Performance status and outcomes in patients with cancer receiving thromboprophylaxis: a subanalysis of the AVERT trial.

Authors

Nicola Potere, Yan Xu, Ranjeeta Mallick, Tzu-Fei Wang, Danny Hill, Alejandro Lazo-Langner, Vicky Tagalakis, Sudeep Shivakumar, Marcello Di Nisio, Philip S Wells, Marc Carrier

Published in

Cardio-oncology (London, England). Volume 12. Issue 1. Jul 22, 2026. Epub Jul 22, 2026.

Abstract

The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is central to cancer care planning and prognostication. Whether ECOG-PS also carries prognostic value in the setting of primary thromboprophylaxis for cancer-associated venous thromboembolism (VTE) remains unknown.
To evaluate the impact of ECOG-PS on clinical outcomes in ambulatory patients with cancer initiating chemotherapy.
This was a post-hoc analysis of the AVERT randomized controlled trial that evaluated apixaban (2.5 mg twice daily) for thromboprophylaxis in patients at intermediate-to-high VTE risk. Multivariable survival models assessed the association between ECOG-PS (0-1 versus 2-3) and the composite primary outcome of VTE or clinically relevant bleeding (CRB), as well as its individual components and all-cause mortality, over 180 days.
Of 428 patients included, 368 (86.0%) and 60 (14.0%) had an ECOG-PS of 0-1 and 2-3, respectively. The primary composite outcome occurred in 12.8% (n = 47) in those with ECOG 0-1 and 18.3% (n = 11) with ECOG-PS 2-3 (6-month cumulative incidence: 13.0% [95% CI: 9.8%-16.7%] versus 19.9% [95% CI: 10.5%-31.4%], respectively). Worse performance status was associated with higher risks for the composite outcome (aHR: 1.76; 95% CI: 1.14-2.72; p = 0.011), CRB (aHR: 1.58; 95%CI: 1.53-1.63; p < 0.0001), and all-cause mortality (aHR: 5.77; 95% CI: 4.98-6.67; p < 0.0001). In exploratory treatment-effect analyses, apixaban reduced VTE risk across ECOG-PS strata, including among participants with ECOG-PS 2-3, without clear evidence of excess CRB in this subgroup.
ECOG-PS predicts VTE-related outcomes in ambulatory patients with cancer and may inform individualized, value-based shared decision-making regarding anticoagulant thromboprophylaxis.

PMID:
42897686
Bibliographic data and abstract were imported from PubMed on 20 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.