Coagulation and inflammation in cancer: Limitations and prospects for treatment

Area of Science:

• Oncology
• Immunology
• Hematology

Background:

• Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy by modulating T cell responses against tumors.
• However, low response rates, secondary resistance, and severe adverse effects, including thrombotic complications, limit their efficacy.
• These complications are linked to immune reactions, complement activation, and skin toxicity, suggesting a role for the tumor microenvironment.

Purpose of the Study:

• This review examines the role of the coagulation system in tumor formation and progression.
• It aims to elucidate the molecular mechanisms involving circulating tumor cells, coagulation, and immune cells.
• The ultimate goal is to identify novel therapeutic targets for cancer patients.

Main Methods:

• Literature review of studies on cancer, coagulation, inflammation, and immunotherapy.
• Analysis of molecular mechanisms underlying tumor cell circulation and immune evasion.
• Synthesis of data on the interplay between the coagulation cascade and anti-tumor immunity.

Main Results:

• The coagulation system is implicated in multiple stages of tumorigenesis, from initiation to metastasis.
• Interactions between tumor cells, plasmatic coagulation factors, and immune cells are crucial.
• Enhanced coagulation and inflammation are associated with increased mortality and adverse events in ICI therapy.

Conclusions:

• The tumor microenvironment's coagulation-inflammation axis is critical throughout cancer progression.
• Targeting the coagulation system alongside immunotherapy may overcome resistance and reduce toxicity.
• Further research into these molecular interactions could lead to improved cancer treatments.