Chemotherapy induced changes to fibrin clots properties in lung cancer: is it favorable?

Patients with cancer are frequently in a hypercoagulable state and the reported incidences of venous thromboembolism (VTE) and arterial thrombosis in patients with cancer are 4–20% and 2–5%, respectively (1-3). In particular, VTE is associated with worse prognosis in patients with cancer (4,5); therefore, extensive investigations have been performed for the development of useful risk assessment models, identification of better VTE biomarkers, and exploration of efficient therapeutic interventions. Type of cancer, such as ovarian and pancreatic cancers, advanced stage, and systemic treatment with hormonal or cytotoxic drugs have been reported as risk factors for cancer associated VTE in several studies (1,3). Furthermore, accumulating evidence has revealed that the underlying molecular mechanisms of cancer associated VTE are orchestrated by many players, including increased leukocyte and platelet counts as well as the release of procoagulant factors, such as tissue factor (TF), from tumor cells and possibly from surrounding stromal cells (1,2,6). Recently, TF has been reported as a biomarker for predicting recurrent VTE in patients with cancer (7)