Tissue Factor: Old and New Links with Cancer Biology

Blood coagulation is one of the most profound factors that influence cancer progression. Especially the initiator of coagulation, tissue factor (TF), has been subject to many studies investigating the overlap between coagulation and cancer. It has been known for decades that TF is a risk factor for metastasis, and in mouse models, TF drives metastasis in a coagulation-dependent manner. However, TF also serves as a cellular receptor to drive primary tumor growth and tumor angiogenesis. Nevertheless, recent studies have indicated that TF plays more fundamental roles in cancer biology. TF regulates tumor cell dormancy, is associated with cancer stem cell behavior, epithelial-to-mesenchymal transition, and dictates establishment of the tumor cell premetastatic niche. Especially with regard to these recent roles attributed to TF, no clear idea exists on the exact molecular pathways that are initiated by TF. Finally, TF alternative splicing results in an isoform with different characteristics and functions in cancer. In this review, a summary will be given on both the established as well as the new aspects of TF function in cancer progression.