","year":"2021","journal-title":"Med"},{"key":"2026052723001324000_13.5.e010761.15","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.thromres.2022.10.020","article-title":"Clinical impact of venous thromboembolism in non-small cell lung cancer patients receiving immunotherapy","volume":"221","author":"Bj\u00f8rnhart","year":"2023","journal-title":"Thromb Res"},{"key":"2026052723001324000_13.5.e010761.16","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-11-882993"},{"key":"2026052723001324000_13.5.e010761.17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01440"},{"key":"2026052723001324000_13.5.e010761.18","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00294"}],"container-title":["Journal for ImmunoTherapy of 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