Evolving biomarkers and risk prediction models in colorectal cancer-associated venous thromboembolism

The pathological hypercoagulable state and associated risk of thrombosis in colorectal cancer (CRC) persist throughout the disease course. Accurate identification of patients at high risk of venous thromboembolism (VTE) and judiciously applying drug or mechanical prevention measures can significantly reduce the incidence of VTE. The review details a range of biomarkers, including platelet count, soluble P-selectin, D-dimer, and vascular endothelial growth factor (VEGF), which have been shown to correlate with increased VTE risk in CRC patients. In addition to the biomarker analysis, the review makes important recommendations for the routine monitoring of these biomarkers in CRC patients, especially those at higher risk for VTE. Furthermore, it discusses the integration of these biomarkers into clinical VTE risk prediction models, advocating for personalized and targeted thromboprophylaxis strategies. The review also explores future research directions, emphasizing the potential of antiplatelet and anticoagulant therapies in improving the prognosis of CRC patients by reducing thromboembolic events. This narrative review not only deepens our understanding of the molecular mechanisms driving cancer-associated thrombosis but also paves the way for novel therapeutic interventions aimed at preventing VTE in CRC patients.