The unseen architects of metastasis: coagulation factors in pre-metastatic niche development

Cancer metastasis, the leading cause of cancer-related deaths, is a complex process driven by the interplay of multiple factors. Pre-metastatic niche (PMN), formed in distant organs before the arrival of circulating tumor cells (CTCs), provides a favorable environment for CTC colonization and growth. While traditionally known for their role in hemostasis, coagulation factors are increasingly recognized for their significant contributions to tumor development and progression. This review first discusses the multifaceted role of coagulation factors in preparing the PMN for tumor cell colonization. We explore the mechanisms by which coagulation factors, including platelets, fibrinogen, thrombin, and tissue factors (TFs), contribute to PMN formation and metastasis. These factors, through their interactions with tumor cells and the surrounding microenvironment, activate endothelial cells, recruit immune cells, release pro-angiogenic factors, and promote inflammation and extracellular matrix (ECM) remodeling, ultimately facilitating tumor cell colonization and growth. Understanding the interplay between coagulation and metastasis helps provide novel insights and directions for clinical anti-cancer treatment.