Incidence and clinical impact of venous thromboembolism during immunotherapy for gynecologic cancer.

Authors

Cassidy S Abdeen, Jessica Sciuva, Reed M O'Connor, Jessica Fulton, Julia Chalif, Danielle C Glassman, Anna Gonzalez, Molly A Morton, Jessica Velasquez, David E Cohn, Larry J Copeland, Casey M Cosgrove, Paulina J Haight, Christa I Nagel, Robert Neff, Floor J Backes, David M O'Malley, Laura M Chambers

Published in

Gynecologic oncology. Volume 215. Pages 1-6. Oct 22, 2026. Epub Oct 22, 2026.

Abstract

To evaluate the incidence, risk factors, and clinical outcomes associated with venous thromboembolism (VTE) in patients with gynecologic cancer treated with immune checkpoint inhibitors (ICI).
This retrospective cohort study included patients with gynecologic malignancies treated with ICI at a single institution between January 2017 and April 2026. The primary outcome was the development of VTE from ICI initiation through one month after the final cycle. Incidence, clinical characteristics, risk factors, and healthcare utilization were evaluated.
Among 458 patients who received ICI therapy, 37 (8.1%) experienced a VTE. Deep vein thrombosis was the most common event (48.6%, n = 18), followed by pulmonary embolism (40.5%, n = 15). The median time from ICI initiation to VTE was 1.43 months (IQR, 0.70-2.93). Endometrial cancer was the most common disease site among patients with VTE (54.1%, n = 20). Smoking history differed significantly between groups (p < 0.01). ICI monotherapy was more common among patients who experienced VTE compared with those who did not (64.9% vs. 44.9%, p = 0.020), and patients with VTE had received fewer total lines of therapy (2.4 vs. 3.3, p = 0.008). Most events required emergency department evaluation (64.9%, n = 24) and hospitalization (59.5%, n = 22), and ICI therapy was delayed in 24.3% (n = 9) of cases. Breakthrough thrombosis was observed in 18.9% (n = 7) of patients receiving anticoagulation.
VTE occurred in 8.1% of gynecologic cancer patients receiving ICI, was early in onset, and carried significant clinical burden. These data can guide provider awareness and patient counseling when initiating ICI in this population.

PMID:
42913285
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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