The role of platelets and megakaryocytes in bone metastasis

Blood platelets have been known for more than a century as important partners for successful metastatic dissemination of solid tumors. Cancer cell-induced platelet activation is a key event responsible for prometastatic activity of platelets. Blocking platelet aggregation inhibits the progression of skeletal metastases through mechanisms that are not fully understood. The establishment and progression of bone metastases are strongly influenced by the bone remodeling process. Growth factors and cytokines released upon platelet activation may contribute to both skeletal tumor growth and osteolytic lesions. Megakaryocytes are platelet precursors located in the bone marrow that control bone mass through direct stimulation of osteoblast functions and indirect inhibition of osteoclast activities. Considering growing evidence for their role in the metastatic cascade, platelets and/or megakaryocytes may provide new therapeutic opportunities to help limit bone metastases.