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Analysis of Human T Cell Activity in an Allogeneic Co-Culture Setting of Pre-Treated Tumor Cells
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Cancer-Associated Thrombosis in Patients Treated with Immune Checkpoint Inhibitors.

Alice Ilari1,2, Maria Ida Abbate1, Melina Verso3

  • 1Medical Oncology Unit, IRCCS Fondazione San Gerardo dei Tintori, 20900 Monza, Italy.

International Journal of Molecular Sciences
|February 27, 2026
PubMed
Summary

Cancer-associated thrombosis (CAT) risk is rising. This review explores the link between immune checkpoint inhibitors (ICIs) and VTE, discussing mechanisms and potential biomarkers for prophylaxis in cancer patients.

Keywords:
biomarkerscancer-associated thrombosisimmune checkpoint inhibitorsrisk assessment modelsvenous thromboembolism

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Area of Science:

  • Oncology
  • Immunology
  • Hematology

Background:

  • Cancer-associated thrombosis (CAT) incidence is increasing.
  • The link between venous thromboembolism (VTE) and chemotherapy is established, but the association with immune checkpoint inhibitors (ICIs) is unclear.
  • Existing risk assessment models (RAMs) for VTE prophylaxis are primarily validated for chemotherapy, not immunotherapy.

Purpose of the Study:

  • To investigate the potential causation between CAT and immunotherapy.
  • To elucidate the underlying pathophysiological mechanisms linking ICIs to thrombosis.
  • To suggest appropriate therapeutic approaches for VTE prophylaxis in patients receiving immunotherapy.

Main Methods:

  • Literature review of studies on cancer-associated thrombosis and immunotherapy.
  • Analysis of proposed pathophysiological mechanisms of ICI-related thrombosis.
  • Evaluation of current risk assessment models and emerging biomarkers.

Main Results:

  • While chemotherapy is a known risk factor for VTE, the relationship between ICIs and VTE risk requires further investigation.
  • Proposed mechanisms for ICI-related thrombosis include inflammation, cytokine release, immune cell activation, tissue factor release, platelet activation, and increased adhesion molecules.
  • Emerging biomarkers show promise for identifying high-risk patients needing VTE prophylaxis during immunotherapy.

Conclusions:

  • The precise mechanisms linking ICIs to thrombosis are still under investigation.
  • Further research is needed to validate RAMs and biomarkers for VTE risk assessment in patients receiving immunotherapy.
  • Personalized prophylaxis strategies may be necessary for cancer patients undergoing immunotherapy.