The coagulation system as a target for the treatment of human gliomas

Coagulation activation in human gliomas may have two consequences: (1) activation of systemic coagulation reactions leading to the development of venous thromboembolic disease, and (2) stimulation of tumor growth and invasion. Anticoagulation in patients with gliomas, therefore, may not only prevent thrombosis but also have anticancer activity. Tissue factor and thrombin are appropriate targets for intervention, and several drugs are suitable for testing. Low-molecular-weight heparin and direct thrombin inhibitors are useful for reducing thrombin production and activity, and recombinant tissue factor pathway inhibitor and statins are examples of drugs that target tissue factor directly. This article reviews the implications of coagulation activation in human gliomas and provides a rationale for clinical testing of anticoagulants as part of a treatment strategy for this devastating human cancer.