The following article features coverage from the European Society of Medical Oncology (ESMO) Congress 2021. Click here to read more of Hematology Advisor’s conference coverage.

A novel prognostic scoring system known as ONKOTEV appears to effectively predict the risk of venous thromboembolism (VTE) among outpatients with cancer, according to research presented at the European Society for Medical Oncology 2021 Congress.

Among outpatients with cancer, it is sometimes unclear under what conditions to initiate primary prophylaxis against VTE. International guidelines currently set scores of at least 2 on the previously described Khorana scale as the recommended criterion for prophylaxis initiation.

Data from the ONKOTEV-2 trial, which was a multicenter study that took place in 3 countries across Europe, were previously used to establish a 4-variable risk assessment model (RAM) for VTE. These included: a Khorana score greater than 2, metastatic disease, vascular/lymphatic compression and history of VTE. For this study, researchers attempted to validate the ONKOTEV scoring system as a tool for assessing VTE risk among outpatients with cancer.

Continue Reading

Data from 473 patients were included; the most common sites of primary disease were breast, esophagus/stomach, colon, rectum, lung, and pancreas. Patients were stratified by Khorana score into low risk (58%), high risk (18%), and very high risk (24%). The ONKOTEV scoring system, which could yield scores from 0 to 3, assigned 27% of patients a score of 0, 55% of patients a score of 1, 15% of patients a score of 2, and 2.4% of patients a score of 3.

The cumulative 12-month incidence of VTE was 12.7%. While Khorana scores of 0, 1 to 2, and 2 or higher were linked with cumulative VTE incidence rates of 8.8%, 9.2%, and 21%, respectively, ONKOTEV scores of 0, 1, 2, and higher than 2 were linked with cumulative incidence rates of 3.7%, 9.7%, 19.4%, and 33.9%, respectively.

“ONKOTEV score [higher than] 2 identified a category of high-risk group of cancer outpatients and significantly improved the VTE predictability of pre-existing RAMs,” the authors wrote. “Therefore, ONKOTEV score has been validated as a new easy-to-use RAM for risk stratification and decision making about primary prophylaxis in cancer outpatients, with promising implications in clinical practice.”

Read more of Hematology Advisor’s coverage of ESMO 2021 by visiting the conference page.


Cella CA, Knoedler M, Hall M, et al. Validation of a new risk-assessment model for prediction of venous thromboembolism in cancer outpatients: The ONKOTEV score. Presented at: European Society for Medical Oncology 2021 Congress; September 16-21, 2021. Abstract 1670MO.